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Anthony Bray, MD
Anthony Bray, MD, Doctor
Category: Health
Satisfied Customers: 6662
Experience:  14 years as clinician in the field of Family Practice
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There is a protein leak in my urine which caused the urine

Resolved Question:

There is a protein leak in my urine which caused the urine to be very foamy.

It was a sudden occurrence some 4 days ago and don't know what caused it. Urine test with a dip stick showed only protein, no blood or sugar, BP at border line 140/90.

I am 48 years of age. Last medical blood test results done in July 2012 showed liver and kidney functions normal, sugar and cholesterol levels all within range.

Could it be a temporary issue? Have reduced protein from my diet, taking more water, went for acupuncture treatment and hoping it will subside in the next few days.

What are ur views on my condition? Pls advise
Submitted: 1 year ago.
Category: Health
Expert:  Anthony Bray, MD replied 1 year ago.

Anthony Bray MD :

Hello!

Anthony Bray MD :

I would advise that you do follow up with regard to monitoring your BP>> check this several times a week and check in seated position after 10 minutes rest.. check and keep a list or record... it is best to look at an average of say 10 to 15 numbers over time... the average should be 135/85 or less >> if it stays higher then you might need treatment>> the first step in this regard would be to reduce your salt (or sodium ) in your diet consumption....

Anthony Bray MD :

The BP very much ties to kidney function. The kidneys have a key role in regulating the BP and conversely the BP remaining normal is important to the health of tyour kidneys ( as well as heart and blood vessel health)...

Anthony Bray MD :

The foamy appearance of the urine is not generally regarded to be a sign of pathology... I would not stress this so much to be a key factor...

Anthony Bray MD :

On the other hand it is normal that you would would not have much protein in the urine... small amount may be present but a high amount of protein in the urine would be abnormal...

Anthony Bray MD :

If urine dipstick indicates more than minimal protein then you may indeed need further follow up on that>> A 24 hour urine to quantify the protein in urine may be needed in some cases...

Anthony Bray MD :

Certain kidney diseases can lead to abnormal protein loss...

Anthony Bray MD :

I hope this information helps >> Let me know if youhave further questions ? information / discussion >> I will be happy to get back with you!!

Anthony Bray MD :

If my answers have been helpful and to your satisfaction then please remember to leave positive feedback. That would be very much appreciated! Thank you and Best Regards,

Anthony Bray MD :

Anthony Bray MD

Customer:

I still have foamy urine and decided to do another urine test this morning,the dip stick at the hospital showed no more protein and the lab test as well showed very little trace which contradicts the earlier two GP test which I did on Tuesday.

Customer:

I did go for acupuncture trearment on Thursday and took some Chinese herbs from the TCM to cleanse the kidneys which could have resulted in the urine clearing up the proteins. However the urine is still a bit foamy.

Customer:

BP is stable at 140/85,I am attaching the lab urine test which the doc commented does not show any thing serious but can of course opt for a kidney scan if still concerned.

Anthony Bray MD :

Hello again >> To me it is most assuring that the urine does not show abnormal protein now. That would be the main potential concern from your history...

Anthony Bray MD :

As for the foamy appearance of the urine I do not have patients specifically look for this although if there has been a dramatic change then it could be a sign of more contaminants such as protein in the urine. Some foam or bubbles of the urine is a common phenomenon and not necessarily a sign of any pathology ( ie > not indicating any disease of the kidney)

Anthony Bray MD :

If you urinate into a toilet and the water in the bowl has any detergent lingering then this will create a lot of foam itself...

Anthony Bray MD :

I agree that your BP is borderline elevated > goal is for your AVERAGE to be maintained at 135/85 ...

Anthony Bray MD :

I would advise that you try to exercise regularly and to cut the salt /sodium content down in your diet adn continue to follow your BP over time... if it stays at or above that 140/90 then treatment to control it should be considered....

Anthony Bray MD :

Consider that compared to AVG of 135/85 VS 155/95 >> this degree of difference over time ( years) would correspond with a double risk of heart atttack/stroke as you age...

Anthony Bray MD :

Now the 140 /90 is not that far from 135/85 so many would elect not to treat that early but even at this 5 point elevation IF THIS IS AVERAGE for you and you fail to improve it with diet and exercise then a mild treatment for BP should be considered. HCTZ is an option that would be cheap, mild and usually no side effects for most who take this...

Anthony Bray MD :

I hope that this helps! Let me know if you have further questions and I will be happy to get back with you!

Anthony Bray MD :

Best Regards,

Anthony Bray MD :

Anthony Bray MD

Customer:

no,there is no detergent in the bowl which of course I ensure,and yes it is a dramatic change in foaminess. Its not more of a bubble but more like Beer like foam.

