Proteinuria in Children – Reasons, Symptoms, and Prevention

The kidneys have very small blood vessels that filter water, salt, and wastes from the blood. These are known as glomeruli. They maintain protein in the blood, supporting them to soak up water out of tissues. A major protein function in the blood is maintaining the body’s fluid levels. Once these filters are flawed, protein can seep out from the blood into the urine. This results in Proteinuria, a disease related to too much protein in urine in child patients. Albuminuria or urine albumin are other names of Proteinuria. 

The extra protein in your child’s urine can’t be visible. However, it can be related to swelling in their ankles, legs, and eyelids. High blood pressure is one more sign of this condition.

What Is Proteinuria In Children?

Although Proteinuria is painless and is usually harmless and may result from exercise, fever, or stress, it can also be an indication of latent kidney disease or a disease that originated in some other part of your child’s body. At times, infection or chemicals hurt the kidneys, which affects the kidneys’ functioning. Proteinuria will be cured as the infection is treated in case of an infection. Protein in the urine can also be linked with type 1 and type 2 diabetes. 

When your child is in the early stages of Proteinuria, your child will have no symptoms. There will be substantial amounts of protein that will move from the blood into the urine with advancement. Then it will be thrown out of the body. During this time, the following symptoms may be visible as large amounts of protein move from the blood to the urine and then out of the body. The following signs and symptoms may occur that may signal the development of kidney disease.

• Difficulty in breathing
• Hypertension
• Tiredness
• Puffiness (edema), specifically near the eyes, hands, feet, and belly
• Urine that looks frothy or fizzy due to heavy portions of protein

Prevention is not possible for Proteinuria, and you can’t avoid this disease. Nevertheless, you can carry out kidney health by drinking plenty of water every day, which will flush waste out of your kidneys.

How Common Is Proteinuria in Children?

Doctors have diagnosed Proteinuria in around 2 or 3 in 100 children of any age. In most cases, Proteinuria is mild and harmless. About 1 in 100 children have Proteinuria that is lasting, and this type of Proteinuria may be more profound.

Causes

Protein in urine could be due to mild health conditions or as an outcome of other medical conditions. The mild conditions may comprise  

• Gravitational force
• Lack of hydration
• Aspirin treatment
• Cold climate
• Worry and pressure
• High body temperature
• Noticeable protein in the urine after an intense physical exercise

Persistent Proteinuria could signal a latent illness such as:

• Nephrotic syndrome in childhood.
• Glomerular disorders
• Infections in the urinary tract
• Immune disorders like Goodpasture’s syndrome or lupus
• Cardiac disorders
• Renal abnormalcy
• Renal cancer
• Intravascular hemolysis (a condition where red blood cells are broken, and hemoglobin is discharged into the blood flow)
• High levels of toxins
• Acute kidney damage
• Hypertension

Signs and Symptoms

Most children with Proteinuria do not show any symptoms. You cannot normally notice protein in the urine, but sometimes the urine looks bubbly. Proteinuria is painless. When the kidneys seep out a lot of protein, this is called nephrotic range proteinuria, which gives rise to nephrotic syndrome. Children often have bulges in their bodies, specifically their feet, legs, and face. 

Hematuria is a condition when there is blood in the urine. When there is a lot of blood, the urine may be dark brown or red, which occasionally happens with Proteinuria. Children with asymptomatic Proteinuria often have the orthostatic or transient types. When it’s the case of persistent Proteinuria, the following symptoms may be observed.

• Recurrent urination
• Muscle contractions (particularly at night)
• Foamy urine
• Puffy eyelids, hands, and feet
• Nausea
• Loss of appetite

What Are the Possible Complications and Risk Factors of Proteinuria in Children?

Some children may be at risk of Proteinuria due to the following factors.

