Protein in Urine

[Jason2233]

I am 32 years old with family history of kidney disease. 5 Months ago, I went to my primary physician and asked him why my urine was foamy and bubbly. He did a random and 24 hours protein test. Protein result was 187, which was slight over the normal range, and other kidney functions were normal. Primary physician advised me to keep a close eye during annual check up. I was not content so I ended up going to a specialist. There they had discovered that I had high blood pressure consistently. He prescribed me Losartan. 4 months of taking Losartan, I rarely noticed bubbly fomaly urine up untill 3 weeks ago and my urine is bubbly on a consistent basis. I have not changed anything. What could this be? I want to stay on top of this. Any type of advise would be appreciated.

[Bet117 NKF Ambassador]

Hi Jason,

A lot of debate, but most importantly that you noticed the bubbly urine and addressed it to your PCP as to trouble shoot potential problems.

A 24 hour urine catch is considered the " gold seal" marker among nephrologists as it is an average of protein spilling, function, etc. ; on the same idea as an A1C is a 3 month average of glucose, so your PCP was competent there. I am surprised that your BP elevation wasn't addressed and treated in that office before now, but that is in the past.

I applaud you for your self advocacy by seeing a nephrologist. Based on your family history, if there

is a potential kidney issue brewing, you are now under the care of an appropriate specialist and it can be identified and treated early. Unfortunately, many PCP's wait until it is a potential problem.

You can be spilling protein for any number of reasons with normal kidney function, which is why it is so important that you are now under the care of a nephrologist.

High blood pressure, diabetes and other issues are a prelude to kidney disease.

As far as the Losartan, it is Angiotensin II Receptor Blocker, which is one of two families of drugs most commonly prescribed to lower protein spilling; the other being an ACE Inhibitor such as Lisinopril. So, in your case, it serves two purposes; lower your BP and address the protein spilling.

I would also print out your last set of labs and take a look at your cholesterol, albumin, electrolytes such as sodium, potassium, phosphorous CO2, CL etc. calcium, vitamin D levels, your glucose and CBC as well. Anything out of range check them off.

I would speak to your nephrologist and ask him/ her about your labs as well as what they suspect is causing the protein spilling, bubbly urine and what your treatment plan will be, going forward.

Many responses here can speculate, but your first line of communication must be with your doctor. See that your doctors communicate with each other and clearly with you.

Make a list of questions, take a notebook and ask.

What else you can do? Make some dietary changes. Low sodium ( 1500- 2000mg daily ) spices as onion, garlic powder, smoky paprika and other non salt based spices add great flavor! Avoid fried foods, no red meat, cold cuts, canned or processed foods. Add more fresh, steamed or roasted vegetables

and fruits to your diet. Watch dairy, avoid dark colas, NASID's as Advil, Motrin and Aleve and drink plenty of water. If you work out, stop the protein drinks unless your doctor clears them. Take a walk when possible.

Just remember that you are the wiser for acting immediately on what you saw as a possible problem.

You are now a welcome member of our community. Please let us know what your doctor has to say. Feel free to reach out at any time as one of us will always reach back.

Stay strong and safe in these crazy times!

Bet

[Jason2233 in reply to Bet117]

Thank you. I go in for my annual physical next week, and they will do another urine and kidney test. Hopefully I will get some answers and a peace of mind.

[Bet117 NKF Ambassador in reply to Jason2233]

No thanks ever needed.

Think positive and advocate for yourself!

Let me know what the outcome is. ..

Bet

[Jason2233 in reply to Bet117]

I am still worried about it. Why do you think I rarely ever had bubbly urine for almost 4 months ( When I got put on Losartan) and all of a sudden started to show up again. So clearly Losartan did the trick but not anymore is what just getting me worried.

[Bet117 NKF Ambassador in reply to Jason2233]

Hi Jason,

Your feelings are very normal. When there is doubt and things are up in the air, instinctively worry comes. Every time I have labs done, I feel like I am sitting on an egg waiting for it to hatch until my results are posted.

