Finding protein in your urine, called proteinuria, can be worrying, especially if you have IgA nephropathy (IgAN) or another type of chronic kidney disease. Proteinuria that involves a protein called albumin is known as albuminuria.

Proteinuria does not predict how long you’ll live, but it can offer important clues about your kidney health and your risk of future problems. Here’s what proteinuria may mean for your outlook, what can affect your risk, and how treatment may help protect your kidneys over time.

Proteinuria and Life Expectancy

There is no set life expectancy for someone with proteinuria. People can live for many years with protein in their urine, especially when the cause is treated and their kidney function stays stable. Proteinuria does not automatically mean you’ll live a shorter life, but it can be a sign that your kidneys are under stress or damaged and that you have a higher risk of kidney and heart problems.

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How proteinuria affects your outlook depends on factors like how much protein is in your urine, how well your kidneys are working, and how quickly kidney function is changing. In general, higher or long-lasting proteinuria is linked with faster loss of kidney function. If IgA nephropathy or another kidney condition is causing proteinuria, regular monitoring and treatment can help protect your kidneys over time.

Proteinuria Factors That Influence Kidney Damage and Function

The kidneys have tiny filters called glomeruli. When these filters are damaged, a protein in the blood called albumin can leak into the urine. How much protein leaks out can offer clues about your kidney health.

Your nephrologist (a doctor who specializes in kidney diseases) will look at your proteinuria along with other test results to see how well your kidneys are working and whether your kidney function is staying stable.

Protein Levels and Blood Pressure

The amount of protein in your urine is one important factor. It can help doctors understand your risk of kidney disease getting worse over time. It’s important to remember that any life expectancy numbers you see are averages, not a prediction of exactly how long you’ll live.

For people with IgAN, the goal is to keep proteinuria below about 0.5 grams per day, and ideally below 0.3 grams per day. Even lower levels of long-term proteinuria can still carry some risk.

In addition, keeping your blood pressure under control can help your kidneys function better, even if you have long-term 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.

Kidney Function and eGFR

How quickly 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 may take time to work. Starting the right treatment and taking it as prescribed may help protect your kidneys.

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.

Taking steps to protect your kidneys may help slow kidney disease and lower your risk of complications. Many people whose kidney problems, such as IgAN, are found early can live for many years, even if some protein remains in their urine.

Age, Sex, and Life Expectancy With Proteinuria

Your age and sex assigned at birth can play a role in how kidney disease progresses if you have proteinuria. These factors don’t determine how long you’ll live, but they may affect 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 steps you can take to support your kidney health and help reduce the protein in your urine. Not every approach will be right for everyone. Your doctor can help you develop a treatment plan based on your kidney health and the cause of your proteinuria.

Lifestyle Changes

Certain lifestyle changes may help protect your kidneys. You may need to limit sodium, adjust how much protein you eat, or change how much potassium or phosphorus you get from food based on your lab results.

These changes can reduce the amount of waste and minerals your kidneys have to handle. A registered dietitian can help you build a balanced eating plan that fits your kidney needs and other conditions, such as diabetes or high blood pressure.

If you drink alcohol or use tobacco, your doctor may recommend cutting back or quitting. Regular exercise can also support kidney and heart health and may help with blood pressure, diabetes, mood, and weight. Talk with your doctor about what types of activity are safe for you and whether you need help from a physical therapist or other exercise professional.

Medications

There are medications that can help protect your kidneys and slow the loss of kidney function.

Medications That Protect Kidney Function

Angiotensin-converting enzyme (ACE) inhibitors and angiotensin-receptor blockers (ARBs) reduce the effects of a hormone called angiotensin-2. These medications help relax blood vessels and lower pressure in the kidneys, which can help protect kidney function and lower proteinuria. They are commonly used for several kidney diseases, including IgAN.

Medications called sodium-glucose cotransporter 2 (SGLT2) inhibitors may also help protect your kidneys and lower proteinuria. They help your body get rid of extra salt and sugar through the urine, which helps the filtering system in your kidneys work better. This lowers pressure in the kidneys’ filters, which can help slow kidney damage. They may be especially useful for people living with IgAN and proteinuria.

Medications called nonsteroidal mineralocorticoid receptor antagonists (nsMRAs) affect aldosterone, a hormone that helps control salt and fluid levels in the body. This allows the body to release more salt and water in urine, which lowers pressure in the kidneys’ filtering system.

Finerenone (Kerendia) is currently the only nsMRA available in the United States. It is approved by the U.S. Food and Drug Administration (FDA) for chronic kidney disease linked to type 2 diabetes, but not specifically for IgAN. Researchers are studying finerenone and other nsMRAs for people with IgAN and other types of kidney disease.

Medications That Target Inflammation or IgAN

If proteinuria is caused by certain autoimmune or inflammatory kidney diseases, your doctor may consider corticosteroids or other medications that suppress the immune system. Doctors consider these medications carefully because they can weaken the immune system and cause side effects.

Medications that suppress the immune system are usually used only when IgAN is more likely to get worse. Treatment may also include blood pressure control, lifestyle changes, SGLT2 inhibitors, or medications that target IgAN directly, depending on your risk and kidney function.

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.