Doctor how to check urine protein in my nephrotic syndrome child?

Nephrotic syndrome is kidney disease with protein passing with urine (proteinuria), low albumine protein in blood (hypoalbuminemia) & body swelling (edema).

 

Children having nephrotic syndrome is not uncommon in Sri Lanka. If not treated properly, there is a risk for your child’s life. Parental motivation and

 

involvement is essential in the reatment of a child with nephrotic syndrome. Patients and parents who have a clear understanding of the disease comply better with treatment.

 

Checking your child’s urine daily for protein is very much important to assess his condition.

 

Therefore always record the amount of protein in your child’s nephrotic syndrome diary on daily basis.

 

Here are the points to watch

 

* Always use fresh morning urine specimen

 

* For 5 ml of urine, add 3 drops of 30% sulphosalicylic acid if you are using sulphoaiicylic acid

 

* Observe for the change in turbidity.

 

Heat method to assess the proteinuria

 

1. Collect the first morning void.

 

2. Fill two third of a test tube with urine

 

3. Hold the tube at a slant and heat the upper half of the tube until the boiling point.

 

4. If no turbidity appears consider it as “Nil”.

 

5. If turbidity appears, add 2 drops of 10% acetic acid or vinegar. If turbidity disappears consider it also as “Nil”.

 

6. Assess the degree of proteinurea against a background of black print.

 

Grading

 

Trace – Slight turbidity, but can read the print easily.

 

+ : Slight turbidity, but can read the print with difficulty.

 

++ : Can not read the print, but can notice the blackness

 

+++ : Can not notice the blackness

 

++++ : Can not notice the backness and with precipitate

 

We call your child is now in a “relapse” if 3 days of 2+ or more proteinuria or albuminuria.

And we call your child is now in a “remission” if 3 days of 0 or trace proteinuria or albuminuria.

 

Contact your local peadiatrician or the renal unit if your nephotic syndromic child has:

 

* Protein ++ or more in their urine for 3 days

 

* Contact with Chickenpox

 

* If you need advice about immunisation

 

* Diarrhoea and vomiting

 

Dr. Yapa Wijeratne