Child Kidney Dis.  2017 Oct;21(2):152-155. 10.3339/jkspn.2017.21.2.152.

A Case of Orthostatic Proteinuria Progressed to Persistent Proteinuria Associated with Renal Pathology

Affiliations
  • 1Department of Pediatrics, Chungbuk National University Hospital, Cheongju, Korea. tsha@chungbuk.ac.kr
  • 2Mirae ING Hospital, Seoul, Korea.
  • 3Department of Pediatrics, Chungbuk National University College of Medicine, Cheongju, Korea.

Abstract

Orthostatic or postural proteinuria is the most common cause of asymptomatic proteinuria in children. As orthostatic proteinuria (OP) is a benign disease with relatively good prognosis, it has no specific management, and patients only need to be observed. However, if OP shows a persistently high level of proteinuria, in theory, glomerular changes can occur. An 11-year-old girl was referred to the hospital due to asymptomatic proteinuria and was diagnosed as having OP based on the results of clinical and laboratory examinations, urinalysis, and protein/creatinine (TP/Cr) ratio at both supine and erect positions. During follow-up observation, the 24-hour TP/Cr ratio was persistently higher than 1.5 mg/mg for 2 years. We performed renal biopsy, which showed mesangial proliferative glomerular lesions with focal effacement of the podocyte foot processes, but without immune depositions. OP can be accompanied by glomerular lesions if moderate to severe proteinuria persists.

Keyword

Proteinuria; Glomerulonephritis; Child; Orthostatic proteinuria

MeSH Terms

Biopsy
Child
Female
Follow-Up Studies
Foot
Glomerulonephritis
Humans
Pathology*
Podocytes
Prognosis
Proteinuria*
Urinalysis
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