Fixed and Reproducible Orthostatic Proteinuria

Publisher Website
Google Scholar
Abstract
A 5-yr. follow-up evaluation was carried out on 57 of 64 young men who had presented with "fixed" orthostatic proteinuria in 1959. Initial renal biopsy specimens from 51 to 64 patients were classified as "definitely" or "subtly" abnormal or "normal". Five yrs. later, overt clinical or laboratory evidence of renal failure was not observed in a single patient. Of the patients 10% exhibited diabetes mellitus, hypercalcemia, or hyperuricemia. Sustained diastolic hypertension was not observed. Importantly, at least 70% still exhibited some form of asymptomatic proteinuria. Almost 1/2 (49%) demonstrated "fixed" orthostatic proteinuria. A rising incidence of urinary sediment abnormalities was noted, especially in patients whose initial renal biopsy specimens had exhibited "definitely" or "subtly" abnormal changes of glomerular architecture. These results demonstrate that the short-term prognosis is excellent for young men whose "fixed" orthostatic proteinuria is 1st observed during late adolescence or early adulthood. The long-term prognosis must still be regarded with reservation. Further follow-up evaluation is required to document the exact natural history and clinical significance of "fixed" orthostatic proteinuria.