How to Manage Proteinuria

Rebekah Kuschmider
Rebekah Kuschmider
January 17, 2023
min read
Medically reviewed by:
Trager Hintze, PharmD
How to Manage Proteinuria

Excess protein in your urine, sometimes called proteinuria, is a sign that your kidneys are not working properly. Kidneys are supposed to filter waste materials out of your bloodstream so you can excrete them as urine.

The kidneys also return helpful substances, such as microalbumin, or blood protein, to your bloodstream so your body can use them. These proteins are used for functions like muscle development, wound healing, and immune system functions. At times, the filters in the kidneys allow protein to leak into your urine instead of staying in your bloodstream. This is one of the first early signs of kidney disease, so if you are at risk for kidney-related health concerns, testing for protein in your urine can help you identify health problems before they become serious.

Causes of Proteinuria

In some cases, high protein levels in the urine can signal a serious health condition. Kidney disease, fatty kidney, diabetes, high blood pressure, heart disease, and certain cancers can lead to proteinuria1.

You can also develop excess protein in the urine due to temporary conditions. When those arise, you can make changes to your lifestyle to fix the problem. Temporary causes of protein in urine include1:

  • Pregnancy
  • High fever
  • Dehydration
  • Strenuous exercise
  • Prolong exposure to extremely cold temperatures

Learn about causes and symptoms of proteinuria in this related blog.

If you have excess protein in your urine, it’s important to see your doctor to determine the underlying cause. Your doctor will help you develop a treatment plan for any significant health conditions you have. In addition, you can ask your doctor how to reduce urine microalbumin through diet and lifestyle changes.

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Seven Ways to Remove Excess Protein From Your Urine

A small amount of protein in your urine is normal and will usually improve over time1. Too much protein or proteinuria that lasts a long time can be a sign of kidney problems, though. Figuring out the best method for decreasing the protein in your urine can be overwhelming. However, there are a few simple lifestyle and diet changes that can help.

In order to manage proteinuria you need to monitor your blood pressure, exercise regularly, reduce stress, limit phosphorus intake, consider medication options, and regularly monitor kidney function.

1. Reduce Protein Intake

High protein, low carb diets are popular, but too much protein in your diet can cause blood protein to leak into your urine. This becomes even more of a problem if you have diabetes, high blood pressure, or kidney disease2.

There is no clear definition of what constitutes a high-protein diet. However, research suggests that eating 1.68 grams of protein per kilogram of weight daily leads to an increase of protein in the urine2. A recent analysis showed that eating less protein or adopting a low-protein diet can significantly decrease protein in your urine3.  

The recommended daily protein intake is 0.8 g/kg, roughly 56 grams for adult males and 46 grams for adult females4. If you eat more than the recommended amount, lowering it may help your proteinuria.

However, eating less than the recommended amount may lead to malnutrition. It’s vital to work with your doctor to find your optimal protein intake.

Protein rich diets can lead to proteinuria, especially for those with underlying health conditions. However, consulting with a doctor is essential to determine the optimal protein intake to avoid malnutrition and manage the condition.

2. Limit Salt Intake

High salt intake is a major cause of high blood pressure and kidney damage, which can lead to increased protein in the urine5. A study comparing a low-salt diet to a high-salt diet found that those who consumed more salt had lowered kidney filtration and higher protein output6. A higher salt intake also raises blood pressure, which negatively affects urine protein5.

Other data indicate that lowering salt intake from 10 grams to 5 grams daily reduces proteinuria. In fact, the 2020-2025 dietary guidelines recommend an even lower salt intake, suggesting you get less than 2.3 grams daily4.

Reducing salt intake is crucial for managing proteinuria, as it helps lower blood pressure, prevents kidney damage, and reduces the excretion of protein in urine.

3. Check Your Blood Sugar

Diabetes and long-term high blood sugar are the leading causes of chronic kidney problems7. The high blood sugars damage the blood vessels that help filter proteins in your kidneys, leading to protein in the urine8.

Managing your blood sugar is essential for kidney health, as tight glucose control significantly reduces protein in the urine, including tiny amounts called microalbuminuria.

There are a few simple tips for how to reduce urine microalbumin, including:

  • Monitor your blood sugar and urine protein regularly
  • Take your insulin or diabetes medication as prescribed
  • Follow your diet and exercise plan
Diabetes and high blood sugar damage kidney function, causing proteinuria. Regular monitoring, adherence to medication, diet, and exercise help maintain protein and reduce microalbuminuria.

4. Eat More Fiber

Fiber is an indigestible carbohydrate found in fruits, vegetables, and many other foods. Fiber stays in your gut longer than other carbohydrates, which regulates blood sugar and helps lower protein in your urine10.

A fiber-rich diet with fruits, vegetables, whole grains, nuts, seeds, and legumes helps regulate blood sugar and reduce proteinuria.

Studies show that a vegetarian diet high in vegetables and fiber and low in animal protein lowered urine protein in patients with diabetes11. Try adding more fiber-rich foods to your diet, including:

  • Whole grains
  • Nuts
  • Seeds
  • Legumes
  • Fruits
  • Vegetables

5. Exercise

You may notice proteinuria after intense exercise, such as running a marathon. This type of temporary proteinuria is normal and returns to normal within a few hours. It is usually caused by muscle damage or dehydration, or because your body focused on salt and water reabsorption instead of filtering proteins12.

