Foamy Urine: Causes, Concerns, and Kidney Health

Q: Foamy Urine: Causes, Concerns, and Kidney Health

Hello Ms. <br>Huang： The normal value for urinary protein is less than or equal to 150 mg per day. <br>The report for urinary protein can be presented in two ways： one is as a concentration value, such as 100 mg/dL, and the other is as a number of "+" signs, such as "2+". <br>The

Foamy urine issue

Hello, Doctor: For the past month or so, I have noticed small bubbles in my urine (sometimes a whole patch when it's severe), most of which disperse and disappear within five minutes, but sometimes a little bit remains for a long time.
Additionally, I have been experiencing unexplained twitching in my calves, similar to cramping, especially at night while sleeping.
I have also been taking psychiatric medications for the past 2-3 years, which makes me worried about having chronic kidney disease.
I went to a large hospital's nephrology department for a urine test, and the results were negative.
The doctor advised me to follow up in six months to a year.
I would like to ask the doctor:
Question 1: Is it possible that the proteinuria is still very minimal, which is why the test result is negative? Could it be that the urine protein is below normal levels, but the kidneys are already damaged?
Question 2: Is there a need to perform a 24-hour urine collection? Under what circumstances would a doctor decide to conduct a 24-hour urine collection?
Question 3: Does the 24-hour urine collection require hospitalization for collection? I am really worried about missing the early golden treatment period.
Thank you for your help in clarifying these concerns.

Ms. Huang, 40~49 year old female. Ask Date: 2023/09/10

Dr. Huang Yaoxuan reply Internal Medicine

Hello Ms.
Huang: The normal value for urinary protein is less than or equal to 150 mg per day.
The report for urinary protein can be presented in two ways: one is as a concentration value, such as 100 mg/dL, and the other is as a number of "+" signs, such as "2+".
The latter is typically determined using a dipstick test to measure protein content, and usually, a concentration exceeding 300 mg/dL will show "1+".
If your urine test report is in this format, you can follow your physician's advice and schedule a follow-up in about six months to a year.

Additionally, since the normal value for urinary protein is "less than or equal to 150 mg per day," a 24-hour urine collection is theoretically required.
However, collecting 24-hour urine can be cumbersome, so clinically, an alternative method has been developed that only requires a single urine sample, known as the Urine Protein-to-Creatinine Ratio (UPCR).
If your urine test report is in this format, there is no need for re-testing.
Lastly, regardless of the urinary protein test results, it is recommended that you measure your blood pressure daily, as this is the most important and fundamental method for "maintaining kidney health."

Reply Date: 2023/09/10

More Info

Foamy urine can be a concerning symptom, and it’s understandable that you’re worried about your kidney health, especially given your history of medication use and the recent symptoms you’ve described. Let’s break down your questions and concerns regarding foamy urine, its potential causes, and its implications for kidney health.

Understanding Foamy Urine
Foamy urine can occur for several reasons, and it is often associated with the presence of protein in the urine, known as proteinuria. When urine is concentrated or when there is an increased amount of protein, it can create bubbles or foam. However, not all foamy urine indicates a serious problem. Here are some common causes:
1. Dehydration: Concentrated urine due to dehydration can lead to foamy urine. Ensuring adequate hydration can often resolve this issue.

2. Diet: High protein diets can lead to temporary proteinuria, which may cause foamy urine.

3. Infections: Urinary tract infections (UTIs) can sometimes cause foamy urine, although this is usually accompanied by other symptoms.

4. Kidney Issues: Persistent foamy urine can indicate kidney problems, particularly if it is due to significant proteinuria, which can be a sign of kidney damage or disease.

Addressing Your Questions
1. Could proteinuria be present but still yield a negative urine test?
Yes, it is possible for protein levels to be low enough that they do not register on standard urine dipstick tests. These tests are designed to detect significant protein levels, and mild proteinuria may go unnoticed. If you have concerns about kidney damage, further testing may be warranted.

2. Should you undergo a 24-hour urine collection?
A 24-hour urine collection is often recommended if there is a suspicion of significant proteinuria or if the initial tests are inconclusive. This test measures the total amount of protein excreted in urine over a full day, providing a clearer picture of kidney function. Your doctor may suggest this if you have persistent symptoms or if there are other risk factors for kidney disease.

3. Is hospitalization required for a 24-hour urine collection?
Generally, a 24-hour urine collection does not require hospitalization. You can usually collect urine at home, following specific instructions from your healthcare provider. It’s important to keep the collection container refrigerated during the collection period to prevent bacterial growth and ensure accurate results.

Additional Considerations
Given your symptoms of leg twitching and the medications you have been taking, it’s also essential to consider other factors that could contribute to your symptoms. Medications, especially those affecting the central nervous system, can sometimes lead to side effects like muscle spasms or twitching.
If you are experiencing persistent foamy urine, it’s crucial to maintain regular follow-ups with your healthcare provider. They may recommend additional tests, such as blood tests to assess kidney function (e.g., serum creatinine, blood urea nitrogen) and possibly imaging studies if indicated.

Conclusion
In summary, while foamy urine can be benign, it can also indicate underlying kidney issues, especially if it persists. Regular monitoring and appropriate testing, such as a 24-hour urine collection, can help ensure that any potential kidney problems are identified early. Stay hydrated, maintain a balanced diet, and keep an open line of communication with your healthcare provider regarding your symptoms and concerns. Early detection and intervention are key to managing kidney health effectively.

Similar Q&A

Understanding Foamy Urine: Causes, Kidney Health, and What to Watch For

What causes foamy urine? Is it related to the kidneys? What should I be aware of?

Dr. Chen Xiuyi reply Urology
Hello: If urine has persistent bubbles that do not disappear, a urinalysis should be performed to check for protein, urinary tract infection, crystalluria, etc. If proteinuria is present, it is generally related to kidney issues and further investigation is needed. Sincerely, Dr....

Persistent Foamy Urine: Understanding Causes and Concerns

The suspected causes began with panic disorder leading to autonomic nervous system dysfunction, resulting in symptoms such as body heat, sweating, and loss of appetite, where I could only consume nutritional products like Ensure. Additionally, I experienced pain in my cervical an...

Dr. Du Shixi reply Urology
Hello: From a physician's perspective, if urine and blood tests are normal, there is no issue. Drink plenty of water and limit sugary beverages. Wishing you good health.

Understanding Persistent Bubbles in Urine: Kidney Health Concerns

Hello, doctor! I have a question: My boyfriend has a lot of bubbles in his urine when he urinates, and the bubbles do not disappear after a while; they persist, similar to when there are a lot of soap bubbles. Does this indicate a potential kidney problem? Is there a possibility ...

Dr. Zhao Chongliang reply Internal Medicine
The causes of foamy urine include the presence of protein in the urine, gas-producing bacteria in the urine, the formation of a fistula between the urethra and the intestine, and the introduction of foreign substances. Typically, men have more foamy urine because the urinary and ...

Excessive Foamy Urine: Causes and Dietary Connections Explained

Recently, I've been noticing a lot of bubbles in my urine, especially in the morning or evening. Even when the urine is very light in color, almost like water, the bubbles take a long time to dissipate. I haven't used any cleaning agents or deodorizers in my toilet. In ...

Dr. Xu Weikai reply Urology
Chihuahua: Hello, having bubbles in your urine is mostly a normal phenomenon clinically. Sometimes, it is important to consider whether it is caused by an increased concentration of dissolved substances in the urine, such as infections or proteinuria. Recommendation: It is advisa...