Simple Proteinuria: Symptoms, Diagnosis, and Concerns

How can one determine if it is simple proteinuria?

I previously asked some questions and still have a few more.
I would appreciate your answers.
I have had proteinuria for two months, with two different tests showing one result as 1+ and another 24-hour result as 791.
I also visited a nephrologist at a local hospital, who scheduled a follow-up appointment for me in a month regarding the urine tests.
I probably won't be able to retest, as my parents say it's unnecessary, and I will follow up in a month.
I do not have hematuria or edema (I have been paying attention; my face is not swollen when I wake up, and I usually do not have swelling in my face or legs).
The doctor said I only have simple proteinuria.
Is that really the case? What are the obvious symptoms of glomerulonephritis? Additionally, I was prescribed Persantin 50 mg.
Before prescribing the medication, the doctor mentioned he was unsure if it would affect my growth, so I looked it up and found that it should not.
However, I am a bit worried and would like to ask about it (I take it once daily after breakfast for a month, then I will follow up).
Thank you.

A Geng, 10~19 year old female. Ask Date: 2012/07/03

Dr. Wu Jiyu reply Internal Medicine

1.
The 24-hour result is 791 mg, which has not yet reached the level of nephrotic syndrome, and there are no clinical symptoms (such as edema or hypertension); therefore, there is currently no necessity for a kidney biopsy.
2.
When is a kidney biopsy necessary? It is recommended for individuals aged 16 and older who have nephrotic syndrome.
3.
Persantin 50 mg is a prescription that many physicians may use.
4.
Most importantly, regular blood tests to assess kidney function and urine tests for proteinuria are essential.
If there are any issues, please consult a professional nephrologist.
Changhua Hospital Nephrology Department cares about you.

Reply Date: 2012/07/03

More Info

Understanding simple proteinuria is crucial for both patients and healthcare providers. Proteinuria, or the presence of excess protein in urine, can be a sign of underlying kidney issues, but it can also be benign in certain contexts. In your case, you've reported that your proteinuria has persisted for two months, with one test showing a result of 1+ and a 24-hour urine collection indicating 791 mg of protein.

Characteristics of Simple Proteinuria
1. Definition: Simple proteinuria is often defined as the presence of protein in the urine without accompanying symptoms of kidney disease, such as hematuria (blood in urine) or edema (swelling).
2. Symptoms: As you noted, you do not have symptoms like blood in your urine or swelling, which is a positive sign. Common symptoms of more serious conditions, such as glomerulonephritis (inflammation of the kidney's filtering units), include:
- Hematuria
- Edema, particularly in the face and legs
- Hypertension (high blood pressure)
- Decreased urine output
3. Diagnosis: The diagnosis of proteinuria typically involves urine tests, including dipstick tests and 24-hour urine collections. Your results indicate that while you have proteinuria, it is not at the level typically associated with nephrotic syndrome (which usually requires over 3.5 grams of protein in 24 hours).

Next Steps and Monitoring
Given that your nephrologist has scheduled a follow-up appointment in a month, this is a reasonable approach. Continuous monitoring of your kidney function and protein levels is essential. Regular blood tests to check kidney function (e.g., serum creatinine and eGFR) and urine tests to monitor protein levels will help determine if there are any changes in your condition.

Concerns About Medications
Regarding the medication Persantin (Dipyridamole), it is often prescribed to improve blood flow and has been used in various conditions, including those affecting the heart and kidneys. While there are concerns about medications affecting growth and development, studies generally indicate that Dipyridamole is safe for use in adolescents. However, it is always best to discuss any concerns with your healthcare provider, especially regarding potential side effects and the impact on your development.

Conclusion
In summary, your current situation appears to be manageable, especially since you lack significant symptoms. Simple proteinuria can be benign, particularly in young individuals without other concerning signs. However, it is essential to continue monitoring your condition and follow up with your healthcare provider as scheduled. If you notice any new symptoms, such as swelling, changes in urine color, or increased blood pressure, you should seek medical advice promptly. Regular follow-ups and tests will help ensure that any potential issues are caught early, allowing for timely intervention if necessary.

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