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Proteinuria on urinalysis in the Emergency Department

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Action and Follow-up Instructions for the Emergency Department Team

For patients with 2+ protein or more:

  • Please also refer to the glomerulonephritis and nephrotic syndrome guidelines to check possible diagnoses and subsequent investigation/management. The information below is about ensuring appropriate community follow-up.
  • If your patient has Henoch-Schonlein Purpura then the investigation and follow-up plan should be in line with the specific guideline.
  • In all cases with clinical concerns regarding nephrotic syndrome or 3+ or more of protein please send a formal urine sample for a protein:creatinine ratio to the lab.
  • For all other patients with incidental findings i.e. during a urinary tract infection/intercurrent illness please advise follow up in 1-2 weeks at their GP. This should include an early morning urine sample being sent for a protein:creatinine ratio.
    • Please give the family the Parent Information leaflet: “There’s something in my child’s pee” and a universal container to take home.
    • On the discharge letter please alert the GP and cut and paste the below link into your discharge letter. This will ensure that the GP has the advice on onward referral should your patient require it.

https://www.clinicalguidelines.scot.nhs.uk/media/2685/proteinuria-in-the-ed-gp-information-leaflet.pdf

Links:

Editorial Information

Last reviewed: 26 October 2021

Next review: 31 October 2023

Author(s): Dr Steffi McCallion (Paediatric Medicine trainee, RHCG) & Dr Natalie Bee (Consultant in Paediatric Emergency Medicine, RHCG)

Co-Author(s): Co-authors/stakeholders: Dr Ben Reynolds (Consultant in Paediatric Nephrology, RHCG); Correspondence link: Dr Steve Foster (RHC ED guidelines co-ordinator, RHCG).

Approved By: RHC ED clinical governance committee