Proteinuria: How long can it be controled?

[RoxanneKidney]

If we have proteinuria and lower it with bp meds, what is the average rate that it comes back? Can it stay down indefinately? In a 24 hr urine test it dropped from 569 total to 115 after taking 2.5 mg of lisinopril for a month. I have stage 3a CKD. and I'm 56. I eat low protein and low salt. Mostly vegan. Thanks!

[userotc]

According to the link below, proteinuria can stay away indefinitely with proper management. We are aiming for that with my 65-yr old mum with natural treatment via diet, supplements and wellbeing at least initially as we are generally anti-drugs. Her latest 24h level is 280mg but increasing fast although her nephro appears unconcerned since her serum data are good and consistently increasing. Technically she's also stage 3a with latest eGFR 59ml/min.

Her total protein is 0.15g/l - what's yours?

healthcheckup.com/general/p...

[RoxanneKidney in reply to userotc]

That is good to know. This lisinopril has my bp really low. Like 96/60. But it is not making me dizzy or anything.

[userotc in reply to RoxanneKidney]

Ok but it's close to dizziness levels. Mum's BP has been stable at ~123/75 for a while (no meds). What's your total urinary protein level?

[RoxanneKidney in reply to userotc]

My total was 115 in the 24 hr sample. Down from 569...

[userotc in reply to RoxanneKidney]

Yes I realised that but I didn't mean the 24h data but total. See mum's figures yesterday showing both.

[RoxanneKidney in reply to userotc]

Sorry, I am not following your question. Do you mean both in urine and blood? The second time, my blood wasn't tested from protein, but the first time it was one or two numbers below the low normal. I'm sure it is higher now because i'm not dragging my ass.

[userotc in reply to RoxanneKidney]

No Im only referring to urine test results. Mum has total protein (g/l) measured and also 24h urine protein output (g/24h).

[RoxanneKidney in reply to userotc]

On this one only 115 mg/24hrs etc. Are you in another country besides the USA?

[userotc in reply to RoxanneKidney]

Yes UK but we are normally lagging behind US not ahead!!

[runningjohanna]

Hi I have similar situation re. Proteinuria and take perendopril to control what is already low BP. I am similar kidney desease too and age. I’m convinced that diet is really major in our world which you appear to be aware of. I have no words of wisdom but busy reading articles and kidney diet book by Lee Hull which is quite full on but interesting. Ooh and exercise!

[RoxanneKidney in reply to runningjohanna]

Thanks for that. I am just walking now and really slashing salt.

[Skeptix in reply to RoxanneKidney]

Afaik the reason for reducing salt intake is to lower blood pressure (high pressure being kidney adverse). But if your meds are lowering your BP so much, why the need to be reductory in salt?

BTW, my renal dietician told me that my sodium target was too low - that you need a certain amount and that folk can sometimes go a bit crazy in their attempting to lower salt intake - to the point where it's detrimenal

[RoxanneKidney in reply to Skeptix]

I just notice that my eyelids swell, and fingers when I eat salty foods. That just alarms me. Right not I'm over by Asia, and they like things salty here, so I just stay away.

[Skeptix in reply to RoxanneKidney]

Okay. My own diet (pre going plant based, keto acid etc wasn't particularly salt laden ( now that I think of it). But when told that salt was "bad" I went mad cutting it out. Hence my renal dietician saying I need to increase it.

I recall my mother (Irish) visiting friends in the States and talking of the amount of salt and sugar they consumed. Added by the bucket load was my impression.

You tracking your diet such that you could target x my per day or something?

[RoxanneKidney in reply to Skeptix]

I appear to be salt sensitive.

[Bet117 NKF Ambassador]

Hi RoxanneKidney,

Your question is a good one and deemed for your attending physician; be they a GP, nephrologist or urologist.

I have been there and still am. Proteinuria can go up and down depending on the person, diet, water and specific kidney disease.

I have Membraneous Nephropathy which is an autoimmune kidney disorder which is an inflammation of the glomeruli.

Proteinuria and hematuria are symptoms. Friends from the site have IGAN and Minimal Change Disorder and FSGS; different disease but similar symptoms. You didn't mention your diagnosis.

Lisinopril, an ACE Inhibitor, is one of the most widely prescribed drugs in the US for kidney issues and Ramipril, it's sister drug in the UK. Losartan, an Angiotensin II receptor blocker is also used in the US as a first line drug to try to reduce proteinuria, take pressure off the kidneys and protect them.

Nephrologists consider the 24 hour catch, as annoying as it is, as their gold star marker; as like your A1C, which is an average of your glucose over 3 months; this is an average of urine content over 24 hours as opposed to the cup that you deposit in the office, which measures that moment.

My nephrologist requires a 24 hour catch as he found that the spot urine varied.

I, too, am on a very low dose of lisinopril as my BP is low to low normal.

