u/Far_Fix5047

I'm a 54-year-old male and have had proteinuria for several years. My kidney function has remained normal, but my urine protein has been steadily increasing.

Here's the trend:

• Apr 2024: 175 mg/L
• Jun 2025: 473 mg/L
• Dec 2025: 506 mg/L
• Jun 2026: 779 mg/L

My urine microalbumin/creatinine ratio also increased from 534 mg/g in Dec 2025 to 997 mg/g in Jun 2026.

The confusing part is that my kidney function is still good:

• Creatinine: 1.02
• eGFR: 87
• Blood pressure: 116/70

I also don't fit the typical metabolic profile. I'm 6'4", 158 lb, don't drink alcohol or soda, run a 5K every weekday, ride my Peloton 10 miles every weekday, and my A1C is 5.6%.

I've been taking Jardiance since July 2025 and switched from lisinopril to losartan in December 2025 because I couldn't tolerate lisinopril.

Part of my hesitation is that my nephrologist had been recommending a kidney biopsy for several years, and I finally agreed to have one in 2024. About a month before the scheduled procedure, I had a pre-biopsy appointment with her. During that visit she reviewed the potential complications in detail, including significant bleeding and the rare possibility of losing the kidney. That discussion honestly scared me enough that I canceled the biopsy.

Fast forward to today. My nephrologist told me that if my urine protein came back under 500 mg/L, she would not recommend a biopsy. Unfortunately, my latest result came back at 779 mg/L, so she's recommending that I seriously reconsider it.

I'm really conflicted. I understand why she's recommending the biopsy, but I'm also struggling with the idea of undergoing an invasive procedure on kidneys that are otherwise functioning well, especially after hearing about the potential complications.

For anyone who has been in a similar situation:

• Did you end up getting the biopsy?
• If so, what diagnosis did it reveal?
• Did it change your treatment?
• Were your doctors able to significantly reduce your proteinuria afterward?
• If you declined the biopsy, how was your condition managed?
• Did anyone get a second opinion before deciding?

I'm not looking for medical advice or someone to tell me what I should do. I'm just hoping to hear from people who have been in a similar situation and learn how they approached the decision.

I'm a 54-year-old male and have had proteinuria for several years. My kidney function has remained normal, but my urine protein has been increasing.

Here's the trend:

• Apr 2024: 175 mg/L
• Jun 2025: 473 mg/L
• Dec 2025: 506 mg/L
• Jun 2026: 779 mg/L

My urine microalbumin/creatinine ratio has also increased from 534 mg/g in Dec 2025 to 997 mg/g in Jun 2026.

The confusing part is that my kidney function is still good:

• Creatinine: 1.02
• eGFR: 87
• Blood pressure: 116/70

I also don't fit the typical metabolic profile. I'm 6'4", 158 lb, don't drink alcohol or soda, run a 5K every weekday, ride my Peloton 10 miles every weekday, and my A1C is 5.6%.

I've been taking Jardiance since July 2025 and switched from lisinopril to losartan in December 2025 because I couldn't tolerate lisinopril. My nephrologist said that if my urine protein remained above 500 mg/L, she would recommend a kidney biopsy. With today's results at 779 mg/L, that conversation is now back on the table.

I'm struggling with the decision because the biopsy is invasive and has risks, but I also understand that persistent proteinuria despite treatment may indicate an underlying kidney disease that can't be diagnosed without a biopsy.

For anyone who has been in a similar situation:

• Did you end up getting the biopsy?
• If so, did it change your diagnosis or treatment?
• If you declined the biopsy, how was your condition managed?
• Did anyone get a second opinion before deciding?

I'm not looking for medical advice, just hoping to hear from people who have gone through something similar.