Customer:

So if the protein has subsided and not showing in the test done ,I cant understand the presence of the foam unless it is an on and off leak.

Anthony Bray MD : Hello again,
Anthony Bray MD : I would be reassured if you had the follow up urinalysis that showed no protein at this point...
Anthony Bray MD : From my perspective this would be a very good finding and would be more important than foam or no foam of the urine...
Anthony Bray MD : I would consider the ursine foam more as a potential sign of trouble than any definite sign of trouble...
Anthony Bray MD : As I noted earlier this is a sign that I would not really inquire of patients but I would have interest in the report if significant change as in your case....
Anthony Bray MD : As long as you had normal BUN and creatinine on your blood tests ( this reflects your kidney function) and the urinalysis looked good--- then these two indicators would be reassuring of normal kidney function...
Anthony Bray MD : If you had any kidney disease then it would be reflected by either and probably both the urinalysis and the blood tests of BUN and creatinine.
Anthony Bray MD : I hope that this information helps. Let me know if you have futher questions! I will be happy to get back with you!
Anthony Bray MD : Best Regards,
Anthony Bray MD : Anthony Bray MD
Anthony Bray, MD, Doctor
Category: Health
Satisfied Customers: 6662
Experience: 14 years as clinician in the field of Family Practice
Anthony Bray, MD and 5 other Health Specialists are ready to help you
Customer: replied 1 year ago.

Hi Doc,its been 10 days and my foam in urine has not cleared.I went for a ultra scan and the kidney and bladder showed normal functions,


went for a full blood test and uric acid was high but all others creatinine etc all normal,


 


Redid urine full test and it showed trace in blood at level 2 which the doc says is normal and protein leakage at 1+ which is not in the danger zone


 


He might call for a 24 hr urine test if it does not clear in a weeks time.


 


I had a bruise on my left kidney after a session of hard massage 12 days ago and noticed the leak and foam in my urine 2 days later.


 


I exercise like 5 days a week walk and a jog


 


I also was on herb Tonkat Ali for one and a half months which I have temporarily stopped.


 


I also take supplements like Cinnamon, Omega 3,Cranberry,Vitamin C,brain tonic.


 


I am pretty worried and from your experiance how long will the foam clear off and the leak as well.


 


Should i lay off exercise for a while? Should I go on a vegetarian diet for a while?Are there any medications I can take to block the leakages?


 


Should I stop my acupunture therapy that I have just restarted as an alternative treatment.Please advise.


 

Customer: replied 1 year ago.

Hi Doc,its been 10 days and my foam in urine has not cleared.I went for a ultra scan and the kidney and bladder showed normal functions,


went for a full blood test and uric acid was high but all others creatinine etc all normal,


 


Redid urine full test and it showed trace in blood at level 2 which the doc says is normal and protein leakage at 1+ which is not in the danger zone


 


 


He might call for a 24 hr urine test if it does not clear in a weeks time.


 


I had a bruise on my left kidney after a session of hard massage 12 days ago and noticed the leak and foam in my urine 2 days later.


 


I exercise like 5 days a week walk and a jog


 


I also was on herb Tonkat Ali for one and a half months which I have temporarily stopped.


 


I also take supplements like Cinnamon, Omega 3,Cranberry,Vitamin C,brain tonic.


 


I am pretty worried and from your experiance how long will the foam clear off and the leak as well.


 


Should i lay off exercise for a while? Should I go on a vegetarian diet for a while?Are there any medications I can take to block the leakages?


 


Should I stop my acupunture therapy that I have just restarted as an alternative treatment.Please advise.


 

Expert:  Anthony Bray, MD replied 1 year ago.
Hello again,I would of course follow up on the urine. The 1 plus protein sounds consistent with only minimal protein loss but I do think that follow up would be the best-- maybe in 2 and 6 months time for example . I would not overly worry about the foam with urination. We do not really look at this as a reliable clinical sign of pathology of the kidney( on the other hand I would listen to reports of a dramatic change in this regard). The Bun and creatinine being normal on your blood work would be the most important indicator of NORMAL function of your kidneys. Decreased kidney function leads to a rise in these blood markers. The 24 hour urine may not be needed if you have only 1plus protein. It would be needed if this were 3 or 4 + protein. So the collection if your results seems to me to be more reassuring of your kidney health and function and not concerning.The acupuncture should not harm your kidneys.The supplements are fine as far as I am aware. ( I don' know all the ingredients of your brain tonic but I doubt anything harmful...) Continue to monitor your blood pressure with goal of keeping this average 135/85 or less. If you should need medicine for BP then an ACE inhibitor or A2 blocker would be the best choices as these are protective if the kidneys and tend to reduce protein loss. These are protective for diabetics with chronic kidney disease for example.I hope that this information helps. Let me know if you have further questions or concerns. Best Regards,Anthony Bray MD
Customer: replied 1 year ago.
Hi Doc I am back, urine is still with protein,
i bought the dip stick from the pharmacy and it fluctuates from 0.3 to 3+ at different times.

