Proteinuria plays an important role in the prognosis of kidney disease. The commonly used drugs for proteinuria are steroids. Besides steroids, what other medicines can be used? Go on reading, you will find out the answer.

A kidney patient left a message on our website. He said his proteinuria increased to 2g from 0.8g after discharging from hospital for 3 months.

I asked him: what treatment do you receive now?

He said: I have been taking steroids. But once I reduce the dosage, the disease gets relapse.

From what he said, I can basically judge that he is steroid-sensitive, but he is also steroid-dependent. Only few patients have such a condition. Why?

There are two causes.

1. After kidney function is damaged, the effect of drugs on lesion is reduced. That is, the body’s ability to absorb drugs decreases. Besides, physical condition, age and so on can also lead to the occurrence of steroid dependence.

2. Steroids mainly play a role in regulating sugar, protein and other substances, and have a certain role in fighting inflammation. But it can not eliminate inflammation and restore a portion of slightly damaged kidney function. Therefore, it is effective only when you keep on steroids to lower proteinuria for long term. If you stop the medicine in a short term, it is likely for you to suffer from relapse.

Steroid + immunosuppressant is the most common and effective treatment for renal proteinuria.

But is there any other way or drug for refractory proteinuria besides steroids?

There are 2 points in treating proteinuria. One is to lower the index, and the other one is to restore renal function.

If you do not choose the steroid plan, you can choose other treatment plans.

For example, immunosuppressant + rituximab.

Rituximab was previously used for the treatment of lymphoma. According to the research, it has obvious effect of lowering protein on the treatment of hormone-dependent patients with childhood nephrotic syndrome, and it has good tolerance and low nephrotoxicity. It has high safety and is expected to be one of the drugs to reduce hormone therapy.

Leflunomide + steroids.

Leflunomide is also an immunosuppressant with certain anti-inflammatory effect, which can reduce the urine protein level of patients with progressive IgA nephropathy and delay the deterioration of renal function, but has minor adverse reactions.

Leflunomide combined with low dose hormone can effectively treat progressive IgA nephropathy, which is better than sufficient hormone alone.

ACEI and ARBs can also have the function of reducing proteinuria and slow down the progression of kidney disease. But you should pay attention to their side effects. For example, they can elevate creatinine and potassium. And they are only suitable for kidney patients whose renal function is normal, and creatinine is lower than 265. Pregnancy women, patients with stage 3 CKD or over, and patients with bilateral renal artery stenosis should avoid them.

The above material about other medications to lower creatinine rather than steroids is intended for information only. For specific suggestions, please leave a message below or contact online doctor.