Marsciani Martino, Pasini Andrea, Montini Giovanni
Azienda Ospedaliero-Universitaria di Bologna, Policlinico S. Orsola-Malpighi, Bologna, Italy.
G Ital Nefrol. 2011 Sep-Oct;28(5):489-98.
Asymptomatic proteinuria is a common finding in primary care practice. Most children with asymptomatic proteinuria, diagnosed at screening urinalysis, do not have kidney disease. When proteinuria is detected, it is important to determine whether it is transient, orthostatic or persistent. Transient proteinuria is most often associated with fever, exercise or stress and it resolves on urine testing when the cause is withdrawn. Orthostatic proteinuria is a benign and common condition in school-age children. Persistent proteinuria should be carefully evaluated because it is a marker of renal damage and associated with kidney disease. It is not necessary to extensively investigate all children found to have proteinuria. Children with persistent proteinuria should be referred to a pediatric nephrologist to get a diagnosis and start treatment when necessary.
无症状蛋白尿在基层医疗实践中是常见的发现。大多数在筛查尿常规时被诊断为无症状蛋白尿的儿童并无肾脏疾病。当检测到蛋白尿时,确定其是一过性、直立性还是持续性的很重要。一过性蛋白尿最常与发热、运动或应激相关,当诱因去除后尿液检测时蛋白尿会消失。直立性蛋白尿在学龄儿童中是一种良性且常见的情况。持续性蛋白尿应仔细评估,因为它是肾损伤的标志且与肾脏疾病相关。没必要对所有发现有蛋白尿的儿童进行广泛检查。持续性蛋白尿患儿应转诊至儿科肾病专家处进行诊断,并在必要时开始治疗。