What is included in the medical management of proteinuria?

Updated: Mar 25, 2020
  • Author: Beje Thomas, MD; Chief Editor: Vecihi Batuman, MD, FASN  more...
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Medical management of proteinuria has the following two components:

  • Nonspecific treatment - Treatment that is applicable irrespective of the underlying cause, assuming the patient has no contraindications to the therapy

  • Specific treatment - Treatment that depends on the underlying renal or nonrenal cause and, in particular, whether or not the injury is immune mediated

As an example of specific treatment, sodium-glucose co-transporter 2 (SGLT2) inhibitors (eg, canagliflozin, empagliflozin) have gained wide use in the management of type 2 diabetes mellitus and have effects beyond glucose lowering that include reducing the risk of development or worsening of albuminuria. [32] A meta-analysis concluded that although SGLT2 inhibitors did not have a statistically significant effect on eGFR in patients with type 2 diabetes, compared with monotherapy, the combination of SGLT2 inhibitors with other hypoglycemic agents can reduce albuminuria levels (SMD - 0.13, 95% CI - 0.19, - 0.06, p < 0.0001). [33]

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