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. 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 …