Journal of the American Society of Nephrology
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Journal of the American Society of Nephrology, Vol 4, 36-39, Copyright © 1993 by American Society of Nephrology

REGULAR ARTICLES

Mechanisms of orthostatic proteinuria: lessons from a transplant donor

P Devarajan
Yale University, New Haven, CT.

Orthostatic proteinuria accounts for 60% of all children and 75% of adolescents with proteinuria. Despite its frequent occurrence, the underlying pathophysiologic mechanisms remain unclear. The following three possibilities have been reviewed: (1) a normal variant; (2) a glomerular abnormality; (3) a hemodynamic abnormality. On the basis of the experience with an individual who had orthostatic proteinuria and who was a donor of a living-related kidney transplant, novel insights and a potentially unifying hypothesis for the pathogenesis of this condition are presented. It is suggested that individuals with orthostatic proteinuria may be predisposed by a subtle glomerular abnormality. However, a precipitating factor, in the form of an exaggerated response to the upright position, appears to be essential to unmask the condition.




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Copyright © 2008 by the American Society of Nephrology. Online ISSN: 1533-3450 Print ISSN: 1046-6673