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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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 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.
Lowering urine protein levels may help delay or even prevent kidney failure, a complication that affects about 25 percent of adults with IgAN.
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.
Signs of High Protein Levels in Urine
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:
- 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
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:
- Heart attack
- Stroke
- Heart failure (when the heart has trouble pumping blood effectively)
Medical Treatments for Lowering Protein in Urine
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.
Following your treatment plan and taking medications exactly as prescribed 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 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.
- Atrasentan (Vanrafia) — Atrasentan blocks endothelin receptors, helping to reduce pressure inside the glomeruli. In clinical trials, atrasentan reduced proteinuria by over 36 percent.
- 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. In clinical trials, budesonide lowered the urine protein-to-creatinine ratio (UPCR) by an average of 34 percent in participants with IgAN.
- Iptacopan (Fabhalta) — This medication targets complement factor B (part of an overactive immune pathway involved in IgAN) to help reduce inflammation and protein leakage. In clinical trials, iptacopan lowered proteinuria by 44 percent over nine months.
- Sibeprenlimab-szsi (Voyxact) — This monoclonal antibody helps prevent the immune system from creating harmful IgA deposits. Participants in clinical trials saw an over 50 percent reduction in proteinuria over nine months.
- Sparsentan (Filspari) — 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. Over nine months in clinical trials, sparsentan lowered proteinuria by 45 percent on average.
ACE Inhibitors
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
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 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 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.
How To Reduce Protein in Urine Naturally
Along with taking medication, research suggests that some daily habits can 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. They might refer you to a dietitian who can help you decide what to eat and what to avoid. A consistent kidney-friendly diet can help your kidneys leak less protein into your urine.
Keeping 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 IgAN 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 — may be better for 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 level of 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 physical activity 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 taking quiet time for yourself.
Some substances can harm kidney health, such as alcohol or caffeinated beverages. This is especially true if they’re used in excess.
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.
Talk to Your Doctor
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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