Learning that you have protein in your urine, a condition that is also called proteinuria or albuminuria, may make you wonder what it means for your kidney health. This often happens in people living with IgA nephropathy (IgAN) or other types of chronic kidney disease (CKD), conditions in which the tiny filters in the kidneys are damaged. Many people want to know what this means for their health and how it could affect their future.

The good news is that understanding why protein builds up in your urine and how it’s treated can help you protect your kidney function. With the right care, many people with proteinuria live well for many years. Knowing what steps you can take may also give you peace of mind and improve your quality of life.

Proteinuria and Life Expectancy

Protein in your urine doesn’t automatically mean you’ll live a shorter life, but it can be a sign of a higher risk for kidney and heart problems. It often signals that your kidneys are under stress or have some degree of damage. When your glomeruli (kidney filters) don’t work properly, they can let proteins, especially albumin, leak into your urine instead of keeping them in your bloodstream.

Have you ever wondered how long you can live with proteinuria? The answer depends on how much kidney damage you have and how well your kidneys can be protected over time. Reduced kidney function can affect your overall health, and high levels of protein in your urine are linked with faster loss of kidney function. In general, kidney function gets worse as levels of proteinuria go up.

IgAN is one common cause of long-term proteinuria. Keeping this condition under control through regular monitoring can help preserve your kidney function so you can live longer, with or without proteinuria. Your doctor can monitor proteinuria by taking urine samples and running regular urine protein tests.

Proteinuria Factors That Influence Kidney Damage and Function

There are a few factors to look at when figuring out how well your kidneys are working. Your nephrologist (a doctor who specializes in kidney diseases) will likely test these, along with your urine, to help you understand how your kidneys are doing. They’ll also monitor you to make sure your kidney function is stable.

The amount of protein in your urine is definitely a factor when it comes to determining kidney function and overall life expectancy. It’s important to remember that any numbers you see are averages, not a specific predictor for how long you’ll live.

In addition, keeping your blood pressure under control can help your kidneys function better, even if you have chronic proteinuria. In fact, hypertension (high blood pressure) is common enough in people with kidney problems that some researchers have suggested lower life expectancies in people with proteinuria may be partially caused by high blood pressure, but this relationship is still being studied.

How rapidly your kidney function is changing can also affect your overall outlook. In IgA nephropathy, people whose kidney function declines more slowly often have better long-term outcomes. Treatments usually take time to show benefits, and they work best when kidney function is still relatively stable. This means that starting a treatment early and sticking with it may help protect your kidneys over the long term.

Finally, your doctor may also test your estimated glomerular filtration rate (eGFR). This number is calculated from a straightforward blood test that gives you and your nephrology team an estimate of how well your kidneys are filtering. You can have proteinuria and a normal eGFR. However, people with a higher eGFR often have a better outlook overall, even if they have some protein in their urine.

It’s important to remember that taking care of your kidneys can extend your lifespan, no matter how they're currently functioning. Many people who catch kidney problems like IgAN early can live a long time, even if there’s always a little protein in their urine.

Age, Gender, and Life Expectancy With Proteinuria

Your age and gender can play a role in how kidney disease progresses if you have proteinuria. These factors don’t determine your exact lifespan, but it’s worth knowing that both of these factors may change your overall outlook.

If your healthcare provider discusses proteinuria and your long-term outlook, ask whether the information is based on people with a similar profile and similar health conditions. This can help you get a clearer picture of what to expect and how to best protect your kidney health.

Treatments for Proteinuria

There are actions you can take to support your kidneys and help them filter more effectively, which will reduce the protein in your urine. These actions may not all be applicable to you or work for you, but you and your doctor should figure out a treatment plan for your kidneys and the protein in your urine.

Lifestyle Changes

Changing your lifestyle in certain ways may help your kidneys to work better. You may need to change the way you eat so that your kidneys don’t have to work as hard. For instance, you may need to limit sodium and adjust protein. Some people also need to limit potassium or phosphorus based on their lab results. The goal is to lower the amount of waste products and other minerals the kidney has to handle and thus reduce the load on the kidneys. The best way to find a diet that works for you is to talk with a registered dietitian. They can help you decide which foods to limit and how much of those foods you can tolerate. They can also make sure you still get a balanced diet and adjust your diet for other conditions like diabetes and high blood pressure.

If you regularly drink alcohol or use tobacco, your doctor may recommend that you quit to see if doing so helps your kidneys. If you need help quitting, they can get you the medication or other support that you need to make this change.

Getting regular exercise can also help your kidneys function better. It can also help with issues and conditions often associated with CKD, like diabetes, heart function, blood pressure, depression, anxiety, and obesity. You and your doctor should talk about what exercises you like and what's safe for you to do. They may refer you to an exercise professional, like a physical therapist or an exercise physiologist, if you need additional support coming up with the best plan to get physical activity.

Medications

There are medications you can take that can help improve your kidney function.

ACE inhibitors and angiotensin receptor blockers (ARBs) change the way a hormone called angiotensin-2 (AT2) works in your body. These medications help relax the blood vessels in your kidneys, which can allow the kidneys to work better. These are common medications for a number of kidney diseases, including IgAN. Taking them may help lower your proteinuria, too.

Medications called sodium-glucose cotransporter 2 (SGLT2) inhibitors may also help your kidneys and, as a result, your proteinuria. They help your body get rid of extra salt and sugar via the urine, which helps the filtering system in your kidneys work better. This allows your kidneys to relax, which can slow the rate of damage. They may be especially useful for people living with IgAN and proteinuria.

A class of medication known as nonsteroidal mineralocorticoid receptor antagonists (nsMRAs) change the way a hormone called aldosterone works in the body. This allows them to release more salt and more water in urine, which lowers the pressure in the filtering system. There’s only one of these medications, finerenone, that has been approved in the United States, and it is approved only for chronic kidney disease linked to type 2 diabetes. More nsMRA treatments are currently undergoing clinical trials and may eventually become available to help treat IgAN.

If the cause of the proteinuria is any autoimmune condition (the immune system attacks your own tissues) or inflammatory condition, your doctor may consider medications like corticosteroids or other immunosuppressants. However, doctors prescribe these medications with caution, as they may weaken the immune system and cause harmful side effects.

In recent years, several new medications have received FDA approval for adults with primary IgAN who are at risk for disease progression. Some are approved because they lower proteinuria or slow the loss of kidney function:

• Atrasentan (Vanrafia) — A selective endothelin A receptor antagonist that lowers proteinuria and helps protect kidney function
• Budesonide (Tarpeyo) — A targeted-release steroid that reduces inflammation in the gut, which can decrease IgA production and lower proteinuria
• Sparsentan (Filspari) — A dual endothelin-angiotensin receptor antagonist (DEARA) that helps lower pressure in the kidney filters and reduces proteinuria
• Iptacopan (Fabhalta) — A complement factor B inhibitor that reduces over-activation of the immune system involved in IgAN, helping reduce proteinuria
• Sibeprenlimab-szsi (Voyxact) — An antibody that targets the IgA pathway and is approved to reduce proteinuria in adults with primary IgAN

Your doctor will help you choose the best medication or combination of medications based on your symptoms, kidney function, and overall health.

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What treatment options have worked best to help you manage your proteinuria? Let others know in the comments below.