Proteinuria during dengue fever in children

- Protein excretion in urine of children with dengue increases during the course of dengue disease to reach a maximum level approximately one week after the onset of fever.
- Neither urine dipstick nor UPCR measurement were useful for dengue patient triage at the time of first visit to hospital.
- Monitoring the urinary protein excretion during the course of the disease might be a factor indicating the evolution towards disease recovery.

ObjectivesThis study aimed to investigate proteinuria occurring during dengue disease in children and assess if measurement of this parameter can help physicians in the clinical management of patients.MethodsProteinuria was assessed by dipstick and quantified by urine protein:creatinine ratio (UPCR) in samples from patients hospitalized with a confirmed dengue infection and in healthy controls.ResultsThe dipstick tested positive in 42.9% of the patients presenting at hospital with dengue versus 20.0% in healthy controls. UPCR increased during the critical phase of the disease; peaking one week after fever onset then decreasing as the patients recovered. Patients with warnings signs or severe dengue were more likely to present with proteinuria detected by UPCR at the time of hospital admission compared to patients without warning signs. The sensitivity of this marker, however, was limited as only 16.1% of the patients with warning signs had proteinuria.ConclusionsUrine dipstick and UPCR do not seem to be very valuable for the triage of the patients at the time of the initial consultation but the observation of a decrease of the UPCR during the course of the illness appears to indicate an evolution towards recovery.