Protein in the urine in a child


Q: My 12 year old daughter had her annual check up recently. Her urine sample showed a small amount of protein (+2). We waited 2 days and did an AM sample and random sample at home. We took the samples back to her doctor's office and this time +1 was indicated for protein in the AM sample. Everything else her doctor checked for was negative. She wants my daughter to repeat the test in 3 weeks. If I remember correctly, my son (who is now 18) had this same thing happen around the same age. My daughter is very active, playing 7 different sports, year round. Her doctor seems to think this is why she may have the protein in her urine, but I am still nervous about possible outcomes. Are her results normal? She is a picky eater, not a great diet, lack of vegetables, etc. She is 5'1" and 95 pounds, lean and muscular. From what I read on the internet, small amounts of protein could be normal. Your thoughts? Thank You


A:   Protein in the urine in children may be caused by glomerular disease, intrinsic kidney disease (tubulointerstitial disease), fever, intensive exercise and orthostatic (or postural) proteinuria, in which protein excretion is increased only in the upright position. Children with persistent dipstick-positive proteinuria must undergo a quantitative measurement of protein excretion, most commonly a 24-hour urine collection for protein. Therefore if your daughter’s repeat urine dipstick is positive for protein, I would advise further investigation with a 24 hour collection and possible referral to a nephrologist. .

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