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Proteinuria, or high levels of protein in the urine, is one of the main signs of immunoglobulin A nephropathy (IgAN). Damage to your kidneys’ filtering systems can cause protein to leak into your urine, and sometimes blood as well. These signs can give doctors important clues that your kidney disease may be progressing.
Although IgAN can’t be cured, lowering the amount of protein in your urine can help slow down IgAN progression. Keeping protein levels low is a good sign that your IgAN treatment plan is working. You can take steps to reduce protein in your urine both on your own and with help from your nephrologist.
In this article, we’ll talk about evidence-based strategies for how to reduce protein in urine, including medical treatments and daily lifestyle tips you can use at home.
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Research shows that consistently high levels of protein in the urine are linked to worse outcomes for people living with IgAN. 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.
Inflammation and damage to your glomeruli (kidneys’ filters) can cause proteins to leak into your urine. Protein leaking into your urine can contribute to further kidney damage over time. Reducing protein in your urine helps protect these filters and supports your kidneys’ ability to remove waste from your blood.
High levels of protein in your urine don’t always cause symptoms. In fact, the only way to know for sure is by taking a urine protein test. Still, some people may notice signs of protein in their urine. These can include:
If you don’t take steps to lower protein in your urine, persistent proteinuria can lead to more than just kidney problems. Proteinuria is also associated with a higher risk of serious cardiovascular (heart and blood vessel) diseases, including:
Doctors prescribe several medications 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. Taking your medications as prescribed is one of the most effective ways to help protect your kidneys and prevent long-term damage.
Several newer medications can help people with primary IgAN 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.
Your doctor may prescribe ACE inhibitors as an initial 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 (ARBs) work similarly 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 IgAN.
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 2. This form of angiotensin raises blood pressure by tightening blood vessels and making the body hold on to more fluid. By blocking angiotensin 2 from attaching to its receptors, ARBs help blood vessels stay relaxed and lower blood pressure.
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 IgAN.
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.
If you have proteinuria because of IgAN, attend your regular checkups, pay attention to the results of your urine tests, and take your medications as prescribed.
Your nephrologist can help you find safe ways to lower protein in your urine and slow the progression of IgAN.
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Hello. My name is Ed Marshall. I began doing Dialysis about 12 years ago. What I was wondering is, if anybody knows if these new treatments would benefit me now?
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