Isolated proteinuria in asymptomatic patients

Abstract

In the authors' approach to the management of patients with isolated proteinuria, they emphasize yearly follow-up evaluation. The initial evaluation includes a thorough physical examination, a determination of the persistence of a given qualitative pattern, urinalysis, and measurements of quantitative protein excretion and endogenous creatinine clearance. Ultrasonography is sometimes performed as well. Renal biopsy usually is not undertaken unless there is a distinct change in the clinical course, such as an abrupt and definite increase in daily protein excretion, the appearance of distinct and persistent abnormalities of the urine sediment, or impairment of renal function. A 38 year old man with known proteinuria for 19 years is presented and discussed.