What workup is warranted following a report of “trace” protein in the urine of an apparently healthy individual?
—Stephen Parker, DO, Roselle Park, N.J.
The discovery of “trace” proteinuria in healthy individuals is surprisingly common. Transient proteinuria may, in fact, occur in up to 4% of men and 7% of women on a single examination. This can have a simple cause, such as physiologic stress (fever) or heavy exertion. If proteinuria persists, a careful history and physical exam are crucial, as are examination of the rest of the urine sediment (looking for infection or glomerular disease) and measurement of the serum creatinine. If the urinalysis is otherwise benign and the creatinine is normal, imaging with ultrasound and/or IV pyelogram should be pursued. If all these results are normal and the degree of proteinuria remains small, periodic monitoring is acceptable.
—Christopher Ruser, MD (102-14)