The presence of protein in the urine is never normal (when the amount exceeds 150 mg per day, the doctor informs you that it is abnormal). There may be occasional circumstances where their level is high and in this case the problem resolves itself; however, if the situation is constant or particularly severe, you should see your doctor for treatment. When the proteinuria persists for more than a few days, it is often an indication of some underlying kidney disease or other disorder.
Steps
Part 1 of 2: with Lifestyle Changes and Medical Care
Step 1. Take steps to lower your blood pressure
Make lifestyle changes to alleviate this disorder; here are some examples:
- Reduce your salt intake; For example, avoid putting too much on the dishes you prepare at home. Perhaps it is even more important to try not to eat too many times in restaurants or consume an excessive amount of industrially processed foods, as they are known to have a high salt content (on average much more than what you put in home cooked dishes).
- Reduce cholesterol; its accumulation can contribute to the formation of plaques in the arteries, which in turn create problems with hypertension. Ask your doctor for a blood test to measure fat and cholesterol levels to see if you need to improve your diet.
Note:
Hypertension puts a lot of strain on the kidneys, and since persistent proteinuria (high protein levels in the urine) is almost always associated with a kidney problem, lowering blood pressure can significantly alleviate the problem.
Step 2. Take medication to regulate blood pressure
Basically, the doctor prescribes blood pressure medicines to anyone suffering from kidney disease or dysfunction (which is the primary cause of a high and persistent amount of protein in the urine). In particular, the first-line products for this problem are ACE inhibitors (angiotensin converting enzyme inhibitors); among these are ramipril, captopril and lisinopril. These blood pressure medications are also beneficial for the kidneys, as they have a "protective" action.
- Ask your doctor to prescribe them if you are not already taking them.
- For severe kidney disease, you may need to take more than one blood pressure medication.
Step 3. Ask your doctor about other drug therapies
For example, if you have an autoimmune disease that causes kidney disease (and therefore the presence of protein in the urine), you may need medicines to suppress the immune system. If your kidney problem and proteinuria are a complication of diabetes, you need to take medications, such as metformin and insulin, to better control your daily blood sugar. There are several pathologies that can lead to kidney problems and consequently to the presence of proteins in the urine, so you must contact your doctor to find the best drug treatment for your specific case.
Part 2 of 2: Evaluate the Cause
Step 1. Define the cause
Keep in mind that the only way to reduce (or treat) this is to diagnose the underlying cause. This is because proteinuria is not a disease per se, but a symptom that indicates some other problem; only by diagnosing and treating the latter can the high protein level be better treated and managed.
Step 2. Define the type of proteinuria that is afflicting you
There are three types of this disorder, but the good news is that two out of three do not require treatment and over time they resolve themselves; however, for the third type, more in-depth medical evaluations are needed to establish the underlying cause. Here are what they are:
- Transient proteinuriaIn this case, the urine test reveals an occasional high level of protein which reduces on its own and returns to standard levels on subsequent checks. Usually, this form is associated with acute stress, such as an illness that causes fever or more exercise than usual (for example, training for a marathon). Once physical stress is relieved or the body adjusts to it, proteins return to normal.
- Orthostatic proteinuria: develops when high protein levels are associated with postural changes (from standing to sitting or lying down); it is a rather unusual form and occurs more frequently in adolescents. When it develops, no treatment is needed and it almost always resolves on its own in adulthood.
- Persistent proteinuria: occurs when protein levels in urine remain elevated over multiple runs. This form indicates an underlying problem, such as kidney disease, diabetes, autoimmune disease, or other medical conditions and requires several tests to diagnose the cause, as well as medical treatments.
Step 3. Assess if you are going through a stressful time
As previously stated, if you are currently ill and have a fever, are exercising more than usual or are experiencing some particularly demanding situation, the concentration of protein in your urine may be temporarily elevated. It is therefore important to go to the doctor to repeat the examination after a few days to check if the level has decreased and / or in the hope that it has returned to normal values. If you are suffering from "transient proteinuria", the good thing is that you do not have to undergo any treatment and the values spontaneously return to the standard level within a few days or at most a couple of weeks.
Keep in mind that if you are subjected to particularly stressful factors (such as fever, strenuous exercise, or something else), you should visit your doctor to repeat the tests and make sure there is no more serious problem
Step 4. Request to repeat the test
This is a very important step, as you have to take a series of different measurements to see if the situation improves on its own. Your doctor may prescribe a urine test to be done at the clinic or may ask you to collect a sample at home and take it to the laboratory for analysis. Remember that if you choose to store urine at home, you need to keep it in the refrigerator until you can take it to the lab for testing.
Step 5. Run the blood test
This is another diagnostic test that your doctor may prescribe for you, especially if you suspect any underlying kidney disease or other health problems. In this case, he probably wants to know the urea nitrogen index (BUN) and creatinine values; both of these tests evaluate kidney functions and provide the doctor with information about the health of these organs.
- Your doctor may also order additional blood tests, such as glycated hemoglobin to check for diabetes or, if you are concerned there may be an autoimmune problem, autoantibody.
- This all depends on your medical history and the health conditions that your doctor believes may put you at greater risk of suffering from this disorder.
Step 6. Get a kidney biopsy
In some cases, this test is required as a further test to understand the cause of the presence of the proteins in the urine. This is a rarer procedure, but it may be necessary if the doctor is unable to define the etiology in another way.
Step 7. Know that the presence of protein in urine during pregnancy is another matter entirely
If you are currently pregnant and your protein level is high, gestosis could be the cause. Read this link if you want to learn more about preeclampsia and a high level of protein in the urine during gestation.
