Does my child need treatment for proteinuria?
After your child’s doctor has confirmed the diagnosis and the type of proteinuria, they will decide on the best treatment plan for your child.
When treatment is needed
Your child will not need treatment for:
- orthostatic proteinuria – the kidneys leak a small amount of protein during the day, especially when standing up or after exercise
- mild proteinuria that goes away after the first urine test – this may happen during a fever or a urinary tract infection.
Your child may need treatment or to be monitored for:
- persistent proteinuria – where the proteinuria does not go away
- nephrotic syndrome
- kidney damage if it is suspected.
It is important that your child follows the treatment plan outlined by your doctor.
Reducing protein lost in the urine
Angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs) may be used to reduce the amount of protein lost in the urine. They may also be used to help reduce or control blood pressure. Common ACE inhibitors are: captopril, enalapril, lisinopril.
Doctors understand that in some children these medicines will reduce the risk of long-term kidney problems.
Controlling blood pressure
Some children with proteinuria also have high blood pressure, or hypertension. Their blood pressure will need to be controlled so it is in the healthy range.
If your child has hypertension, he or she may need to change what he or she eats and drinks. Some children need to take medicines.
Questions to ask the doctor or nurse
- What treatment will my child need?
- How will the treatment help my child?
- What are the side-effects of the treatment?
- How can I help my child prepare for procedures and treatments?
- If the first treatment does not work in my child, what happens next?
- How will I know if we need to go back to the hospital or see the doctor?
Your healthcare team will speak with you and your family about any long-term effects your child might have with proteinuria. In most children, proteinuria is mild.
Follow up
Your child may need to have follow-up appointments at the hospital or clinic, especially if he or she has persistent proteinuria. It is important to go to these appointments, even if your child seems well – remember to bring the results from home urine testing. You will also have the opportunity to ask any questions.
At these appointments, your child may have:
- his or her height and weight checked
- a physical examination
- urine tests – to check for protein and other substances in his or her urine
- blood tests – to check for the amount of protein and other substances in his or her blood, and measure his or her kidney function
- his or her blood pressure measured.
It is important that your child keeps all their appointments for these tests, to help prevent long-term damage to their kidneys.
Urine testing at home
You may need to continue to do urine tests at home to check whether the proteinuria has come back. If there is proteinuria for a few days, contact your doctor.
Long-term effects
Mild proteinuria
In most children, proteinuria is only present for a short time. It is harmless and will not cause problems in the long term.
Other types of proteinuria
Children who have the following may need to have treatment or be monitored:
- persistent proteinuria
- nephrotic syndrome.
Kidney damage
In a small number of children the proteinuria is a sign that there may be kidney damage – for example, scars or inflammation in the kidney. Often this damage is minor and the kidneys are working normally.
A very small number of children will have long-term problems with their kidneys. Their kidneys stop working as well as they should – this happens slowly, often over many years. This is called chronic kidney disease (CKD).
If your child has CKD, you and your family will learn more over time about how to help manage the condition, and what to expect.
Impact on your child and your family
Children who have proteinuria can usually do the things that other children their age do. Often no treatment is required and they should be able to continue going to school or nursery. They can play with other children and stay active.
Some child children may need to change their diet and take one or more medicines.
Further support
This can be a stressful time for your child and the whole family, including other children. If your child’s proteinuria is due to a more serious kidney problem, your doctor or nurse will give you more information.