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  Monday, 11 February 2019
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Hello Doctor,

Please Please help me.I don't know what's happening with me and why at such a young age.

Let me elaborate my issues point wise.

Age:23 weight:81kg BMI:26(slight overweight) Blood Pressure: 140/90 (High)

(i)Since last 1 year my urine is continuously foamy.Every time i urinate it foams,no matter even if i am adequately hydrated.I am attaching picture of my morning urine so that you will understand how badly it foams.

I obviously got worried after few months,since the episodes were continuous and approached my physician.

He sent me for the following tests. I am attaching reports in attachment and summarising it here.

BUN : 8 (9-20mg/dl)
creatinine: 0.7 (0.8-1.5mg/dl)
s.proteins: Normal
s.electrolytes:normal
ESR:normal
CBC:Normal

URINE ROUTINE: TRACE PROTEIN AND URIC ACID CRYSTALS FOUND.

24HR Urine Protein: 91mg/24hours (<150 mg/24hrs Normal Value)


After reviewing reports my doctor said everything is fine.However he could not give me concrete explanation as to why my urine is so foamy.
He just asked me to reduce my blood pressure from 140 to 120.


On this topic i have done a lot of online research now.


Doctor please answer my following questions.

Question 1) Ok so seeing reports its clear that its not proteinuria ,then why is my urine foamy?is that 91mg/24hr protein foaming my urine? if yes is 91mg/24
hours urine protein normal? or it should be 0? protein should be completely absent in urine right? then why even 91mg/hr is leaking in my urine?


Question 2)Do i need to repeat 24hours urine protein test or do any additional test?

Question 3)Is this situation start of kidney failure or kidney disease or CDK? Do you think this proteinuria will get worst in future?what is happening? are my kidneys gradually giving up?

Question 4)since last 1 year Most of the time i feel fatigued and exhausted even after adequate sleep ,when i visit my physician he sends me for blood tests like cbc,esr,electrolytes etc.Everything comes back normal and cause of my fatigue remains undiagnosed. Please give your diagnosis.

Question 5)How can i reduce my blood pressure from 140/90 to 120/90?


so to summarize you need to answer why my urine is frothy and why i feel constantly fatigued and exhausted.

I would appreciate if you answer all my 5 questions.

Regards,
Tejas
Question 1) Ok so seeing reports its clear that its not proteinuria ,then why is my urine foamy?is that 91mg/24hr protein foaming my urine? if yes is 91mg/24
hours urine protein normal? or it should be 0? protein should be completely absent in urine right? then why even 91mg/hr is leaking in my urine?


There is still some protein in the urine - which is normal. This protein can act as a detergent and cause foam in the urine. I don't believe it is significant. You do have some uric acid crystals in your urine which might explain some of the foam. This might indicate you are at risk of uric acid stones in the kidney but not kidney failure per se (unless you had an extremely complicated case of kidney stones - which is very unusual)

Question 2)Do i need to repeat 24hours urine protein test or do any additional test?


I do not believe any additional tests are warranted for foamy urine

Question 3)Is this situation start of kidney failure or kidney disease or CDK? Do you think this proteinuria will get worst in future?what is happening? are my kidneys gradually giving up?


There is nothing to indicate that you have any risk for chronic kidney disease based on what you have provided.

Question 4)since last 1 year Most of the time i feel fatigued and exhausted even after adequate sleep ,when i visit my physician he sends me for blood tests like cbc,esr,electrolytes etc.Everything comes back normal and cause of my fatigue remains undiagnosed. Please give your diagnosis.


I don't have a suggestion for this based on the information you provided

Question 5)How can i reduce my blood pressure from 140/90 to 120/90?

The best way to reduce blood pressure without medication is weight loss, salt restriction, excercise and stress relief.

Dr. Jordan Weinstein
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