Intended for healthcare professionals

Practice 10-minute consultation


BMJ 2006; 332 doi: (Published 02 February 2006) Cite this as: BMJ 2006;332:284
  1. Jayne Haynes, senior registrar in general practice (,
  2. Richard Haynes, specialist registrar2
  1. 1 University of Oxford Department of Primary Health Care, Institute of Health Sciences, Oxford OX3 7LF
  2. 2 Oxford Kidney Unit, Churchill Hospital, Oxford
  1. Correspondence to: J Haynes

    A 40 year old woman comes to you after she was found to have a reading of 2+ on a dipstick proteinuria test at an insurance company medical examination. She is fit and well with no major medical history or family history of illness. She has no urinary symptoms and no oedema. She is not pregnant.

    What issues you should cover

    Proteinuria may be an early indicator of renal disease and increases the risk of renal impairment, hypertension, and cardiovascular disease. Exclude causes of transient proteinuria (box), which does not have these associations. If proteinuria of 1+ or more persists on two subsequent dipstick tests at weekly intervals further investigation is indicated.

    History—Ask about symptoms of renal failure and connective tissue diseases (including arthralgia, mouth ulcers, and rashes). Pertinent past medical history …

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