Lowering Proteinuria

Proteinuria, or the presence of excess protein in the urine, is a common sign of kidney disease. If you've been diagnosed with proteinuria, you might wonder what it means, why it is important and how to reduce it. This guide will help you understand proteinuria and provide actionable tips to lower it, helping protect your kidney health.

What is Proteinuria?

Proteinuria occurs when the tiny filtering units in the kidneys, called glomeruli, are damaged and leak protein into the urine instead of keeping it in the bloodstream.

The most common protein found in urine is albumin. Very little protein passes into the urine normally, so when levels are high, it can be a sign of kidney damage or stress.

Why is Lowering Proteinuria Important?

High levels of protein in the urine can worsen kidney function over time and lead to chronic kidney disease (CKD) progression. By lowering proteinuria, you can:

• Slow down kidney damage.

• Reduce the risk of kidney failure.

• Improve overall kidney health 

Ways to Lower Proteinuria

1. Control Blood Pressure

High blood pressure is one of the leading causes of proteinuria and kidney damage. Keeping your blood pressure in a healthy range can significantly reduce protein leakage.

• Target blood pressure: Aim for BP less than 130/80 mmHg (or as advised by your doctor).

• Medications: ACE inhibitors (like lisinopril) and ARBs (like losartan) are commonly prescribed to lower blood pressure and reduce proteinuria. These medications help relax the blood vessels in the kidneys and reduce protein leakage.

2. Manage Blood Sugar Levels

If you have diabetes, high blood sugar can damage the kidneys over time. Keeping your blood sugar levels under control is essential for preventing and reducing proteinuria.

• Target HbA1c: Aim for an HbA1c level below 7% (or as recommended by your doctor).

• Diet and medication: Work with your healthcare team to create a plan that includes a balanced diet, regular exercise, and medications if needed.

3. Adopt a Kidney-Friendly Diet

What you eat plays a significant role in kidney health. A kidney-friendly diet can help reduce proteinuria by lowering kidney workload and improving blood pressure.

• Reduce salt intake: High salt intake can increase blood pressure and worsen proteinuria. Aim for less than 2,300 mg of sodium per day.

• Choose healthy protein sources: Too much dietary protein can stress the kidneys. Switch to plant-based protein sources (like beans, lentils, and tofu) or opt for lean proteins (like fish and chicken) in moderation.

• Limit processed foods: Processed foods often contain high sodium levels and unhealthy fats.

• Increase fruits and vegetables: These provide essential nutrients and help maintain a healthy blood pressure.

4. Maintain a Healthy Weight

Being overweight or obese can increase your risk of developing high blood pressure and diabetes, both of which can contribute to proteinuria. Losing even a small amount of weight can help reduce proteinuria.

• Exercise regularly: Aim for at least 150 minutes of moderate-intensity weekly exercise.

• Set realistic goals: Gradual, sustainable weight loss is more effective than quick fixes.

5. Stay Hydrated

Proper hydration helps your kidneys function better. However, if you have advanced kidney disease, you may need to limit your fluid intake. Talk to your doctor about how much water you should be drinking daily.

6. Avoid NSAIDs and Other Harmful Medications

Non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen and naproxen, can worsen kidney function and increase proteinuria. Avoid these medications unless specifically approved by your doctor.

7. Monitor Proteinuria Regularly

Regular doctor visits and urine tests can help track your protein levels. Early detection of worsening proteinuria allows for timely adjustments in your treatment plan.

• Urine protein-to-creatinine ratio (UPCR): This test measures the amount of protein in urine compared to creatinine. It's commonly used to monitor proteinuria.

• 24-hour urine test: Sometimes, your doctor may request a 24-hour urine collection to get a more accurate measure of protein loss.

8. Manage Stress

Chronic stress can contribute to high blood pressure and poor blood sugar control, worsening proteinuria. Finding ways to manage stress can positively impact your kidney health.

• Relaxation techniques: Try mindfulness, meditation, or yoga.

• Sleep well: Aim for 7-8 hours each night to allow your body to repair and recover.

Medications That Help Lower Proteinuria

Several medications can help reduce proteinuria and protect your kidneys:

1. ACE Inhibitors: These lower blood pressure and reduce protein leakage by relaxing the blood vessels in your kidneys.

2. ARBs (Angiotensin II Receptor Blockers): Like ACE inhibitors, ARBs help reduce proteinuria by protecting the kidney's blood vessels.

3. SGLT2 Inhibitors: Originally developed for diabetes, these medications (like empagliflozin and dapagliflozin) have lowered proteinuria and slowed CKD progression.

4. Aldosterone Antagonists: These may be added to treatment if proteinuria remains high despite other medications.

Questions to Ask Your Doctor

To better understand and manage proteinuria, you can ask your doctor the following questions:

1. What is the cause of my proteinuria?

2. How much protein is in my urine, and what is the target level?

3. What medications should I take to lower proteinuria?

4. Should I make any changes to my diet or lifestyle?

5. How often should I monitor my protein levels?

Takeaway

Lowering proteinuria is a key step in protecting your kidneys and slowing down the progression of kidney disease. You can reduce protein leakage and improve your overall health by controlling blood pressure, managing blood sugar, adopting a healthy lifestyle, and taking prescribed medications.

Remember, your healthcare team is there to support you, so don't hesitate to ask questions and seek guidance. Small changes in your daily routine can make a big difference in managing proteinuria and preserving kidney function.