Persistent proteinuria is an accepted sign of renal disease, even in the asymptomatic patient with no other evidence of impaired renal function. Until recently the association of intermittent proteinuria and renal disease has not been as widely accepted. Rather, intermittent proteinuria in asymptomatic patients has been regarded as an innocent physiological process, most frequently seen related to body position, and usually called orthostatic proteinuria.
The use of percutaneous renal biopsy now allows a critical evaluation of orthostatic proteinuria. Robinson et al1 demonstrated distinctive glomerular alterations in 45% of 58 percutaneous renalbiopsy specimens from patients with orthostatic proteinuria. A communication in the May issue of the Archives of Internal Medicine2 presents the cases of 51 patients with asymptomatic, mild, intermittent proteinuria. All were evaluated with selected renal-function tests, and none showed impaired renal function. None of these patients had a history of renal disease, nor did they present evidence