Stephen P Peters, MD, PhD, FACP, FAAAAI, FCCP, FCPP Thomas H Davis Chair in Pulmonary Medicine, Chief, Section on Pulmonary, Critical Care, Allergy and Immunologic Diseases, Professor of Internal Medicine, Pediatrics, and Translational Science, Associate Director, Center for Genomics and Personalized Medicine Research, Wake Forest University School of Medicine; Executive Director of the Respiratory Service Line, Wake Forest Baptist Medical Center
Stephen P Peters, MD, PhD, FACP, FAAAAI, FCCP, FCPP is a member of the following medical societies: American Academy of Allergy Asthma and Immunology , American Association of Immunologists , American College of Chest Physicians , American College of Physicians , American Federation for Medical Research , American Thoracic Society , Sigma Xi
Disclosure: Serve(d) as a speaker or a member of a speakers bureau for: Integrity CE, Merck<br/>Received income in an amount equal to or greater than $250 from: – Array Biopharma, AstraZeneca, Aerocrine, Airsonett AB, Boehringer-Ingelheim, Experts in Asthma, Gilead, GlaxoSmithKline, Merck, Novartis, Ono Pharmaceuticals, Pfizer, PPD Development, Quintiles, Sunovion, Saatchi & Saatichi, Targacept, TEVA, Theron.
Before treating proteinuria, a proper diagnosis must be established to determine the primary cause. Commonly, proteinuria is a symptom of diabetic nephropathy, therefore, proper glycemic control must be observed to slow the progression of the condition. Typically, medical management involves angiotensin converting enzyme inhibitors as the first-line medication for proteinuria. In some instances when ACE inhibitors cannot control proteinuria, the patient is given angiotensin receptor blocker or aldosterone antagonist such as spironolactone to help in protein retention. If ACE inhibitor therapy is combined with these agents, caution must be observed as there is a risk of developing hyperkalemia. If proteinuria has an autoimmune origin, steroids and steroid-sparing agent in combination with the use of ACE inhibitors are used. In supplement to blood sugar and blood pressure control, dietary salt and protein is restricted. A dietician may be consulted for a healthy eating plan.