The bubbly urine could be a result of a number of reasons; the Losartan may or may not have effected it. At this point the bubbly urine could be indicative of protein spilling or may be nothing. See what the doctor tells you.

I am glad that you are going in for your annual physical next week as you will have a more clear cut picture of where you are now and go forward.

I would take a look at your glucose, electrolytes, calcium, your CBC and renal functions.

Many things can effect your lab results. Make sure that you are well hydrated; that you can control.

Just bear in mind that if your PCP and nephrologist don't use the same lab, the ranges and results may vary.

As far as your BP, I would be attentive to that and why it was not addressed prior. Don't laugh, make sure that you don't sit with your legs crossed in the office; crossing your legs can yield a higher pressure. I have seen it with myself.

I would print out current labs from your patient site and next to your current results write the date and the results of your last labs. This will shows a pattern, baseline or up/ down.

Also check off any results which flag H or L based on the ranges provided next to your results and ask. I also would ask about areas which you want clarification.

If you are spilling protein ask which lab indicates this. If you are told borderline in any case, ask what that means and what action plan can be put together to get the lab in a better range.

Ask about medication side effects, diet ( especially sodium) and any concerns that you may have.

Write down any questions that you may have on your lab sheets or in a small notebook including vitals and what was discussed at the visit. I often jot things on my lab sheets when seeing my PCP and then transfer them to my notebook.

When I leave, no doubts and this will serve as a reference point for my next appointment.

When seeing the nephrologist, I ask my husband to come with me and scribe so that I can better focus on the discussion. Just a thought.

You are the patient and have the right to know.

The most important thing is that you questioned an issue and had it addressed.

Know that I and other members of the community are here waiting to know what your doctor had to say.

In the meantime, sit tight and stay positive.

You are among friends!

Bet

[Jason2233 in reply to Bet117]

Hi, All my labs came back normal. Kidney functions were normal. The test was done about 3 weeks ago. My doctor did the random stick test to see if there was any protein. Thankfully it was negative so he didnt feel the need to do 24 hours urine test. Now 3 weeks later, I am noticing more bubbly urine consistently. Surely there is protein leaking more now. I just hate that I am not getting anywhere with this and not getting any answers. What do you suggest I do?

[Bet117 NKF Ambassador in reply to Jason2233]

If you are concerned, Jason, either speak to your doctor about it and if you aren't pleased with the response; get a second opinion.

I would also watch your sodium ( 1500- 2000mg a day) avoid red meats and drink more water. That's just kidney health.

Remember that you are the patient and entitled to be heard, communicated with and must be your own advocate!

Let us know your outcome as we care.

Bet

[jmkb]

Hey there! Are you eating meat, meat products and/or processed foods? These things, as well as nightshades and gluten, can ignite inflammation and thus cause foamy urine.

[Mimi310]

Hi Jason. How are you doing today ? Any updates about your health ? My son is half your age and we are faced with a similar situation as yours. It’s terrifying.

[Jason2233 in reply to Mimi310]

I continue to have foamy urine. And I continue to test negative on dip stick urine test. I am trying not to worry or think about it too much but I am pretty sure there is something wrong. I am waiting on nephro referral and then I will try to have all the test done.

[Mimi310 in reply to Jason2233]

Hi Jason. So sorry to hear that you continue to experience bubbly urine. It’s hard not to worry about it when you see the bubbles day in and day out. As for us, this week was full of worries about my son’s test results but thank God, miraculously, everything came back normal. They do not test eGRF for kids under 18. But I really believe that the bubbles are there for a reason and I need to find the reason. I’m hoping for something benign such as “orthostatic proteinuria.” But because of my son’s other symptoms like knee and kidney area back pain, occasional episodes of itching, etc., I will have to continue to investigate. But for now, I’m just going to de-stress myself. Best wishes to you Jason, and please keep us posted once in a while.

[Jason2233 in reply to Mimi310]

Does his bubbles go away after few seconds.

[Mimi310 in reply to Jason2233]

No, they stay, unfortunately.