If a doctor tells you that your child has protein in their urine, you might feel a little scared, right? Or if you're a young person, you might hear something like this yourself? But don't worry. Today we're going to talk about a condition that you might hear about at times like these, but it's not that dangerous. This is called Orthostatic Proteinuria.
What is Orthostatic Proteinuria?
Simply put, orthostatic proteinuria is when you urinate while standing or sitting, and the protein level in your urine is slightly higher. However, if you urinate in the morning after lying down (either on your back or side) and have a good night's sleep, the protein level in your urine is normal. Isn't that amazing? This is also called 'postural proteinuria.'
This is a harmless , common condition. It is most common in young children and young adults. The important thing is that it does not cause any problems or harm to your kidneys. In most cases, this condition will get better on its own over time, without any treatment.
Why does the body need protein?
Now you might be wondering, 'Why are we talking about this protein so much? What does this protein do to our body?' Protein is essential for our body to stay healthy. Take a look at what happens to this protein:
- It helps build and develop our bones and muscles.
- It controls the amount of fluid in our blood.
- Fighting against diseases means helping our immune system .
- When the body is injured, it helps repair the tissue.
Is this a dangerous situation?
No, not at all . Orthostatic Proteinuria is not dangerous. Research has shown that this condition does not lead to long-term kidney diseases, such as Chronic Kidney Disease (CKD). So there is no reason to worry.
As common as it is, it's actually quite rare . It affects between 2% and 5% of young people. It's very rare in people over 30.
What are the symptoms?
Orthostatic proteinuria has no obvious symptoms that you can see or feel. The only way to know if you have this condition is for a doctor to check the level of protein in your urine.
What could be causing this?
Doctors and medical researchers are still not sure what exactly causes orthostatic proteinuria. However, they believe it may be related to certain kidney functions. Here are a few examples:
- Glomeruli abnormalities: Inside your kidneys are many tiny blood vessels that filter blood. These are called glomeruli. Some studies have shown that in about 43% of people with orthostatic proteinuria, the walls of these glomeruli are slightly thicker than normal.
- Abnormal hemodynamic response: Hemodynamics refers to the way blood flows through our blood vessels. Our body's Renin-Angiotensin-Aldosterone System (RAAS) (a system of hormones, proteins, and enzymes) helps control our blood flow. So, problems with this RAAS system can cause an abnormal response in blood flow, which can affect the kidneys.
- Nutcracker syndrome (or Left Renal Vein Entrapment Syndrome): Doctors and researchers think that when you stand, the pressure on your left renal vein can cause more protein to pass through the glomeruli than when you're lying down. Think of it like a tube being squeezed.
Some experts think gravity may also play a role. They suspect that standing or sitting for long periods of time can cause some protein to 'leak' out of the kidneys.
Who is affected the most by this situation?
Orthostatic proteinuria mainly affects young people . It is also slightly more common in boys. Orthostatic proteinuria is rarely seen in adults.
Are there any complications?
No, doctors consider orthostatic proteinuria to be a benign condition. It poses no threat to your kidneys, your overall health, or your life.
How do you recognize this exactly?
A doctor will first take your medical history , then perform a physical examination. In addition, they will order several tests to help confirm the diagnosis.
You may also be referred to a nephrologist , a doctor who specializes in kidney diseases.
What kind of tests are done?
Your doctor will perform at least two urinalysis tests. During a urinalysis, you urinate into a special bottle, either at the doctor's office or at a hospital.
- First urine test: In this, the doctor will take a 'day sample'. This is usually the urine sample you collect after you have slept well at night (either supine or prone) and first thing in the morning.
- Second urine test: This involves taking a 'night sample'. This sample is taken while you are standing or sitting throughout the day, either in the evening or at night.
Now, if your nighttime urine sample contains more protein than your morning urine sample, your doctor can confirm that you have orthostatic proteinuria.
What are the treatments?
This is the best news! Orthostatic Proteinuria does not require any treatment . You do not need to change your diet or stop exercising.
However, if you or your child has this condition, it's a good idea to keep an eye on your protein levels. Your doctor may recommend that you have a urine test once a year to monitor your protein levels.
Can this be prevented?
No, orthostatic proteinuria cannot be prevented. However, as mentioned earlier, it is not a harmful condition , so there is nothing to worry about.
So, how do you live with this situation?
The prognosis for this condition is excellent . This is not a sign of chronic kidney disease or any other kidney disease. Also, you do not need any treatment.
Most of the time, orthostatic proteinuria goes away on its own as you get older.
Should I see a doctor?
Although orthostatic proteinuria does not require any treatment, in some cases your doctor may recommend that you have a urine test once a year to monitor your protein levels.
You can ask the doctor questions like these:
- How do you know for sure that I have Orthostatic Proteinuria?
- Do you recommend getting a urine test once a year?
- Do I need to see a nephrologist, a doctor who specializes in kidney disease?
Remember as a summary
Orthostatic proteinuria is a harmless type of proteinuria that doctors usually see in young children and young adults. Simply put, it means that the level of protein in your urine when you stand is higher than when you sit or lie down. It doesn't mean that there is anything wrong with your kidneys. Also, the condition usually gets better on its own as you get older. If you or your child has orthostatic proteinuria, it's a good idea to ask your doctor about getting tested annually.
` Orthostatic Proteinuria, Proteinuria, Kidney, Children, Adolescents, Urinalysis
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