Kidney Function and Foamy Urine: Key Questions Answered

I would like to inquire about the relationship between kidney function and foamy urine?

Hello Doctor: Three months ago, I underwent a routine blood test and urinalysis.
Most of the indices were normal, with blood sugar and blood pressure also within normal ranges.
However, my kidney function (creatinine) was 1.35, and both high-density and low-density lipoprotein cholesterol levels were on the borderline.
The doctor mentioned that my creatinine level might be elevated due to my higher body weight and advised not to worry, especially since there was no proteinuria or elevated blood sugar, and my blood urea nitrogen was normal.
However, I had a positive urine test for hematuria with 6-8 red blood cells.
The doctor indicated that this could be due to my history of kidney stones, suggesting there might be small stones in my urinary system.
A renal ultrasound was performed, and everything appeared normal at that time.
Recently, I noticed that when I wake up in the morning, my urine has an excessive amount of bubbles.
Although most of the bubbles dissipate after five minutes, some still float.
My urine during the day also has bubbles, but not as pronounced as in the morning.
I would like to ask the doctor: 1.
Do I need to return for a follow-up to check for protein in my urine? Additionally, is there really no need for special treatment regarding the creatinine level of 1.35 and the hematuria? 2.
I experienced blood during ejaculation six months ago; could this be related to the hematuria? 3.
I have been taking the second-generation antihistamine Aerius (desloratadine) at 60 mg, two tablets a day for three months, starting after my last check-up due to chronic urticaria.
Could the bubbly urine be a side effect of the antihistamine? Note: The doctor reviewed my previous records and mentioned that my creatinine levels have consistently been elevated in the past.
Thank you, Doctor.

Hong Cha, 20~29 year old female. Ask Date: 2017/09/29

Dr. Liao Jiasheng reply Family Medicine

The presence of bubbles in urine is related to the acidity or alkalinity of the urine.
Hematuria indicates the presence of red blood cells, so a referral to a urologist for further examination is appropriate.

Reply Date: 2017/09/29

More Info

Hello! Thank you for your detailed questions regarding your kidney function and the presence of foamy urine. Let's address your concerns one by one, and I'll provide some additional context based on medical knowledge.

1. Need for Follow-Up Urine Protein Testing: Given your history of elevated creatinine levels (1.35 mg/dL) and the presence of hematuria (6-8 red blood cells in urine), it is advisable to follow up with urine protein testing. The presence of foamy urine can indicate proteinuria, which is the presence of excess protein in the urine. This can be a sign of kidney damage or disease. While your doctor may have reassured you that your creatinine level is not a cause for concern, monitoring your kidney function is crucial, especially if you notice changes in your urine. A 24-hour urine protein test or a spot urine protein-to-creatinine ratio can provide more insight into your kidney health.

2. Relation Between Hematuria and Blood During Ejaculation: The occurrence of blood in your urine (hematuria) and blood during ejaculation could potentially be related. Hematuria can arise from various causes, including urinary tract infections, kidney stones, or other underlying conditions. If you have a history of kidney stones, it's possible that they could be causing irritation or injury to the urinary tract, leading to both hematuria and blood during ejaculation. It would be prudent to discuss this with your healthcare provider, as they may recommend further evaluation, such as imaging studies or a urology consultation.

3. Foamy Urine and Antihistamines: The use of second-generation antihistamines, such as the one you mentioned (likely referring to cetirizine or a similar medication), is generally not associated with causing foamy urine. Foamy urine is more commonly linked to proteinuria rather than medication side effects. However, if you have concerns about the medication or if you notice any other unusual symptoms, it’s always best to consult your physician. They can help determine if your current medication regimen is appropriate or if adjustments are needed.

Additional Context on Kidney Function: Elevated creatinine levels can indicate impaired kidney function, but they can also be influenced by factors such as muscle mass, hydration status, and diet. Since you mentioned being overweight, this could contribute to higher creatinine levels. However, consistent monitoring is essential, especially if you have risk factors for kidney disease, such as a history of kidney stones or hypertension.

Foamy urine can be a sign of proteinuria, which is often a marker of kidney damage. Conditions such as diabetes, hypertension, and glomerulonephritis can lead to proteinuria. Therefore, regular check-ups and urine tests are crucial for early detection and management of potential kidney issues.

In summary, I recommend scheduling a follow-up appointment with your healthcare provider to discuss your symptoms, the need for further testing, and any concerns regarding your medications. Regular monitoring and proactive management are key to maintaining kidney health, especially given your history and current symptoms. Thank you for your questions, and I wish you the best in your health journey!

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