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Treatment of elevated protein in urine
Medical expert of the article
Last reviewed: 07.07.2025
Treatment for elevated protein in the urine depends on the cause that prevented the kidneys from completely returning the protein that entered the tubules into the blood, and it ended up where it shouldn't 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 this can already be considered proteinuria. This is what increased protein in the urine is called in clinical medicine. This pathology is divided into prerenal proteinuria (with increased breakdown of protein in tissues), renal (with 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 types has many subtypes.
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Basic principles of treatment of elevated protein in urine
It should be noted that 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 foods in the diet, with prolonged muscle tension, exposure to cold or sun, and stress. As soon as the negative factor disappears, everything returns to normal. And in such cases, treatment for 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 the urine (more than 0.5 g/l per day), the more likely it is that kidney failure will develop.
First of all, treatment of elevated protein in urine is required for glomerular diseases - acute and chronic glomerulonephritis (nephritis) and nephrotic syndrome. Increased protein content in urine is also listed as a symptom of diseases such 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, increased protein in the urine is observed with the negative impact of certain medications, poisoning with toxic substances and heavy metals, with chronic potassium deficiency in the body. And when protein in the urine is detected in a pregnant woman in the last trimester of gestation, then there is a clear symptom of nephropathy - dysfunction of the placenta, which is fraught with premature birth.
It is quite obvious that treatment of elevated protein in urine can be either etiological - aimed at eliminating the cause of the underlying disease, or pathogenetic, when the goal of therapy is the mechanism of disease development.
Drugs for the treatment of elevated protein in urine
The renal basement membrane is responsible for the concentration of proteins in urine - the glomerular barrier that filters blood plasma proteins and prevents them from entering the urine. When the permeability of this barrier is impaired, the level of protein in the urine increases.
In acute glomerulonephritis, this occurs as a result of streptococcal, staphylococcal or pneumococcal infection (pharyngitis, tonsillitis, sinusitis, pneumonia, etc.), the toxins of which damage the renal membrane and lead to the formation of antibodies to the M-protein of streptococcus and immune inflammation of the glomeruli of the kidney.
Nephrotic syndrome is considered an autoimmune disease that can develop with lupus erythematosus or systemic protein metabolism disorder (amyloidosis), as well as with diabetes mellitus (diabetic nephropathy) and malignant neoplasms. Exacerbations and relapses of nephrotic syndrome can be provoked by infections. Patients with such diagnoses experience edema, 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).
In these diseases - after clarifying the diagnosis and antibacterial therapy of existing infections - urologists prescribe the following main drugs for the treatment of increased protein in the urine: corticosteroids (prednisolone or methylprednisolone); cytostatics (cyclophosphamide); antiplatelet agents (dipyridamole).
Corticosteroids
Methylprednisolone is an analogue of prednisolone (a synthetic adrenal hormone cortisone), but it has fewer side effects and is better tolerated by patients both when administered intramuscularly (suspension for injections of methylprednisolone sodium succinate) and orally (in tablets of 0.004 g). The dosage of the drug is determined by the doctor depending on the severity of the disease: the average daily dose is 0.004-0.048 g (in tablet form); intramuscularly - 4-60 mg per day. The course of treatment is 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, bone fragility (osteoporosis), damage to the gastric mucosa, decreased adrenal function. The use of methylprednisolone during pregnancy (as with all corticosteroids, since they penetrate the placenta) is possible if the expected effect of treatment for the woman exceeds the potential risk to the fetus.
Cytostatics
The drug cyclophosphamide (synonyms - cytoforsfan, cytoxan, endoxan, genoxol, mitoxan, procytoke, sendoxan, claphen) prevents cell division at the DNA level and has an antitumor effect. Cyclophosphamide is used as an immunosuppressant, as it suppresses the division of B-lymphocytes involved in the immune response. This action is used in the treatment of elevated protein in the urine in glomerulonephritis and nephrotic syndrome.
The drug (in ampoules of 0.1 and 0.2 g) is administered intravenously and intramuscularly - according to the treatment regimen prescribed by the doctor at the rate of 1.0-1.5 mg per kilogram of body weight (50-100 mg per day). Tablets of 0.05 g are taken orally, dosage: 0.05-0.1 g twice a day.
