Health Tips

Most Malaysians love a cup of foamy teh tarik, it’s a great way to start the morning or to watch a football match at night. But a foamy urine? Not loving it.

We apologise for comparing teh tarik to urine, but you get it — your urine can be a window to your health.

Normal urine is clear, yellowish and sometimes with bubbles; those bubbles are big, clear and flushable. On the other hand, if you notice foams in your urine that don’t settle away even after a few minutes/after you flush, then you should see a doctor. Here’s why.

It may be proteinuria

Freshly voided urine by a patient with nephrotic syndrome. Image credit: https://doi.org/10.2215/CJN.06840619

A foamy urine is called proteinuria, which stems from the combination of the words ‘protein’ and ‘urine’. The persistent foam is a sign of protein present in your urine, which should not be the case in an otherwise healthy person. Kidneys filter waste products and excrete them into the urine, but proteins should not be filtered out into the urine, they should instead stay in the blood. If proteins escape the kidneys into the urine, it may mean that your kidneys are damaged.

Proteinuria, accompanied with other complications, constitute a condition known as nephrotic syndrome, which is one form of kidney damage. Nephrotic syndrome can be caused by many medical conditions, including chronic kidney diseases, diabetes and taking non-steroidal anti-inflammatory drugs (NSAIDs) for long-term.

Why is having proteins in the urine bad for you?

Proteins are the building blocks for a healthy body, so just imagine losing proteins daily into the urine. That would lead to protein malnutrition and loss in lean body mass. The main type of protein lost in nephrotic syndrome is the albumin, therefore it can also lead to hypoalbuminemia. Hypoalbuminemia is a condition in which there’s too little albumin in the blood, and this can have knock-off events on the body’s physiology, such as higher blood lipid levels and affect how certain medications work in the person’s body.

Losing proteins into the urine also leads to swelling in the legs, ankles, feets, lower abdomen or other parts of the body. People can gain weight because of these swellings.

Nephrotic syndrome is also known to cause blood clots that can lead to thrombosis (clots stuck in the blood capillaries and obstructs blood flow to the organs). People with foamy urine also have poorer immunity because they lose immunoglobulins into the urine, and they can get sick easily. Immunoglobulins are the important part of the immune system that fight against infections.

Studies have found that foamy urine is linked with higher risks of high blood pressure, worsening of chronic kidney disease and end stage kidney failure—that’s when you need to start dialysis.

Seek medical attention as early as possible

If you notice persistent foams while also having the following issues:

• High blood pressure

• Kidney disease

• Diabetes

• Swellings in your legs, ankles or abdomen

Seek medical attention as soon as possible. Your doctor would conduct urine dipstick analysis to screen for proteinuria and if there’s any blood in the urine (called haematuria). Depending on your conditions, your doctor may prescribe you certain medication that is known to be beneficial for people with high blood pressure and proteinuria. They are known as the:

• Angiotensin-converting enzyme (ACE) inhibitor, e.g. perindopril, lisinopril, enalapril

OR

• Angiotensin receptor blocker (ARB), e.g. losartan, valsartan, telmisartan

You may read more about medications for high blood pressure here.

Your doctor may also prescribe diuretic (‘water pill’) to reduce your body’s swelling, and such treatment is usually short-term and should be stopped after you do not have swelling. If you are at high risk for developing blood clots, your doctor may also prescribe you with blood thinners.

Meanwhile, it’s super, super important for you to continue adhering to your medical treatment for diabetes, high blood pressure, high blood cholesterol and chronic kidney disease.

These problems do not usually happen in isolation— they happen in tandem, and worsening of one condition can affect the progressions of another. It’s also crucial for you to limit your salt intake in your daily diet (limit to 2300mg of salt/ 1 teaspoon of salt) and follow your doctor’s order on fluid intake (if any).

Isn't it amazing that there is so much knowledge in just a foamy urine? If you’re keen to learn more, consult a healthcare professional.

A word from DOC2US

If you have any questions related to kidney health, you can consult our professional doctors and healthcare professionals on DOC2US. DOC2US is a mobile application that allows you to talk to a doctor or any healthcare professionals via text chat at any time and from anywhere. For better communication, you can even send our online doctor images or voice messages related to your medical inquiry.

Download DOC2US app on Apple App Store, Google Play Store and Huawei App Gallery; or use our web chat at https://web.doc2us.com/

Note: DOC2US is not for medical emergencies. In the event of urgent medical conditions, please call 999.

Disclaimer: As a service to our users and general public, DOC2US provides health education contents. Please note the date of last review or update on all articles. No content on this site, regardless of date, should ever be used as a substitute for direct medical advice from your doctor or other qualified clinician.

Specific references have been linked in its relevant part of the article. 

Cover image credit: Jonathan Lin, CC BY-SA 2.0 , via Wikimedia Commons

Written by

Ms Joyce Toh