Medical expert of the article
New publications
Treatment of high protein in the urine
Last reviewed: 23.04.2024
All iLive content is medically reviewed or fact checked to ensure as much factual accuracy as possible.
We have strict sourcing guidelines and only link to reputable media sites, academic research institutions and, whenever possible, medically peer reviewed studies. Note that the numbers in parentheses ([1], [2], etc.) are clickable links to these studies.
If you feel that any of our content is inaccurate, out-of-date, or otherwise questionable, please select it and press Ctrl + Enter.
Treatment of high protein in the urine depends on the cause that prevented the kidneys from completely returning the protein that entered its tubules into the bloodstream, and it ended up where it should not be - in the urine.
The presence of protein in the urine - in accordance with physiological norms - is practically zero (less than 0.03 g per liter of urine per day). If this indicator is higher, then it can already be considered proteinuria. This is how in clinical medicine is called increased protein in the urine. This pathology is divided into proteinuria prerenal (with increased protein breakdown in tissues), renal (in renal pathologies), postrenal (with diseases of the urinary system) and infrarenal (secretory). In turn - by the nature of the key pathophysiological mechanism - each of these species has a lot of subspecies.
What tests are needed?
Who to contact?
Basic principles of treatment of increased protein in the urine
It should be noted that an increased protein in the urine is not always a sign of any disease. The so-called physiological proteinuria manifests itself with an excess of protein food in the diet, with prolonged muscle tension, staying in the cold or in the sun, under stress. As soon as the negative factor disappears, everything comes back to normal. And in such cases, treatment of increased protein in the urine is not required.
But constantly or long-term elevated protein in the urine is evidence of very serious health problems. The higher the protein content in urine (more than 0.5 g / L per day), the more real the development of renal failure.
First of all, treatment of high protein in the urine is required for glomerular diseases - acute and chronic glomerulonephritis (nephritis) and nephrotic syndrome. An increase in the content of proteins in urine is also on the list of symptoms of such diseases as pyelonephritis, cystitis, urethritis, kidney tuberculosis, kidney cyst, prostatitis, amyloidosis, diabetes mellitus, rheumatoid arthritis, systemic scleroderma, gout, arterial hypertension, heart failure, malaria, leukemia , hemolytic anemia.
In addition, elevated protein in the urine is noted with the negative effects of certain drugs, poisoning with toxic substances and heavy metals, with chronic potassium deficiency in the body. And when the protein in the urine is detected in a pregnant woman in the last trimester of gestation, there is a clear symptom of nephropathy - dysfunction of the placenta, which is fraught with premature birth.
It is clear that the treatment of increased protein in the urine can be either etiologic - aimed at eliminating the cause of the underlying disease, or pathogenetic, when the purpose of therapy is the mechanism of the development of the disease.
Preparations for the treatment of high protein in the urine
For the concentration of proteins in the urine is responsible for the renal basal membrane - the glomerular barrier, which filters the blood plasma proteins and prevents their release into the urine. When the permeability of this barrier is disturbed, the level of protein in the urine increases.
In acute glomerulonephritis, it occurs due to streptococcal, staphylococcal or pneumococcal infection (pharyngitis, angina, sinusitis, pneumonia, etc.), the toxins of which damage the renal membrane and lead to the formation of antibodies to the streptococcal M protein and immune glomerular glomeruli.
Nephrotic syndrome is considered an autoimmune disease that can develop in case of lupus erythematosus or systemic impairment of protein metabolism (amyloidosis), as well as diabetes mellitus (diabetic nephropathy) and malignant neoplasms. Exacerbations and relapses of a nephrotic syndrome can be provoked by infections. Patients with such diagnoses have swelling, high blood pressure, increased protein in the urine (3-3.5 g / L per day), as well as the presence of blood in the urine (macrohematuria) and a decrease in daily diuresis (urine output).
With these diseases - after clarifying the diagnosis and antibacterial therapy of existing infections - urologists prescribe the following basic drugs for the treatment of increased protein in the urine: corticosteroids (prednisolone or methylprednisolone); cytostatics (cyclophosphamide); antiaggregants (dipyridamole).
Corticosteroids
Methylprednisolone is an analogue of prednisolone (a synthetic hormone of the adrenal cortisone), but it has fewer side effects and better tolerability in patients with intramuscular injection (suspension for injection of methylprednisolone sodium succinate) and oral administration (in tablets of 0.004 g). The dosage of the medicinal product is determined by the doctor depending on the severity of the disease: the average daily dose is 0.004-0.048 g (in the form of tablets); intramuscularly - 460 mg per day. The course of treatment - from one week to a month.
Side effects of this drug: sodium and water retention in tissues, loss of potassium, increased blood pressure, muscle weakness, brittle bones (osteoporosis), damage to the gastric mucosa, decreased adrenal function. The use of methylprednisolone during pregnancy (as with all corticosteroids, as they penetrate the placenta) is possible if the expected effect of treatment for a woman exceeds the potential risk to the fetus.