Contraindications of this medicine include: hypersensitivity, severe renal dysfunction, bone marrow hypoplasia, leukopenia, anemia, cancer, pregnancy and lactation, active inflammatory processes. Possible side effects of cyclophosphamide: nausea, vomiting, abdominal pain, menstrual irregularities, alopecia (hair loss), loss of appetite, decreased white blood cell count, changes in nail color.
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Antiplatelet agents
To treat this pathology, doctors use dipyridamole (synonyms - curantil, persantin, penselin, anginal, cardioflux, corozan, dirinol, trombonin, etc.). This drug inhibits platelet aggregation and prevents the formation of blood clots in blood vessels, so it is used to prevent the formation of blood clots after surgery, myocardial infarction and problems with cerebral circulation. In chronic kidney diseases associated with dysfunction of the glomerular barrier, this drug helps improve blood filtration.
It is recommended to take 1 tablet of 0.025 g dragee three times a day. In some cases, dipyridamole may have side effects in the form of short-term hyperemia of the face, increased heart rate and skin rashes. Contraindication to the use of this drug is widespread sclerosing atherosclerosis of the coronary arteries.
For symptomatic treatment of elevated protein in urine, antihypertensive, diuretic and antispasmodic agents are used.
For example, among diuretics, the herbal diuretic drug Kanefron is recommended, which contains centaury, rose hip peel, lovage and rosemary. It reduces the permeability of kidney capillaries and helps normalize their functions. In addition, Kanefron works as a uroseptic and antispasmodic.
Canephron is available in the form of drops and dragees. Dosage for adults is 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.
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Treatment of elevated protein in urine with antibiotics
The use of antibacterial drugs in the complex treatment of elevated protein levels in urine is aimed at eliminating the source of infection in the initial stage of the disease and suppressing the infection in the further course of the disease.
Of the penicillin antibiotics, ampicillin is prescribed in many cases - for pneumonia (including abscesses), tonsillitis, cholecystitis, infections of the biliary and urinary tracts and intestines.
Tablets and capsules of 0.25 g are prescribed for oral administration: adults - 0.5 g 4-5 times a day, regardless of food intake; for children, the dose is calculated depending on weight - 100 mg / kg. The duration of the course of therapy is at least 5 days.
The use of ampicillin may cause undesirable side effects in the form of skin rash, urticaria, Quincke's edema; with prolonged treatment, superinfection may develop. To avoid this, it is necessary to simultaneously take vitamins C and group B. Contraindications to this antibiotic include hypersensitivity to penicillin and a tendency to allergies.
Treatment of elevated protein in urine with antibiotics is not complete without oleandomycin (analogue - olethetrin) - an antibiotic of the macrolide group - is active against many gram-positive, gram-negative and anaerobic bacteria resistant to penicillin. It is prescribed (tablets of 125 thousand U and 250 thousand U) for tonsillitis, otitis, sinusitis, laryngitis, pneumonia, scarlet fever, diphtheria, whooping cough, purulent cholecystitis, phlegmon, as well as sepsis of staphylococcal, streptococcal and pneumococcal origin.
The dose for adults is 250-500 mg (in 4-6 doses, daily dose no more than 2 g); for children under 3 years old - 20 mg per kilogram of body weight, 3-6 years old - 250-500 mg per day, 6-14 years old - 500 mg-1 g, after 14 years - 1-1.5 g per day. The course of treatment lasts from 5 to 7 days.
Possible side effects: skin itching, urticaria, liver dysfunction (rare). During pregnancy and lactation, oleandomycin is used with great caution and only according to strict instructions from the attending physician.
Signs that the protein in the urine is significantly elevated include rapid fatigue and dizziness, headache and pain in the lumbar region, swelling, loss of 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 for elevated protein in the urine can only be prescribed by a doctor - a urologist or nephrologist - after a laboratory test of urine, examination of the patient and a comprehensive analysis of the clinical picture of the disease.