Sunday, 08 August 2021
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Dear doctor Weinstein

I am a 33 yo male and reaching out to you, because of the problem that I have foamy urine for a few weeks to months and the reason for it is not yet determined. Sometimes the urine is also cloudy.

I had a blood and urine analysis on July 9 this year with the following results:

Blood:

Urea: 6.4 mmol / l (1.7 - 8.3)
Creatinine: 58 umol / l (< 127)
GFR (CKD-EPI): 128

Urine (dipstick):

Specific weight: 1010 (1015 - 1025)
Proteins: negative
Glucosis: normal
Ketons: negative
Bilirubin: negative
Urobilinogen: normal
Nitrite: negative
Blood: negative
Leukocytes: negative

Urine (analysis):

Proteins: 51 mg / l (10 - 140)
Albumin: < 3 mg / l (< 43)
Creatinine: 5.3 mmol / l

My GP says there is nothing to worry about and that she cannot say what's causing the foamy urine.
The thing is that the urine spot sample I voided on July 9 was quite diluted as you can see form the low specific weight. Despite the dilution there was 51 mg of proteins per L urine, so I assume if I gave them a morning urine sample the results wouldn't be that good...

I have to mention the drugs I take every day, maybe they are causing the foam?

- Perindopril 10mg
- Amlodipine 10mg
- Venlafaxine 75mg ER

Other than that I drink alcohol very moderately (one beer up to 3 times a month), I don't smoke, I'm underweight (182 cm tall, 69 kg) and very active in terms of outdoor sports (walking). I do suffer from regular and heavy stress due to the mental illness (anxiety disorder) I'm suffering from all my life.

Attached you will see a urine sample I have just taken half an hour ago. It is quite concentrated, because I spent the whole morning outside moving around.

urine.jpg

My GP blocks all further requests to do another check and only says I should be drinking enough fluids. This is down to me saying when I'm very well hydrated the foaming isn't as heavy (it's always there). To me this is not enough and causes a significant amount of anxiety. The brother of my best man suffered a sudden complete renal failure (he was 28 at the time) and only survived because of stringent dialysis and a kidney transplant from his own mother. That stuck with me and foamy or cloudy urine does not seem normal. My wife doesn't have that, even when her urine is concentrated.

What is your opinion on that? Does that sound like a kidney problem that needs to be further examined? Could it be that my kidneys begin to fail, but not yet to the extent that serum creatinine is affected? Compared to serum creatinine measured last year it is actually a little LOWER than it was last year (max. 77 umol / l in 2020).

I would be very grateful for a quick reply from your side as I'm terrified I could be suffering the same way one day as did the brother of my best man. He went through an ordeal very few people can imagine going through. He was so strong.

Many thanks.

Best regards from Switzerland.
Damian
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