If you’ve been told you have protein in your urine — a finding called proteinuria or albuminuria — you may wonder whether drinking more water can help. Staying hydrated is important for overall health, but simply flushing your system with water usually doesn’t lower protein levels in urine. In some cases, that approach may even be unsafe, especially if you’re living with chronic kidney disease (CKD) such as IgA nephropathy (IgAN).

This article explains what protein in the urine means and whether drinking water affects it. With this knowledge, you and your doctor can figure out the best treatment plan for your needs.

What Does It Mean To Have Protein in Your Urine?

Your kidneys act as filters. When they’re healthy, they keep important proteins — such as albumin — in your bloodstream and remove extra fluid and waste via urine formation. If the kidneys are damaged, holes form in this filter, and proteins, especially albumin, can leak into the urine. This is called proteinuria or albuminuria. Higher levels of protein in the urine usually suggest greater kidney damage or stress on the kidneys.

Protein in the urine isn’t a disease by itself. There can be temporary increases of proteinuria, which can be reversed by treating the causes. However, persistent proteinuria is often a sign of another long-term health condition and kidney damage. Common causes include diabetes, heart problems, high blood pressure (hypertension), or a chronic kidney condition like IgAN. Tracking and managing proteinuria can help slow kidney disease progression and prevent complications.

Your nephrologist can figure out how much protein is in your urine by taking a urine sample and running a urine test. They won’t only want to know if you have protein in your urine now, but will likely monitor that number over time to see if your kidneys are stable or if your CKD is progressing.

Hydration and Kidney Function

When you’re hydrated, you have the right amount of water in your body for it to function well. Most of the time, making sure you drink plenty of fluids is good for your kidneys. It can help your blood vessels stay open, so your kidneys get the nutrients and the blood that they need. It can also make it easier for your kidneys to remove waste through your urine. Some researchers believe that drinking more water can help protect your kidneys against developing CKD. However, another study showed that increasing water intake does not slow the decline in kidney function in adults who already have CKD.

Your kidneys can also help your body maintain optimal levels of hydration by eliminating excess fluid, stopping urination when you don’t have enough fluid, and signaling to your body that you need to drink more. Note that when your kidneys aren’t working well, and you’re living with advanced CKD or even kidney failure, your body is not able to get rid of the excess fluid, and so you may have to limit your fluid intake.

When it comes to CKD, it’s important to get the right amount of water every day. Both too much water and too little water seem to make the condition worse. A study from the journal Nephrology Dialysis Transplantation showed that people with CKD should drink between one and two liters of water every day. However, the authors note that this finding needs to be supported by additional studies. Your nephrology team can give you medical advice about how much water is right for you, depending on the health of your kidneys.

Another study showed that drinking the right amount of water with CKD may lower the amount of protein in your urine. However, this doesn’t happen because you’re flushing protein out of your system. Rather, it happens because the water helps the filtration system in your kidneys work better, so your kidneys are able to keep the protein in the blood rather than letting it enter your urine. However, before you start drinking more water, it’s important to know how much kidney damage you have, so you don’t cause harmful side effects.

Drinking water isn’t a cure for proteinuria. You’ll need to learn how to manage your CKD to effectively support your kidneys. Drinking the right amount of water may be one part of that, but it isn’t the whole story.

How To Manage Protein in Your Urine

Before you start chugging fluids, make sure you talk to your doctor. As noted above, some people with CKD should limit how much they drink. Your doctor will tell you if this is true for you. Even if you can and should drink more, there are other things you can do to reduce the protein in your urine, too.

Monitoring

Keeping track of how well your kidneys are working will help you and your healthcare provider decide if you need to make changes to your treatment plan. If your kidney function is getting worse, you may need to take more medications or switch to different ones to better support your kidneys. Tracking the protein in your urine is one way to do this, though there are other tests your doctor will likely run, too. They will look at all of the results together to tell you how your kidneys are doing.

Changing Your Lifestyle

Certain lifestyle changes can help your kidneys work better and may reduce the amount of protein in your urine. In addition to drinking the right amount of water, you’ll want to make sure you’re eating a diet that’s friendly to your kidneys. You may need to manage how much you eat of certain nutrients so that you don’t make your kidneys work too hard. A registered dietitian can help you get what you need without overtaxing your kidneys.

Exercise may help, too. If you’re not sure where to start, ask your doctor about getting a referral to an exercise physiologist or a physical therapist who works with people living with CKD. These professionals can make sure you get the physical activity you need in a way that’s safe and healthy for your body.

Finally, you may need to quit smoking and/or drinking alcohol, as both of these can harm your kidneys. Your doctor should be able to help you get any support you need to make these kinds of changes, so reach out if you’re struggling to meet your goals.

Medications

There are several types of medications you can take to help your kidneys work better.

The first are angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs), which help the blood vessels in your kidneys to relax. They’re common treatments for IgAN and some other CKDs, and they can help lower the amount of protein in your urine.

Other medications, called sodium-glucose co-transporter 2 (SGLT2) inhibitors, help your body eliminate more salt and sugar in your urine. This means there’s less pressure on your kidneys’ filtering system, which can help reduce further damage. These medications may be particularly useful for people living with IgAN who experience proteinuria.

One more type of medication, nonsteroidal mineralocorticoid receptor antagonists (nsMRAs), raises the amount of both water and salt that your kidneys can release. Again, this lowers the pressure on that filtering system. Only one medication in this class has been approved in the U.S., but clinical trials are ongoing for other medications.

There are also endothelin receptor antagonists, which help reduce inflammation and scarring in the kidneys, and dual endothelin-angiotensin receptor antagonists, which combine two mechanisms to help slow kidney function decline. Another emerging option is complement inhibitors, which block part of the immune system that can contribute to kidney damage in IgAN.

Some treatments involve targeted corticosteroids, which work directly on the gut-immune pathway involved in IgAN. Others target the immune system more specifically, such as APRIL inhibitors, which block a protein involved in producing the antibodies that drive IgAN.

Talk to your doctor about a treatment plan to help protect your kidneys. Your healthcare professional can help you understand which options are best for you based on your kidney health and overall condition.

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How do you protect your kidneys while living with proteinuria? Let others know in the comments below.