Concerns About Kidney Health After Second Diagnosis: Proteinuria

Second diagnosis of kidney issues (proteinuria)?

Hello, doctor.
I was diagnosed for the second time about two weeks ago (one year after my first diagnosis).
Although I tested negative by the fifth day, I noticed that I have been experiencing foamy urine since then.
I found some articles online suggesting that COVID-19 can cause kidney damage, so I am worried that there might be an issue with my kidneys.
However, the foamy urine does not occur every time; sometimes the bubbles disappear quickly after urination, while other times they persist for over 10 minutes.
I had two health check-ups last year, with a glomerular filtration rate (GFR) of 108.4 in July and 112 in November, both of which were within normal ranges.
Is it possible for the kidneys to suddenly become damaged within a year due to factors like a COVID-19 diagnosis? I am quite concerned.
Thank you.

Niming, 30~39 year old female. Ask Date: 2023/06/25

Dr. Wu Hongjie reply Internal Medicine

Glomerular filtration rate (GFR) increased from 108 to 112, both within the normal range, showing no signs of sudden impairment.
Vaccination and infections can trigger the production of antibodies to protect against foreign viral invasions.
Antibodies are a type of protein, and it is necessary to wait for the effects of the vaccine (which generates a large amount of antibodies) to return to normal.
Only then will the proteinuria induced by the antibodies return to baseline.
It is recommended to follow up 3-6 months after confirmation of diagnosis or vaccination if proteinuria persists, to rule out any renal issues.

Reply Date: 2023/06/25

More Info

It’s understandable to be concerned about your kidney health, especially after a second diagnosis and noticing changes in your urine. Let’s break down your situation and address your concerns regarding proteinuria and kidney function.

Understanding Proteinuria and Its Implications:
Proteinuria, or the presence of excess protein in the urine, can be an early sign of kidney damage. Normally, the kidneys filter waste from the blood while retaining essential proteins. When the kidneys are damaged, they may allow proteins to leak into the urine. The presence of bubbles or foam in the urine can sometimes indicate proteinuria, but it can also occur for other reasons, such as the speed of urination or the concentration of urine.

In your case, you mentioned that you have noticed bubbles in your urine intermittently since your second diagnosis. While occasional foamy urine can be benign, persistent proteinuria should be evaluated further. Given your previous normal kidney function tests (glomerular filtration rate or GFR of 108.4 and 112), it’s important to monitor any changes closely.

Kidney Function and Disease Progression:
Kidney function can change over time, and various factors can contribute to this, including infections, autoimmune responses, and other health conditions. While it is possible for kidney function to decline within a year, especially if there are underlying conditions or risk factors (like hypertension or diabetes), it is not guaranteed. The fact that your GFR was normal during your last evaluations is reassuring, but ongoing monitoring is crucial.

Next Steps:
1. Urine Analysis: It would be beneficial to conduct a urine analysis, including a urine protein-to-creatinine ratio (UPCR) test. This will help quantify the amount of protein in your urine and determine if there is a significant issue that needs addressing.

2. Follow-Up with Your Doctor: Discuss your concerns with your healthcare provider. They may recommend further testing or monitoring based on your symptoms and urine analysis results. If proteinuria is confirmed, they might explore potential causes, including the impact of your recent diagnosis.

3. Lifestyle Considerations: Maintaining a healthy lifestyle can support kidney health. This includes staying hydrated, following a balanced diet low in sodium and processed foods, managing blood pressure, and avoiding excessive protein intake if advised by your doctor.

4. Monitoring Symptoms: Keep track of any other symptoms that may arise, such as swelling, fatigue, or changes in urination patterns. These can provide additional context for your healthcare provider.

Conclusion:
While the presence of bubbles in your urine can be concerning, it does not automatically indicate significant kidney damage, especially if your kidney function tests have been normal. However, it is essential to remain vigilant and proactive about your health. Regular follow-ups and urine tests will help ensure that any potential issues are identified and managed early. If you have further concerns or if your symptoms worsen, do not hesitate to seek medical advice promptly. Your health is paramount, and staying informed and engaged with your healthcare is the best approach.

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