Approach to the Patient with Non-nephrotic Proteinuria

Abstract This chapter reviews the approach to the patient with non-nephrotic proteinuria. The definition and prevalence of proteinuriaare considered. Proteinuriais important because it has implications for progression of chronic kidney disease(CKD) and increased cardiovascular risk. The type of proteinuriamay provide important diagnostic clues to the etiology of CKD. Evaluation includes review of the urine sediment, serological evaluation, and renal biopsyif appropriate. Lifestyle modification and antagonism of the renin–angiotensin–aldosterone system form the cornerstoneof conservative managementfor all patients with proteinuric kidney disease. Immunosuppressive therapy may be indicated, depending on the etiology of the patient's renal disease. Additional specific therapies to reduce proteinuriaand slow progression of CKD are eagerly awaited.