Profiling proteinuria in pediatric patients

Carolyn L. Abitbol, Jayanthi Chandar, Ali Mirza Onder, Obioma Nwobi, Brenda Montané, Gastón Zilleruelo

Research output: Contribution to journalArticle

23 Scopus citations

Abstract

This study was designed to characterize proteinuria in children with kidney disease. Random urine samples from 250 pediatric patients were examined by quantitative measures of total protein (pr), albumin (Alb), and creatinine (cr). Patient diagnoses were subjectively categorized as "Glomerular" (GD) or "Tubulo-interstitial" disease (TD) in origin. Proteinuria was quantitated by the random urine protein-to-creatinine (Upr/cr) ratio, and glomerular proteinuria was assessed as the albumin-to-creatinine ratio (Ualb/cr) and percentage albuminuria (%Alb=Alb/pr* 100). The non-albumin fraction (1-Alb/ pr) includes low-molecular-weight proteins and micro- and macroglobulins. Of the 250 patients, 112 (45%) had GD and 138 (55%) had TD. Both proteinuria and albuminuria correlated with a decline in glomerular filtration rate (GFR) (r=-0.4; p<0.0001). Those with GD averaged significantly greater %Alb than those with TD at all levels of proteinuria (p<0.0001). With loss in GFR, %Alb increased significantly in patients with TD (18±13 to 47±30%; p<0.001) and GD (56±26 to 74±15%; p<0.01), respectively. The %Alb at all levels of GFR averaged <50% in those with TD and >50% in those with GD. In conclusion, random Ualb/cr, Upr/ cr, and %Alb provide a simple and inexpensive assessment of proteinuria and may profile renal disease activity and response to therapy in pediatric patients.

Original languageEnglish (US)
Pages (from-to)995-1002
Number of pages8
JournalPediatric Nephrology
Volume21
Issue number7
DOIs
StatePublished - Jul 1 2006

Keywords

  • Albuminuria
  • Proteinuria
  • Random urine assays
  • Urinary dipsticks

ASJC Scopus subject areas

  • Nephrology
  • Pediatrics, Perinatology, and Child Health

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