My 13 year-old-son, diagnosed 1 year ago, has had positive tests for protein in the urine twice in the past six months. His endocrinologist did send him for additional blood work at a lab, which was normal. The doctor seems to feel that since he is not spilling protein at night, it is orthostatic and not a concern. I am wondering if I should have a nephrologist evaluate my son.

I am sure that his endocrinologist is right and that your son’s albuminuria is orthostatic [related to position] and not a concern. He is too young and has had diabetes for too short a time for this to be a complication at this stage. It is important to know about this however, because when he gets to be 15 or so many diabetes doctors start routine testing for microalbuminuria and if this were to involve collecting a 24 hour sample rather than just an overnight one the orthostatic leak could be misinterpreted. I don’t think that you need to take your son to a nephrologist.

DOB

[Editor’s comment: See also a previous question about orthostatic urine protein.

JSH]