Well ill start with. if you are drinking a lot of water and have protein...because the urine is diluted, you might have even more protein loss then you think. Next consideration is that even if your BP is controlled without meds, the ACE and ARBS help control the protein loss. They are not just for BP. LASTLY regarding the biopsy Mayo Clinic doc has a battery of other non invasive tests that are equally as telling, so do t ju.p the gun out of fear. Oh and a vegan diet is your best medicine.
This fluctuation it's normal and can depend from many causes: diet, drugs interaction, inflammation, etc. The level you deal is not huge but still clear sign of kidney damage. Kidney biopsy should be suggested by your nephrologist, however if you know already underlying cause ( imagine diabetes) I don't think is really necessary. Keep your diabetes and BP under control start renal diet e take drugs suggested by your care team. This should give you years or maybe even never needs for dialysis. Lifestyle can do miracle but needs strong commitment. Rgs
Agree with Tolmezzo. It seems you have diabetes and high blood pressure since your post mentions both of them. High glucose levels causes blood vessels to narrow and stiffen. This creates high blood pressure and impacts filtration vessels in the kidneys so they can't process protein well. Those protein molecules then show up in urine. Diabetes and high blood pressure is the leading cause of kidney failure. Sadly, my husband is a diabetic and his diabetes led to his kidney decline and then kidney failure. My husband's kidneys never needed to be biopsied. However, you indicate you have controlled your issues well. So I suggest you have a discussion with your nephrologist and ask him why you leak protein - is it the diabetes and high blood pressure? Is it an infection ? And so on. Often, doctors assume another doctor has already given you the reason - let him know you want to know now, not later. If it is diabetes, the good news is that, with great diet control and so on, your kidney disease can be stopped from progressing further. I trust that you will find answers soon - answers give you purpose and direction.
First let me say that Darlenia offers tremendous advice and is both highly educated and highly experienced with CKD. However, I must disagree with the statement that “with great diet control kidney disease can be stopped.” PLEASE DONT BE ANGRY DARLENIA!
I am not trying to nitpick or be a jerk only to point out that while true diet control goes a long way in SLOWING progression of CKD it does not stop it. NOTHING will stop the progression once it’s begun
Here is a link for the Mayo Clinicthat May help:
It was clear that about 30% of ALS patients in the trial stabilized after mesenchymal stem cell therapy," says Anthony Windebank, M.D., deputy director of Discovery for Mayo Clinic's Center for Regenerative Medicine and principal investigator of the phase 1 clinical trial. "We also learned that patients who had been treated with mesenchymal stem cells early in their disease had the best outcomes. Our discovery shows potential for therapeutic benefit, but more research is needed to confirm that."
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Protein in urine 
Foamy urine, 24 hr urine shows "urine protein" 0.54 g/d, Urine phosphate 33mmol/d
Blood and protein in urine
Bubbles in urine