However, lower-intensity exercise can also help lower protein in your urine. A 2010 review looked at 13 studies on patients with obesity and kidney disease and compared the effect of weight loss strategies on proteinuria. Exercise was found to decrease protein output in the urine by 49%13. Another study found that swimming for 30 mins twice a week for three months significantly reduced urine protein in patients with chronic kidney disease14.

Intense exercise can lead to temporary proteinuria due to factors like muscle damage and dehydration. However, lower-intensity exercise has been found to effectively reduce proteinuria in various studies.

6. Stop Smoking

Smoking is a high-risk factor for proteinuria and chronic kidney disease, especially if you also have diabetes, high blood pressure, or other kidney diseases.

In a six-year study, researchers compared the risk of kidney disease and urine protein in smokers and those who quit. The group that quit smoking had a 50% decrease in risk of proteinuria compared to those who continued15.

Smoking increases the risk of proteinuria and chronic kidney disease, particularly in individuals with diabetes and high blood pressure. According to a study, quitting smoking can reduce the risk of proteinuria by 50% compared to smokers

7. Avoid Certain Medications

Certain medications can affect your kidney health and cause proteinuria. Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, aspirin, and naproxen, and prescription NSAIDs can cause sudden kidney damage or injury and high protein output16.

NSAIDs may be a problem if you have high blood pressure, are an older adult, or already have poor kidney function or kidney disease16. Avoiding these medications can help you lower your urine protein.

NSAIDs (e.g., ibuprofen, aspirin, naproxen) can cause kidney damage, high protein output, and proteinuria. Avoiding these medications helps reduce urine protein levels, especially if you have high blood pressure or existing kidney issues.

Protein In Urine While Pregnant

Protein in your urine during pregnancy can be a sign of preeclampsia. Preeclampsia is a serious condition that occurs during pregnancy and involves physical symptoms such as high blood pressure and proteinuria. If you have a history of preeclampsia or suspect you have protein in your urine, you should speak to your doctor immediately. They will tell you the best way to manage your health during your pregnancy. Proteinuria related to pregnancy usually goes away after the baby is born2.

Urinalysis test strips can help to detect protein levels in the urine.

Test Strips For Protein In Your Urine

Protein in the urine doesn’t always cause symptoms, so testing is the only way to conclusively diagnose proteinuria. At-home urine protein test strips can detect changes in protein levels and also detect nephrotic range proteinuria, which is indicated by greater than or equal to 3 g/L of protein in the urine. On a urine protein dipstick, it is semi-quantitatively indicated by three or more plus signs (e.g., +++). The reagent pad on test strips for protein in urine produces a light green color for trace or level 1 protein and a dark green color when excess protein is detected. A 24-hour urine collection is recommended to ascertain the diagnosis of nephrotic syndrome. The urine protein to creatinine ratio should also be considered a diagnostic marker for nephrotic syndrome. You can use the results from home testing to talk to your doctor and develop a long-term plan to safeguard your health.

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  3. H, Yue, P, Zhou, Z, Xu, L, Liu, A, Zong, B, Qiu, M, Jia, F, Du, T, Xu, “Effect of Low-protein Diet on Kidney Function and Nutrition in Nephropathy: A Systematic Review and Meta-analysis of Randomized Controlled Trials,” Clinical Nutrition, vol. 39, no 9, pp. 2675-2685, 2020. [Accessed June 7, 2023].
  4. USDA Staff, “Dietary Guidelines for Americans 2020 - 2025,” United States Department of Agriculture, Available Online here. [Accessed June 7, 2023].
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  6. B, Cianciaruso, V, Bellizzi, R, Minutolo, A, Tavera, A, Capuano, G, Conte, L, De Nicola, “Salt Intake and Renal Outcome in Patients With Progressive Renal Disease,” Mineral and Electrolyte Metabolism, vol 24, no 4, pp 296-301, 1998. [Accessed June 7, 2023].
  7. M, Furukawa, T, Onoue, K, Kato, T, Wada, Y, Shinohara, F, Kinoshita, M, Goto, H, Arima, K, Tsushita, “Prediabetes is Associated With Proteinuria Development but not With Glomerular Filtration Rate Decline: A Longitudinal Observational Study,” Diabetic Medicine, vol 38, no 8, 2021. [Accessed June 7, 2023].
  8. C, Tripliit, “Understanding the Kidneys' Role in Blood Glucose Regulation,” American Journal of Managed Care, vol 8, no 1, 2012. [Accessed June 7, 2023].
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About the Author
Rebekah Kuschmider

Rebekah has been writing about culture, health, and politics since 2010. She has a masters degree in Arts Policy and Administration from The Ohio State University. Her work has been seen at WebMD, The Candidly, MedicineNet, YourTango, Ravishly, Babble, Scary Mommy, Salon, Role Reboot, The Good Men Project, SheSaid, Huffington Post, and Mamamia. She is a former cohost of the weekly podcast The More Perfect Union. Rebekah lives in Maryland with her husband, two kids, and a dog who sheds a lot.

About the Reviewer
This blog was
Medically reviewed by:
Trager Hintze, PharmD

Trager Hintze is a clinical assistant professor and emergency medicine clinical pharmacist located in College Station, Texas. He has a bachelor's degree in biology as well as a Doctor of Pharmacy degree. He balances teaching at Texas A&M University College of Pharmacy and practicing emergency medicine at St. Joseph Regional Health Hospital.

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