Cytotoxic agents
The drug cyclophosphamide (synonyms - cytoforsphane, cytoxan, endoxane, genoxol, mitoxane, protsitoke, sendoksan, klafen) prevents the division of cells at the level of DNA and has antitumor effect. Cyclophosphane is used as an immunosuppressive agent, since it suppresses the division of B-lymphocytes participating in the immune response. It is this action that is used in the treatment of elevated protein in urine with glomerulonephritis and nephrotic syndrome.
The drug (in ampoules of 0.1 and 0.2 g) is administered intravenously and intramuscularly - according to the prescribed treatment scheme of the doctor at a rate of 1.0-1.5 mg per kilogram of body weight (50-100 mg per day). Inside take the tablets at 0.05 g, dosage: 0.05-0.1 g twice a day.
Among the contraindications of this drug: hypersensitivity, severe renal dysfunction, bone marrow hypoplasia, leukopenia, anemia, cancer, pregnancy and lactation, the presence of active inflammatory processes. Possible side effects of cyclophosphamide: nausea, vomiting, abdominal pain, menstrual irregularity, alopecia (loss of hair), loss of appetite, lowering of blood leukocyte count, discoloration of nail plates.
[8], [9], [10], [11], [12], [13], [14]
Antiaggregants
For the treatment of this pathology, doctors use dipyridamole (synonyms - curantyl, persantine, penselin, anginal, cardioflux, corozan, dirinol, trombonin, etc.). This drug inhibits the adhesion (aggregation) of platelets and prevents the formation of thrombi in the blood vessels, so it is used to prevent the formation of thrombi after surgery, with myocardial infarction and problems with cerebral circulation. In chronic kidney diseases associated with impaired functions of the glomerular barrier, this drug helps improve blood filtration.
Tablets-pills for 0,025 g are recommended to take 1 pc. Three times a day. In some cases, dipyridamole may have side effects in the form of short-term facial hyperemia, increased heart rate and skin rashes. Contraindication to the use of this drug is a widespread sclerosing atherosclerosis of the coronary arteries.
For symptomatic treatment of high protein in the urine, hypotensive, diuretic and antispasmodics are used.
For example, among diuretics, a diuretic preparation of plant origin kanefron is recommended, which contains a centipose, dogrose, loveliness and rosemary. It reduces the permeability of the capillaries of the kidneys and contributes to the normalization of their functions. In addition, kanefron works as uroseptic and antispasmodic.
Kanefron is available in the form of drops and drops. Dosage for adults - 2 dragees or 50 drops three times a day; children aged 1-5 years - 15 drops 3 times a day, over 5 years - 25 drops or one dragee three times a day.
Treatment of high protein in the urine with antibiotics
The use of antibacterial drugs in the complex treatment of increased protein in the urine is aimed at eliminating the focus of infection in the initial stage of the disease and suppressing the infection in the further course of the disease.
From antibiotics penicillin series in many cases - with pneumonia (including abscesses), tonsillitis, cholecystitis, infections of the biliary and urinary tract and intestines - ampicillin is prescribed.
Tablets and capsules of 0.25 g prescribed to take inside: adults - 0.5 grams 4-5 times a day, regardless of the intake of food; children dose is calculated depending on the weight - 100 mg / kg. The duration of the course of therapy is at least 5 days.
The use of ampicillin can cause unwanted side reactions in the form of skin rashes, urticaria, and Quincke's edema; with prolonged treatment may develop superinfection. To avoid this, you must simultaneously take vitamins C and B group. Contra-indications of this antibiotic include hypersensitivity to penicillin and a tendency to allergies.
Treatment of high protein in the urine with antibiotics can not do without oleandomycin (analogue - oletetrin) - antibiotic group of macrolides - is active against many Gram-positive, gram-negative and anaerobic bacteria resistant to penicillin. It is prescribed (125 000 ED tablets and 250,000 ED each) with angina, otitis, sinusitis, laryngitis, pneumonia, scarlet fever, diphtheria, whooping cough, purulent cholecystitis, phlegmon, as well as with staphylococcal, streptococcal and pneumococcal sepsis.
Dose for adults - 250-500 mg (in 4-6 receptions, daily dose not more than 2 g); for children under 3 years - 20 mg per kilogram of weight, 3-6 years - 250-500 mg per day, 6-14 years - 500 mg-1 g, after 14 years - 1-1.5 grams per day. The course of treatment lasts from 5 to 7 days.
Possible side effects: skin itching, urticaria, liver dysfunction (rarely). During pregnancy and lactation, oleandomycin is used with great care and only under the strict instructions of the attending physician.
The fact that the protein in the urine is significantly elevated is indicated by such signs as fast fatigue and dizziness, headaches and pain in the lower back, swelling, decreased appetite, chills, vomiting or nausea, increased blood pressure, shortness of breath and rapid heartbeat. Self-medication in this case is unacceptable and impossible!
Adequate and effective treatment of high protein in the urine can be prescribed only by a doctor - urologist or nephrologist - after a laboratory urine test, a patient's examination and a comprehensive analysis of the clinical picture of the disease.