Foamy urine and waiting in the wings for open heart surgery

[NMJim]

How fast can CKD hit you? I have controlled hypertension, and missed my physical in 2020 because of covid. Back in Oct of 2019 I had my last blood work done, and it was good on the kidney front. GFR of 90, creatinine where it should be. I have not been dxed with diabetes, though I have the gene for type 2.

The last three weeks though have me worried. I have had foamy urine all the time, but no other symptoms. Well, I have dull lower back pain due to just being a guy in his 50s who hurts his back a lot, so I am not sure if trauma could be masking kidney discomfort. No edema.

I went to my pcp, she confirmed NO UTI, and did bloodwork. I am expecting the results Monday. I normally wouldn't bother folks like you until I had a solid diagnosis, but I am in a bind. I have an aortic aneurysm due to be repaired this year or next, and kidney problems right now would be an amazingly unfortunate complication.

So in the effort of staying on top of this, for the sake of an impending heart surgery and assuming the worst--I really fail to see what consistently foamy urine could be besides a kidney issue--what questions should I think to ask? Should I demand a referral to a nephrotlogist regardless of what my pcp says? If the blood work should come back fine, I would be pleasantly surprised, but given the consistent foam I am nervous about those odds.

How likely would it be to go from 90 GFR to the point where I am passing enough protein to cause foam in 15 months?

Thanks guys. I appreciate your patience with me. Hoping to dodge the bullet, but my aneurysm and heart valve issues have taught me to be very proactive with my healthcare, and I was not expecting to deal with potential kidney issues. Looking for help where I can get it.

[orangecity41 NKF Ambassador]

Advise your Doctor of the symptoms. 90 is a very good eGFR. Perhaps request another eGFR test. You Doctor is the only one who can diagnose you.

[NMJim in reply to orangecity41]

Oh for sure, I definitely wasn't looking for a diagnosis. I was just curious if anyone else went from a GFR of 90 to kidney failure in the space of 15 months is all. It seems very fast to me. If that is what has happened to me, I was trying to arm myself with information to help determine the cause and how to approach a specialist, so I can work around my coming open heart surgery.

Just a lot of medical stuff to process, and trying to stay ahead of things. After my aneurysm diagnosis, I spent a lot of time playing catchup.

Thanks!

[WYOAnne NKF Ambassador in reply to NMJim]

Usually you can only diagnose someone with CKD when you have a series of blood tests done. A doctor usually looks at a trend over time - 10-12 months. One blood test does not CKD make.Foamy urine does not necessarily mean there is something wrong. Your doctor already tested you for a UTI, which can be a cause. Dehydration and forceful urination can also be causes. And Yes, if you have protein in your urine. But that should have shown up in your urinalysis.

When you have your lab results back see what your BUN is? Then, if it is high, shows you are dehydrated. What is your creatinine? A 90 eGFR is a very good value in the normal range. Just know that both your GFR and creatinine can both be effected by hydration, stress, a high protein meal and exercise done the day before testing. And the eGFR is but an estimate.

You should look at a month or so having your labs repeated. Remember for CKD you are looking at a trend over time. Chances are, the foamy urine is but a fluke or maybe you should drink more water throughout the day. I have found that if I don't drink enough many of my lab values can be effected. If the foamy urine continues, certainly get those labs repeated.

Let us know the results. Best of luck with your upcoming aneurysm surgery.

[NMJim in reply to WYOAnne]

Thanks a lot for taking the time to chat with me. Very calming. I have to say, I went from being in what I thought was excellent health three years ago to needing a medical team in the space of one annual physical. Normally I can take it. Sort of numb to it, but this mess with my urine has made me a wreck. Get my results tomorrow, so keeping my fingers crossed. This too shall pass.

[MGNKF in reply to NMJim]

Hi NMJim, hopefully by now you got your blood results and everything is fine. My situation is similar. I went from an 85 GFR to 65 in a matter of two years and my urine has been foamy. Blood work shows I’m leaking some protein. I’ve been on medication for several years for HBP and D2. My PCP for months said he wasn’t worried but I insisted on seeing a Nephrologist. I did last week, he also said I have CKD stage 2 and yes I have protein in my urine but he said I should not be worried, didn’t prescribed additional test or follow up. His only recommendation was to keep my HBP and D2 under control.Im still going to continue my CKD diet and keep an eye on my blood work every three months. Needless to say I still have foam in my urine. Good luck and don’t worry that much but be vigilant.

[NMJim in reply to MGNKF]

Thanks! I did get it back, and surprisingly, all my numbers were great. My GFR was actually 94, better than it has ever tested. My liver, blood sugar, creatinine, BUN, all perfect.

Which while good news, actually leaves me with more questions than answers. Should it end up being kidney problems, I am guessing I am in early days, which is also good news. I understand most people don't get the chance to catch it very early, and the earlier it is caught, the more successful the intervention can be.

Next up, I am going to ride it out a couple weeks and see if there are any changes. Assuming it doesn't quit foaming, I am going to do a blood repeat, and a urinalysis too.

Right now covid is kind of on a tear here, so I am keeping my doctor visits to a minimum, as I have not had access to the vaccine yet.

[MGNKF in reply to NMJim]

Glad you got heat results and your GFR is back up. At that rate you are on stage 1 of CKD. I have the same problem, my GFR is back to 75 (stage 2) and the Urine test shows I’m leaking some protein. I still have foamy urine but the Nephrologist tells me I should just try to control my Diabetes 2 and HBP and most likely will never go pass stage 3.He had some program that calculates the likelihood of a person developing final renal failure..my number is a possibility of 1%.

My Drs are not worried but I al. It doesn’t seem normal to have foam in the urine.

Keep us posted on your progress..