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Proteinuria

Significant renal disease is invariably associated with proteinuria. It is important to exclude orthostatic proteinuria by obtaining a protein / creatinine ratio on an early morning urine sample.  If this is normal the patient can be reassured.
 
Tubular dysfunction can also lead to proteinuria and can be assessed by checking beta-2-microglobulin in the urine.
 
Please refer to the guideline endorsed by your lead paediatric nephrology centre.
 
If a patient has persistent proteinuria (Up/Uc > 100 mg/mmol) it is advised that the case be discussed with a paediatric nephrologist as a renal biopsy may be indicated.
 
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