High Protein in Urine: Understanding Causes & Potential Concerns

Question
Hi,
I am a 17 year old girl, and in a physical for the air force (I am joining ROTC next fall) I was found to have a very high level of protein in my urine. I later did a 24 hour collection and the level was still high.

In blood tests the creatinine and BUN is normal, but the urine shows the creatinine level to be 20, when the normal range (on this scale) is 5-15.

My doctor has suggested that I might have osteopathic proteinura. However, in my research I have found that this generally doesn't produce symptoms other than protein in the urine.

I have reported to my doctor that for the past year I have been nauseous alot and had backaches, as well as general fatigue. I also have just started to have pain in my back and side while uriniating.

Does this sound like osteopathic proteinura or something else? I am seeing the doctor tomorrow to go over a second urine collection lab as well as more blood tests.
However, could you give me information on both osteopathic proteinura and other kidney disorders that might be causing this problem?

Thanks!  

Answer
I am not sure what you are talking about with osteopathic proteinuria.  I have not heard that term.  I am wondering whether you are referring to orthostatic proteinuria.  If that is the case, then you have nothing to worry about, because that is a very benign condition.  However, you have to have a complete evaluation to prove that diagnosis.  Here are a couple excerpts out of some kidney texts on orthostatic proteinuria....

Hope this helps.......

Orthostatic proteinuria occurs primarily in older adolescents and is characterized by increased protein excretion in the upright position and normal protein excretion in the supine position (ie, as found in a urine sample taken early in the morning after the subject has been lying down). Orthostatic proteinuria is a benign condition.6


Orthostatic proteinuria is defined as proteinuria when upright but not while recumbent (sleeping). To make the diagnosis, a first-morning urine should be compared to a urine performed after being upright for several hours. A 20-year follow-up of Air Force recruits with orthostatic proteinuria (obtained on 43 of the original 64 patients) revealed that all those able to be contacted had normal renal function while 6 continued to have proteinuria (5). Hypertension was not more frequent than in the general population in this group of adults. Orthostatic proteinuria is much more common in children and adolescents. Complement levels are usually normal and hematuria is uncommon children.
A microscopic evaluation of the urine is mandatory, looking for cellular elements, casts or anything else to suggest renal disease.