If you have an autoimmune issue, try to cut down or out foods which cause inflammation as they can initiate spilling.

My pharmacist also gave me a heads up that the statin, Creator, or Rouvastatin, can also initiate proteinuria. I looked it and Lipitor, up on Drugs.com ( App is super) and she was correct.

I have shared my experience and knowledge gained via my nephrologist. Hope it helps.

Bottom line is that everyone is different.

When in doubt, give a call or ask at your next appointment.

Please feel free to PM/ Chat me at anytime if I can be of any help.

Best,

Bet

[RoxanneKidney in reply to Bet117]

I dont have a diagnosis yet. Pretty much have eliminated a lot of things, but have not had the biopsy . Thanks for all of your information. I appreciate that.

[Bet117 NKF Ambassador in reply to RoxanneKidney]

Roxanne,

No thanks ever needed. I am here to support.

It will all work out; this is a process. Elimination is good; less to think about.

In the meantime, keep your sodium intake to 1500- 2000mg daily as the kidneys have a tough time processing it. Eliminate red meats, processed foods which also are high sodium and add more fresh or fresh frozen veggies.

Your doctor will help.

Biopsy will tell the story; happy to see you through it if it comes to that.

Stay strong and safe - please reach out again.

Best,

Bet

[RoxanneKidney in reply to Bet117]

My last 24 hr urine test showed 0.9 mg of protein, so back to normal, I guess. Still sticking to a low proten plant based, low salt diet. I feel that salt is my cuplprit. But considering taking a SGLT-2 inhibitor. But since the Lisinopril seems to be working...I will probably stick with it.

[Skeptix in reply to Bet117]

Good point on the 24hr test. My nephr hasn't called one up in years.

Proteinuria is expressed as weight protein/ albumin per weight urine. Given I've only started hydrating for the first time in 58 years recently, I ought to get an improvement!

Foam-in-toilet went down (visibly)just by eating less protein (supplementing ketos). But now that I'm hydrating it's gotten even less. Time to do a 24 hour to see what the score is I guess

[RoxanneKidney in reply to Skeptix]

And not worrying about it probably helps too. Also salt. I really think I'm salt sentitive. I think I need to pretty much cut it completely and not go over 200 mg a meal.

[RoxanneKidney in reply to Skeptix]

I was checking into ketoanalogues ..any suggestions? Was that you taking them?

[Skeptix in reply to RoxanneKidney]

Yeah, Albutrix (and the associated multivitamin, Microtrix). Typically 4 keto pills a day to give me the equivalent of 20gr dietary protein.

I wasn't managing protein at all before the plant/very low protein/ketoacid diet. So was probably on 100gr dietary(incl plenty of meat) protein a day. Now on around 30gr plant only dietary

No surprise the urea / cholesterol drop. Any ketoacid would give that result I suppose.

[RoxanneKidney in reply to Skeptix]

Thanks! So glad it is working okay for you. I was reading about them and as much as possible, I want to control this bullshit with healthy foods.

[Skeptix in reply to RoxanneKidney]

That would be best, of course. My own diet is so much better than before (even though I didn't ear much absolute rubbish). The variety especially.

But I don't think you can diet your way to a very low protein diet - you'd just waste away. And so keto acids an absolute must

[horsie63]

I just did a 24 hr and my results were flagged as abnormal...the creatinine was 2.42 mg/dl; the creat, urine was 30.95 mg/dl, the creat clear was 14.21 flagged low) and the total creat, urine was 0.5 (flagged low); my creatinine serum was the 2.42 (flagged high). I'm 58, taking losartan, diltiazem, and carvedilol for BP. My biopsy showed the damage was due to high BP that was previously uncontrolled...now it averages 115/84.

[RoxanneKidney]

The low creatinine in the urine is relative to a vegan diet--- It will be lower since you eat less meat. I have a feeling mine is due to the same thing.

[RoxanneKidney in reply to RoxanneKidney]

I mean my ckd

[milo_miller]

Hi Roxanne, have you definitively recovered from proteinuria or is it still fluctuating a year later?

[RoxanneKidney in reply to milo_miller]

It increased some ...taking 5 MG of Lisinopril daily. Will get blood test again soon to see if that helped.

[Cobalt2sister in reply to RoxanneKidney]

Hi...was just reading all the posts from 2 yrs ago, and now 5 months ago on the proteinuria journey. I'm on losartan 50 mg and went off crestor about a month ago. I didn't realize it was bad for proteinuria. They took me off it because of terrible muscle pain. Proteinuria much better now. My GFR which was down to 30s and 40s now up to 57/60... Kidney biopsy revealed nothing wrong. They don't know what caused AKI but have not ruled out the effect of Covid which I had right before kidney problems started. Ill continue to follow your journey and all who have shared here. Thanks for sharing and good luck!