title: Effectiveness of supine/standing urinalysis for differential diagnosis of left renal vein entrapment syndrome combined with or without glomerulopathy.
abstract: OBJECTIVE
  To assess the effectiveness of supine/standing urinalysis for differential diagnosis of left renal vein entrapment syndrome (LRVES) combined with or without glomerulopathy.
  
  
  METHODS
  The enrolled patients with abnormal urinalysis and LRVES demonstrated by Doppler sonography were guided to perform a supine/standing urinalysis.
  
  
  RESULTS
  Fifty-two patients were enrolled. Most of them were adolescents (aged 14-29 years, 73.1%) and with low body mass index (BMI, mean BMI, 19.8 ± 2.4 kg/m(2)). Seventeen cases (32.7%) manifested orthostatic urine abnormalities (OUA, proteinuria and/or haematuria show negative in supine while positive after 15 min standing), two patients who had undergone renal biopsies both showed no evidence of kidney lesions, another two patients were changed from abnormal to normal urinalysis after weight gain. The remaining 35 cases (67.3%) manifested non-orthostatic urine abnormalities (NOUA, proteinuria and/or haematuria show positive both in supine and standing), 15 patients had undergone renal biopsies and showed different degrees of glomerulopathy. After prednisone/immunosuppression therapy, four patients with glomerulonephritis were changed from the NOUA to the OUA classification. Statistics analyses showed that serum total protein and albumin levels were significantly lower (P = 0.028, 0.007, respectively) and urinary protein was significantly higher (P = 0.007) in the NOUA group than in the OUA group.
  
  
  CONCLUSIONS
  After the indication of LRVES by ultrasound, patients with OUA likely have only LRVES, while patients with NOUA likely also have glomerulopathy. Supine/standing urinalysis combined with Doppler sonography can be helpful for differential diagnosis of LRVES combined with or without glomerulopathy.
authors.affiliation: State Key Laboratory of Kidney Disease, Institute of Nephrology, Chinese PLA General Hospital, Beijing, China; Medical College, Nankai University, Tianjin, China.
authors.forename: Meiling
authors.initials: M
authors.lastname: Jin
authors.forename: Panpan
authors.initials: P
authors.lastname: Hu
authors.forename: Rui
authors.initials: R
authors.lastname: Ding
authors.forename: Pu
authors.initials: P
authors.lastname: Chen
authors.forename: Qiang
authors.initials: Q
authors.lastname: Qiu
authors.forename: Jie
authors.initials: J
authors.lastname: Wu
authors.forename: Shuwen
authors.initials: S
authors.lastname: Liu
authors.forename: Yuansheng
authors.initials: Y
authors.lastname: Xie
authors.forename: Xiangmei
authors.initials: X
authors.lastname: Chen
mesh_terms: D000293:Adolescent; D000328:Adult; D001706:Biopsy; D003937:Diagnosis, Differential; D005260:Female; D015433:Glomerulonephritis, Membranous / Q000175:diagnosis* / Q000652:urine*; D006417:Hematuria / Q000175:diagnosis / Q000652:urine; D006801:Humans; D008297:Male; D011187:Posture; D011507:Proteinuria / Q000175:diagnosis / Q000652:urine; D059228:Renal Nutcracker Syndrome / Q000175:diagnosis* / Q000652:urine*; D016683:Supine Position; D014057:Tomography, X-Ray Computed; D018608:Ultrasonography, Doppler; D016482:Urinalysis / Q000379:methods*; D059349:Urine Specimen Collection / Q000379:methods; D055815:Young Adult
keywords: glomerulopathy; haematuria; proteinuria; renal nutcracker syndrome; urinalysis