I have got the 24 hours container which I have just started 30 minutes ago and will sent it to the lab tomorrow. I was advised by some doctors to do the Micro albumin test and the bence jones protein test at the same time,my last ultarscan done 7 days ago showed normal kidney and liver functions and blood test cretemine liver,etc all in normal range. I am 48 years of age,is the bence jones necessary in your opinion. What happens if my 24hrs protein is on the high level or low level,what happens from there?
Expert:  Anthony Bray, MD replied 1 year ago.

Hello again,

 

Yes > those added tests would be useful. The urine excretion of protein/albumin and others will vary from day to day to an extent. Physical exercise, infection, fever, marked hypertension, marked hyperglycemia ( high blood sugar) , congestive heart failure are possible reasons for this variation ( I am not saying that you have these conditions but that is the spectrum of factors >> up and down microalbumin in particular...)

 

The microalbumin measures a protein that may not be picked up reliably by the dipstick..

 

The Bence Jones protein ( here the tests combination of immunofixation and urine protein electrophoresis are done) >> these tests screen for abnormal protein PRODUCTION as it may be seen in certain conditions such as lymphoma, monoclonal gammapathy and others...

 

The quantitative protein helps to determine the health of the kidneys in part as well as screening for abnormal protein presence as would be the case in some conditions as mentioned above.

 

Kidney conditions such as IgA nephropathy would be potential to cause ongoing excess of protein in the urine ( this latter condition usually would cause episodes of blood in the urine as well and would have most likely led to abnormal finding of high creatinine...

 

Certain conditions leading to protein in the urine may benefit from treatment with an ACE inhibitor or A2 blocker for your BP>>

 

I hope that this information helps! Let me know if you have further questions and I will be happy to get back with you!!

 

Best Regards,

 

Anthony Bray MD

Anthony Bray, MD, Doctor
Category: Health
Satisfied Customers: 6662
Experience: 14 years as clinician in the field of Family Practice
Anthony Bray, MD and 5 other Health Specialists are ready to help you
Customer: replied 1 year ago.


Hi Doc bence jones was negative,24 hr urine test results as follows:


 


UR TV PROTEIN 2804ML


UR TOTAL PROTEIN 1.00G/L


UR 24 TOTAL PROTEIN 2.80 G/24


UR TV MICROALBUMIN 2804ML


UR MICROALBUMIN 77.73 MG/DL


UR MICROALBUMIN 2180H/MG/24HRS


 


Saw a renal specialist he put me on olmetec 20mg once a day x 30 days and says I am losing 2 gram protein a day and after medication if it does not come down to 1 gram possible biopsy might be needed.


 


I am 10 days on medication right now and the home read dipstick readings are much better fluctuating from Trace to 0.3g/l throughout the day.


BP is stable at 115/75-120/80 with the Olmetec as well


 


My question if with permanent medication it can stay at the 0.3g/l level am I in danger of progressing to Dialysis in the future?

Expert:  Anthony Bray, MD replied 1 year ago.
Hello again!!

The medication that your are taking is a very good choice which contains an A 2 blocker class which helps to reduce protein loss in the kidneys and does help to preserve the health an function if the kidneys. It is not a guarantee to protect the kidneys over time(everyone will have gradual weakening if kidney function with age...)

The blood pressure results look very good. Good control of BP is essential to protect the kidneys as well.

The Medication works by changing the pressure of blood flowing into nephrons ( = the basic functional unit if the kidney. It decreases the pressure on these structures which in excess may do more to force protein out.

So I would expect some improvement with the medication. This may be monitored periodically by checking serum BUN and creatine and 24 hr urine for protein and creatinine clearance.


I hope this helps! Let me know if you have further questions and I will be happy to get back with you! If my answers have been helpful and to your satisfaction then please remember to leave positive feedback. Thank you and best regards,

Anthony Bray MD
Anthony Bray, MD, Doctor
Category: Health
Satisfied Customers: 6662
Experience: 14 years as clinician in the field of Family Practice
Anthony Bray, MD and 5 other Health Specialists are ready to help you

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