Proteinuria (high levels of protein in the urine) is one of the main signs of immunoglobulin A nephropathy (IgAN), also known as Berger’s disease. Normally, the kidneys filter waste from the blood while keeping important substances like proteins where they belong: in your bloodstream. But when the kidneys are inflamed or damaged, they can’t do this job as well. This can lead to protein leaking into your urine, and sometimes hematuria (blood in the urine) as well. These signs can give doctors important clues that your kidneys may be under stress or not working properly.

Although IgA nephropathy can’t be cured, lowering the amount of protein in your urine can help slow down kidney damage. Keeping protein levels low is a good sign that your IgAN treatment plan is working.

In this article, we’ll talk about strategies for how to reduce protein in urine, including medical treatments and daily lifestyle tips you can use at home.

How Reducing Protein in Urine Protects Kidney Health

Research shows that consistently high levels of protein in the urine are linked to worse outcomes for people living with IgA nephropathy. Lowering protein levels may help delay or even prevent kidney failure, a complication that affects about 25 percent of adults with this condition. Kidney failure is life-threatening without ongoing dialysis or a kidney transplant.

When protein levels stay high, it puts added stress on your kidneys and can lead to more kidney damage. That’s partly because the protein you eat breaks down into waste products your kidneys must filter out. The harder your kidneys work, the faster they may decline. On top of that, when proteins leak through your kidneys’ filters, called glomeruli, it causes inflammation and more damage. Reducing protein in your urine helps protect these filters and supports your kidneys’ ability to remove waste from your blood.

This doesn’t mean you should cut out protein from your diet. A registered dietitian can help you find the right balance — enough protein to stay healthy without overloading your kidneys.

Signs of High Protein in Urine

High levels of protein in your urine don’t always cause symptoms. In fact, the only way to know for sure is through a urine test. Still, some people may notice signs of protein in urine. These can include:

• Foamy or bubbly urine
• Frequent urination
• Edema (swelling) in the face, around the eyes, or in the belly, ankles, or feet

Complications of High Protein in Urine

Having persistent proteinuria can lead to more than just kidney problems. Over time, it may also raise your risk of serious cardiovascular (heart and blood vessel) diseases, including:

• Heart attack
• Stroke
• Heart failure (when the heart has trouble pumping blood effectively)

Treatments for Lowering Protein in Urine

Several medications are prescribed for IgAN to help lower the amount of protein in the urine. If your doctor recommends any of these treatments, it’s important to follow their instructions carefully and take your medications exactly as prescribed. This is one of the most effective ways to help protect your kidneys and prevent long-term damage.

Newer Treatment Options for IgA Nephropathy

Several newer medications are available to help people with primary IgA nephropathy lower protein levels in their urine and protect their kidney function. These treatments work by reducing inflammation, adjusting how the immune system responds, or easing pressure on the kidney’s filters.

• Atrasentan (Vanrafia) — Atrasentan blocks endothelin receptors, helping to reduce pressure inside the glomeruli.
• Budesonide (Tarpeyo) — This is a type of steroid that works mainly in the small intestine, where much of the body’s IgA is made. By calming inflammation in this area, budesonide helps reduce IgA activity.
• Iptacopan (Fabhalta) — This medication targets complement factor B (part of an overactive immune pathway involved in IgAN) to help reduce inflammation and protein leakage.
• Sibeprenlimab-szs (Voyxact) — This monoclonal antibody helps prevent the immune system from creating harmful IgA deposits.
• Sparsentan (Filspári) — This dual-action treatment blocks both endothelin and angiotensin receptors. This helps relax blood vessels in the kidneys, reduce strain on the glomeruli, and lower the amount of protein in the urine.

ACE Inhibitors

Your doctor or nephrologist (kidney specialist) may prescribe medications called ACE inhibitors as a first-line treatment to help lower protein in your urine. These medications are often used to treat hypertension (high blood pressure), and they also help reduce pressure inside the glomeruli. Research shows ACE inhibitors are especially helpful for people with high levels of protein in their urine.