• Any heart disease
• Hypercholesterolemia
• Overweight
• High blood pressure
• High cholesterol
• A family history of a chronic renal disease
• Urinary tract problems or kidney-related problems at birth
• When a child has high blood pressure and Proteinuria, it may result in a stroke or heart attack. This heightened pressure may cause other chronic kidney diseases, including kidney failure.
• Similarly, kidney problems and higher cholesterol levels in the blood are not a good sign, as they could increase the child’s risk of a heart attack.

Diagnosis of Proteinuria

Urine tests are performed to determine the occurrence of protein in the baby’s urine. Since protein in pediatric urine cases might be short-lived, a morning urine sample and the one collected later that day can facilitate better understanding. Apart from this, the following tests can also be helpful:

• In the cases of orthostatic Proteinuria, the sample collected in the morning would be free of protein. If there are other symptoms, serial tests provide certain protein urine values.
• Your pediatrician will also suggest a 24-hour urine collection to evaluate the protein level in the urine.
• If a high protein level in the urine is found, your child’s doctor may suggest some tests for advanced assessment. Imaging tests such as MRI, CT scan, or ultrasound of the urinary tracts and kidneys may be done to check any blockages or tumors.
• Blood tests can also help determine the glomerular filtration rate and creatinine levels, a kidney biopsy.

How to Treat Proteinuria in Children?

Your child will not require treatment for:

• Orthostatic Proteinuria – the kidneys seep out a very small amount of protein during the day, especially post-exercise session or standing up.
• Mild Proteinuria that cures after the first urine test – may occur during a fever or an infection in the urinary tract.

However, your child may require treatment for:

• Persistent Proteinuria where the Proteinuria does not fade
• Nephrotic syndrome
• Kidney damage if it is doubted

No treatment is required when your child has small amounts of protein in the urine. At times your pediatrician will test your child’s urine again after some months to check if the amount of protein in the urine decreases. If the amount of protein in the urine doesn’t change or there is more protein, your doctor will refer you to a kidney specialist (a nephrologist). The nephrologist might carry out a kidney biopsy. (In this test, a tiny tissue from the kidney is removed with the help of a needle and then looked at under a microscope.) When your doctor figures out the cause of the protein in your child’s urine, they can suggest to you the best way to address the problem.

Regardless of what caused the kidney problem, a few simple measures can benefit your child. Reducing salt consumption can bring down swelling. Medicine can check the inflammation (swelling) of the kidneys that may cause the protein to get into the urine. This medication is usually prescribed in a high dose at first, and the dosage is tapered later on. Some children have been prescribed a low dose of the medicine for months or even years. It’s vital to abide by your doctor’s instructions, and it’s also crucial to visit the doctor for regular checkups.

Prevention of Proteinuria

Proteinuria can never be avoided or prevented. Nevertheless, you can carry out good renal health by drinking lots of water each day, and more fluid will flush waste out of your kidney. Indeed, Proteinuria cannot be prevented, but you can prevent its development into a chronic illness. Once the primary latent cause of persistent Proteinuria is found out, you can take preventive steps based on it. Lifestyle modifications and diet changes are beneficial if the cause is hypertension, diabetes, or a kidney issue. You would also be suggested to consult a nephrologist regularly.

What Questions to Ask Doctor About Proteinuria?

If your child is diagnosed with Proteinuria, then it is evident that you will have a lot of questions for the pediatrician. So, regardless of whether your child has been diagnosed or you want to take precautionary measures just in case, here are some questions that will help you understand the disease better:

• What course of treatment will my child require?
• How will the treatment assist my child?
• What are the side effects of the treatment?
• How can I make my child get ready for treatments?
• What will be the next step if the first treatment does not work for my child?
• How will I know if we need to return to the hospital or visit the doctor?
• Could swelling in the ankles, legs, and eyelids be due to something else?
• Is Proteinuria life-threatening if treatment is not done?
• Is there anything I can do so that Proteinuria goes away?
• Is there any link between Proteinuria and eating too much protein?

These are the details of the disease named Proteinuria we have covered. You can check all the necessary information you may require about the illness in this blog. 

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