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How to Control Proteinuria in Chronic Kidney Disease

Know more on How to Control Proteinuria in Chronic Kidney Disease, how to reduce proteinuria naturally, proteinuria diet, proteinuria symptoms, how to prevent kidney failure and control persistent proteinuria.

Proteinuria is said to be a marker for chronic kidney disease.  Here are some ways you can control Proteinuria in chronic kidney disease. CKD progression is directly proportional to higher amount of proteinuria. Patients with more than 0.5 g/day spilling proteinuria  is said to have less chance to control in Chronic Kidney Disease. Clinical predictors of a worse outcome of CKD is protenuria above 1g, hypertension and low GFR. You can read more about antiproteinuric therapy.

Proteinuria symptoms and prevent kidney failure

Chronic Kidney disease can be caused by many factors. It is important to control proteinuria. In a recent study titled "Proteinuria as a modifiable risk factor for the progression of non-diabetic renal disease" analysed 1860 patients enrolled in 11 randomized controlled trials. Patients who were taking ACE inhibitors were compared with non takers. The ACE inhibitor group had greater reduction in proteinuria but there was no significant interaction between the beneficial effect of ACE inhibitors and the baseline level of urine protein excretion.

Though in many cases there is no cure for this disease, the condition can be controlled. There are many prospective and retrospective studies which studied the relationship between proteinuria and ckd progression. Higher proteinuria has been linked to faster decline in GFR. Here is a diagram that shows the correlation between protenuria and GFR.

How to Control Proteinuria in Chronic Kidney Disease

Types of proteinuria

Transient proteinuria

It is caused by variations in the environment, heavy excercise, being in very cold climate, extreme stress.

Orthostatic Proteinuria

It means an increased amount of protein is pilled when the person is in the upright position.

Microalbuminuria 

It means low levels of albumin are detected in the urine throught Urine test.

Proteinuria can be tested using dip stick or 24 hour urine collection. 24 hour urine collection is said to be the best method.

1. Manage Blood Pressure to control persistent proteinuria

High blood pressure is said to increase renal pressure and thereby create proteinuria.  By having low pressure the force of the blood flow is less and therefore the proteins are not pushed through the open glomerulus. Body functions requires a minimal of 80/40 to function. Below that is not good.

Beta blockers like Nebiday, ACE inhibitors such as ramipril, enalapril, ARBs such as losartan and calcium channel blockers such as Cilacar is used to control blood pressure. Antihypertensive therapy is one of the used method in controlling CKD progression. Calcium channel blockers and Beta Blockers are not that effective in proteinuric nephropathies. CCBs are used when BP reductions cannot be achieved with other agents.

2. Corticosteroids 

The main treatment method to treat IgA is to use certain corticosteriods such as prednisone, hydrocortisone, and methylprednisolone. These reduce the immunity of the body thereby reducing inflammation. Before that we all know that inflammation is a way of the body to get rid of potential bacteria and viruses. So if there is a bacteria or a virus infect our body, our immune system attacks them using certain cytokines.

These cytokines creates inflammation in the body to kill these viruses. Sometimes the body mistakenly recognize pollens, dust and mites as a potential threat and creates inflammation in the body. This is called Allergy. When body recognize its own cells as a threat, it creates inflammation in the body to kill our own cell. This is called Auto Immune Diseases.

Corticosteriods, IgA and Cytokines

Cytokines such as interferon, interleukin, and growth factors travels in blood and reach kidney and damage kidney. Immunoglobulin G (IgG), IgA antibodies in blood and other body fluids protects against bacterial and viral infections.They form immune complexes which reaches kidney. This damage in the filters in the kidney creates proteinuria. Corticosteriods suppress the immune system and thereby suppress inflammation. Less cytokines are produced by the body hence protect the kidney from further damage and reduce proteinuria.

Classification of Chronic Kidney Disease using GFR and ACR categories

proteinuria symptoms, Classification of Chronic Kidney Disease using GFR and ACR categories


People affected with Hodgkin Lymphoma and Non HL shows proteinuria or nephrotic syndrome. This is because cancerous lymphoma cells in the body multiply more and produce more cytokines and they end up in blood. Chemotherapy and radiations are needed to remove these cells from body and reduce the cytokines. Further steroids treatment might be needed to suppress the immune system to completely reduce proteinuria.

3. Remove Allergenic Foods  - proteinuria diet

Many steroid dependent patients are assessed with food allergies. An oligoantigenic diet was prescribed to many which excluded gluten, diary especially in patients with immune-related conditions, i.e., celiac disease and nephrotic syndrome. The proteinuria was decreased in many but the reasons for that still remains unknown.

4. Plant based diet to reduce proteinuria naturally

Plant based diet is a good way to reduce creatinine level and proteinuria. Many have tried to limit the protein intake through plant based diet which in turn reduced proteinuria. It has been found effective in reducing the progression of kidney disease as well. No Gluten, No Diary, Less Salt, No Added Sugar, No Alcohol, No Animal products - Cut red meat, poultry and No carbonated drinks - dark soda is a good way to start the diet.

5. Hydration to control persistent proteinuria

Hydration is very important in the case of proteinuria. Many kidney patients drink less water than they are prescribed. Dehydration creates many  body changes including blood pressure variation and protenuria.

6. Probiotics and proteinuria diet

Probiotics are linked to enhancing gut microbes and gut balance. Probiotics kills harmful bacteria and reduce the toxic materials in the stomach. Proteinuris is said to be reduced the use of probiotics.

7. Fish oil to control persistent proteinuria

Fish oil is said to reduce the triglycerides level. This will give kidney more time to rest and thins the blood. Many IgA patients are prescribed  - 1-12 mg fish oil by the nephrologist.

8. Moderate Exercise to manage persistent proteinuria

If you go to a gym, lighter resistance/free weights to stretch out muscles but simply walking at max incline on a treadmill is the easiest way to burn calories, more so than running.

9. Weight Loss and Less Protein Intake to reduce proteinuria naturally

Weight loss has been associated reduced creatinine levels and reduce proteinuria. Power lifters and athletes often take protein powders to bulk up and to sustain the energy levels. This must be avoided as more protein intake will create higher amount of proteinuria.

10. Quit Smoking

Smoking builds up more waste in the blood and gives you so many health problems.

11. Manage Stress to reduce proteinuria

Stress has been linked to the increase in protenuria and it is important to control stress and anxiety. Many patients with chronic kidney disease has reported to have high level of health anxiety and stress. High anxiety will increase cortisol level in the blood and is linked with high blood pressure.

The bottom line is it's best to get the guidelines from your nephrologist because everyone's body reacts differently and it's best to get a professional opinion from the individual who's keeping track of your health.