14 August, 2017
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- National Institutes of Diabetes, Digestive and Kidney Diseases: Proteinuria
- Mayoclinic.com: Proteinuria
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How to Reduce Excess Protein in the Kidney
Kidney patients often have high levels of urine protein because their kidneys spill this molecule into the urine. Known as proteinuria, this condition is a red flag for kidney disease. Proteinuria is particularly troublesome because the very act of filtering proteins reduces kidney function over months and years. Therefore, it is desirable for kidney patients reduce the amount of protein spilled by their kidneys.
Monitor your urine protein for several months. Many patients have routine labs every month or every quarter. Different techniques include the 24-hour urine test, the protein:creatinine test and the dipstick. See what technique your nephrologist prefers and why.
Continue monitoring how much protein your kidneys are spilling for several months. Since colds and infections can cause transient increases in protein, you will want at least several months of data.
Take an angiotensin converting enzyme inhibitor if your nephrologist thinks its appropriate. Angiotensin converting enzyme inhibitors are also called an ACE inhibitors. ACE inhibitors are normally given to lower blood pressure. However, in many instances they are given to kidney patients, regardless of blood pressure issues, because they lower urine protein. ACE inhibitors are generally well tolerated by most patients. In many instances, they are all that is needed to reduce excess protein.
Lower your dietary protein if your nephrologist thinks this is advisable. Restricting protein used to be a universally accepted way to treat proteinuria. However, this no longer is standard advice for kidney patients. Different nephrologists have different opinions on this matter.
Take a stronger drug such as prednisone if your nephrologist thinks it is appropriate. The Mayo Clinic suggests that prednisone reduce inflammation, which in turn reduces proteinuria. While not without side effects, a course of prednisone can be very effective in eliminating proteinuria altogether. Some doctors like to use a very high intravenous dose whereas others prefer oral doses every other day. Some patients start with a short course of intravenous treatments, followed by oral doses.
Evaluate other options. Work closely with your nephrologist because he can help you balance the risk of proteinuria against the risk of taking a particular drug.
Protein restriction should never be undertaken without the advice of your nephrologist because it can be harmful. For example, patients with end stage kidney disease are usually malnourished and need all the protein they can get. Likewise, growing children should never be deprived of protein regardless of the state of their kidneys.
Regardless what approach your doctor prescribes, be sure to follow instructions very closely and do not abruptly discontinue taking any drug.
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