Proteinuria in children is usually harmless and may indicate improper functioning of kidneys, renal diseases, or other underlying conditions. Also called urinary protein excretion, this condition is characterized by excess protein levels in the urine (1) (2).
Protein molecules typically cannot pass through the kidneys and do not enter the urine due to their large size, but the above conditions may show protein in the urine, indicating a disorder. However, proper diagnosis and timely treatment could help manage the condition.
This post will help you know about proteinuria in children, including its causes, symptoms, and treatments.
Is Proteinuria Common In Children?
About two or three out of 100 children develop mild proteinuria during childhood, while one in 100 children may develop persistent proteinuria (3).
Most children have “orthostatic proteinuria,” meaning they show protein in the urine only when they are in an upright position, generally in the mornings. This type of proteinuria is benign, and there is no protein removed via urine at night (4). However, persistent protein in the urine could indicate an imbalance in kidney function.
What Are The Causes Of Proteinuria In Children?
- Aspirin therapy,
- Cold weather,
- Sometimes, protein may be observed in the urine after an intense physical activity
- Nephrotic Syndrome
- Glomerular diseases
- Urinary tract infection
- Immune disorders such as Systemic Lupus Erythematosus (SLE) or Goodpasture’s Syndrome
- Cardiovascular diseases
- Renal dysplasia
- Renal cancer
- Intravascular hemolysis (red blood cells are destroyed, and haemoglobin is released into the bloodstream)
- Toxin attack
- Acute kidney injury
- High blood pressure,
What Are The Risk Factors For Proteinuria In Children?
The following factors may put a few children at risk of proteinuria (6).
- Any cardiac disease
- A family history of a chronic kidney disease
- Kidney or urinary tract problems at birth (5)
What Are The Symptoms Of Proteinuria?
- Frequent urination
- Muscle cramps (especially at night)
- Frothy urine
- Swollen eyelids, hands, and feet (edema)
- Nausea and/or vomiting
- Loss of appetite
What Are The Complications Of Proteinuria?
The complications of proteinuria may arise based on the underlying cause. However, some common complications of proteinuria include high blood pressure and high cholesterol (8).
If proteinuria is accompanied by high blood pressure, it could lead to a heart attack or a stroke. Alternatively, this increased pressure may even cause other chronic kidney diseases, including kidney failure.
Similarly, kidney problems accompanied by higher cholesterol levels in the blood are not a good sign, as they could increase the child’s risk of a heart attack.
How Is Proteinuria Diagnosed?
Urine tests are conducted to know the presence of protein in the urine. Since pediatric proteinuria could be short-lived, a morning urine sample and the one collected later that day can offer better insights. In the cases of orthostatic proteinuria, the morning sample would be devoid of protein.
If there are other accompanying symptoms, consecutive tests offer reliable protein urine values. Your child’s doctor will also recommend a 24-hour urine collection to measure the amount of protein in the urine (1).
If a high level of protein in the urine is identified, your pediatrician may recommend the following tests for further evaluation (5).
- Imaging tests such as CT scan, MRI, or ultrasound of the kidneys and urinary tracts to identify any tumors or blockages
- Blood tests to determine the glomerular filtration rate and creatinine levels
- Kidney biopsy
What Are The Treatments For Proteinuria In Children?
Orthostatic proteinuria requires no treatment. However, your child’s doctor may suggest another urine test after a stipulated time.
If persistent proteinuria is identified, further treatments are ordered based on the underlying condition. The primary goal would be to avoid renal failure. For diabetes and hypertension, appropriate pharmacological therapies as well as diet and lifestyle modifications would be advised to keep the protein levels under control.
In addition, you would be asked to monitor the child’s blood pressure and blood sugar levels. As a precautionary measure, medications that lower the blood pressure, such as Angiotensin-Converting Enzyme inhibitor (ACE) and Angiotensin Receptor Blocker (ARB), may be prescribed (2) (7).
How Can Proteinuria Be Prevented?
Proteinuria cannot be prevented, but you can prevent its progression into a chronic illness. Once the underlying cause of persistent proteinuria is identified, you can take preventive measures based on it. Dietary and lifestyle modifications are helpful if the cause is diabetes, hypertension, or a kidney issue. You would also be asked to visit a nephrologist regularly (2).
Frequently Asked Questions
1. Will drinking water reduce protein content in urine for kids?
Drinking water will dilute your urine but won’t stop your kidneys from excreting protein. Drinking water can be helpful only when dehydration is the cause of proteinuria (7).
2. Is proteinuria a serious condition?
Proteinuria could be a serious condition as it might lead to renal failure if untreated.
Proteinuria in children is commonly caused due to dehydration, stress, or fever. Make sure that you take the proper preventive measures to stop the condition’s progression and make the required dietary and lifestyle changes to keep your child healthy. If your child shows signs of frothy urine, loss of appetite, and nausea, it might indicate that they have proteinuria, and you should refer it to the pediatrician at once and get proper treatment started. You should also be on the lookout for signs of high blood pressure or diabetes and keep your doctor updated about the same.
- Protein in urine could be due to benign conditions such as gravity, dehydration, aspirin therapy, or cold weather.
- Common complications of proteinuria include high blood pressure and high cholesterol.
- It is impossible to prevent proteinuria, but you could prevent its progression into a chronic illness.
- Proteinuria In Children
- Jang K. M. and Cho M. H.; (2017); Clinical Approach To Children With Proteinuria
- Protein In Urine.
- Ong L. M. et al.; (2013); Prevalence and risk factors for proteinuria: the National Kidney Foundation of Malaysia Lifecheck Health Screening programme.
- Protein In Urine (Proteinuria) Causes Symptoms & Treatments.