What should I do if I have proteinuria? This article will teach you how to solve it

Proteinuria is the most common manifestation of kidney disease. Although in most cases, patients do not have any symptoms when they have proteinuria, many people still feel panic and worry when they are diagnosed with proteinuria. Therefore, it is more important to know what to do when proteinuria occurs.

After proteinuria occurs, it is necessary to first conduct a qualitative and quantitative diagnosis of the proteinuria and perform some related auxiliary examinations to clarify the cause of proteinuria, and then take appropriate measures according to the different causes.

Classification of proteinuria

According to the cause, proteinuria is divided into physiological proteinuria and pathological proteinuria.

Physiological proteinuria is also called functional proteinuria. It refers to temporary proteinuria that occurs in healthy people. It is caused by stressful conditions such as strenuous exercise, fever, and tension. It is more common in adolescents. The urine protein in qualitative tests is usually no more than (+). Normal pregnant women may have a slight increase in protein in their urine, which is related to increased body position, increased renal flow, and increased glomerular filtration rate. When the inducement is removed, physiological proteinuria will disappear on its own, so it is also called reversible proteinuria or transient proteinuria.

Pathological proteinuria is often seen in various renal or other systemic diseases that affect the kidneys. The common types of proteinuria include glomerular proteinuria, tubular proteinuria, overflow proteinuria and tissue proteinuria. The treatment principles for this type of proteinuria need to be based on the specific cause. Patients can go to the nephrology department or the corresponding internal medicine department for treatment, and a renal puncture biopsy should be performed if necessary.

Specific treatments

1. Physiological proteinuria does not require treatment. After the cause is removed, it can be gradually relieved over time. However, pathological proteinuria can be treated with individualized treatment methods depending on the cause and degree.

2. Dietary treatment: To prevent excessive protein from leaking out of the urine and causing vacuolar degeneration of the renal tubules, animal protein (high-quality protein) that is easily absorbed and utilized should be consumed.

3. Treatment of primary disease: The primary disease should be actively treated for various secondary proteinuria, such as controlling blood sugar, infection, hypertension, anti-allergic treatment, etc.

4. Treatment with angiotensin-converting enzyme inhibitors (ACEI) and angiotensin II receptor blockers (ARB).

5. Hormone therapy: The effect of glucocorticoids on reducing urine protein may be closely related to the immunosuppressive and anti-inflammatory mechanisms. The time when glucocorticoids take effect in patients needs to take into account individual differences, the patient's responsiveness to the drug, the pathological type, etc.

6. Cytotoxic drug therapy: Often used together with hormones, it can reduce the course and dosage of hormones and reduce the occurrence of adverse hormone reactions. It can affect different links of biosynthesis, hinder cell division and proliferation, inhibit immune response, and thus reduce proteinuria. It is mainly used to treat nephrotic syndrome and lupus nephritis.

7. Treatment with traditional Chinese medicine: Tripterygium wilfordii can change the charge state of the glomerular basement membrane, and has immunomodulatory and anti-inflammatory effects, thereby preventing protein filtration.

8. Other treatments: Anticoagulant and lipid-lowering therapy have certain effects on controlling proteinuria.

In addition to the above introduction, patients should also note that if physiological proteinuria is detected, they must insist on follow-up of urine routine, urine protein quantification and other indicators; if pathological proteinuria is detected, treatment should be carried out under the guidance of a professional nephrologist.