If you’re prescribed one of these medications, your doctor will monitor you closely. They’ll regularly check your creatinine and potassium levels through blood tests. The goal is to reduce protein in your urine and help prevent further kidney damage.

Angiotensin-Receptor Blockers

Angiotensin-receptor blockers (ARBs) work in a similar way to ACE inhibitors — they help lower your blood pressure to reduce stress on your kidneys’ filtering systems. Both types of medication are known as renin-angiotensin system (RAS) inhibitors and are often prescribed as first-line treatments for IgA nephropathy.

Your nephrologist may prescribe either an ACE inhibitor or an ARB — not both, as combining them can increase side effects without additional benefit.

ARBs work by blocking the receptors for a hormone called angiotensin II. This form of angiotensin raises blood pressure by tightening blood vessels and making the body hold on to more fluid. By blocking angiotensin II from attaching to its receptors, ARBs help blood vessels stay relaxed and prevent spikes in blood pressure.

Sodium-Glucose Cotransporter 2 Inhibitors

Sodium-glucose cotransporter 2 (SGLT2) inhibitors were first developed to treat diabetes, but they’re now also used to help manage chronic kidney disease, including IgA nephropathy.

These medications work by blocking extra glucose (blood sugar) from being reabsorbed into the bloodstream by the kidneys. Instead, the glucose is flushed out through your urine, which helps take some of the burden off your kidneys. SGLT2 inhibitors also help lower blood pressure and slow the progression of kidney disease.

When used together with a RAS inhibitor, certain SGLT2 inhibitors may provide an additional 15 percent to 26 percent reduction in proteinuria, compared with using the RAS inhibitor alone.

How To Reduce Protein in Urine Naturally

Along with taking medication, there are daily habits you can build to help reduce the amount of protein in your urine. The following lifestyle changes may support your kidney health and improve how your treatment works.

Change Your Diet

Your healthcare provider may recommend some simple adjustments to your eating habits to reduce stress on your kidneys. A consistent kidney-friendly diet can help your kidneys leak less protein into your urine.

Limit Salt

Eating too much sodium (salt) can cause your body to retain fluid, which raises blood pressure and puts extra strain on your kidneys. Cutting back on sodium may help reduce protein in your urine and protect your kidney function.

Most people with IgA nephropathy are advised to aim for less than 2,300 milligrams of sodium per day. You can lower your salt intake by:

• Choosing products labeled “low sodium”
• Eating more fresh, unprocessed foods
• Avoiding adding salt to your meals once they’re prepared

Limit Protein

Too much dietary protein can make your kidneys work harder and may lead to higher levels of protein in your urine. Animal proteins like red meat and processed meats are especially taxing on the kidneys. In contrast, some plant-based proteins — such as beans, lentils, tofu, quinoa, and nuts — are often easier on your kidneys and may help lower the risk of kidney failure or complications.

That said, your body still needs protein to stay healthy, and cutting out too much can lead to malnutrition. Talk to a registered dietitian about the right amount and types of protein for your specific kidney function.

Manage Blood Pressure

Medications that reduce proteinuria often help lower blood pressure, but lifestyle habits play a big role, too.

Regular, moderate exercise can support healthy blood pressure. However, prolonged or intense workouts might increase protein in the urine, so try to find a balance that feels good for your body. If you plan to exercise for long periods, talk to your doctor first.

Healthy stress relief is also important. Chronic stress can raise blood pressure, so it’s helpful to build calming routines into your week. Try activities like yoga, deep breathing, or meditation, or simply take time for yourself.

Avoid stress relievers that can harm kidney health, such as alcohol or caffeinated beverages, especially if used in excess.

Other Lifestyle Management Tips

If you have proteinuria because of IgA nephropathy, you should make it a point to attend every checkup with your doctor and take your medications on time.

Smoking can speed up kidney damage and increase protein in your urine. It also raises your risk of cardiovascular disease. If you smoke and want to protect your kidneys, it’s a good idea to quit.

Join the Conversation

On myIgANteam, people share their experiences with IgAN, get advice, and find support from others who understand.

Which strategies have you used to reduce protein levels in your urine? Let others know in the comments below.