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  Tuesday, 09 July 2024
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I hope you're well. I've seen that you help people by answering their questions, and as a nephrologist, I hope you can help me ease my mind. I'm really afraid and have an appointment with my nephrologist in a month.
I had three phosphatic kidney stones (two in the left, one in the right). I passed two but still have one in my right kidney. I also have constant foamy urine and intermittent leg edema, which usually resolves by morning.
Six months ago, my 24-hour proteinuria analysis showed 230 mg/day and then 116 mg/day. While within the normal range, it's still high normal. I'm worried this might be linked to multiple myeloma.

Here are my recent lab results from two weeks ago:

Hematology Results
• Hemoglobin: 15.8 g/dL (Normal range: 13.0-17.0)
• Leukocytes: 9,700 /mm (Normal range: 4,000-11,000)
• Platelets: 369 x 10¾uL (Normal range: 150-450)

• Sodium: 141 mmol/L (Normal range: 135-145)
• Potassium: 4.5 mmol/L (Normal range: 3.5-5.1)
• Chloride: 102 mmol/L (Normal range: 98-107)
• Bicarbonate (Alkaline Reserve): 25.8 mmol/L (Normal range: 22.0-30.0)
• Phosphorus: 27 mg/L (Normal range: 25-45)

-Uric Acid: 51 mg/L (Normal range: 34-70)
-Urea: 0.22 g/L (Normal range: 0,18-0,45)
-Creatinine: 10,2 mg/L (six months before was 11,4)
-eGFR: 90 (six month before was 79)

-Total serum Proteins: 76 g/L (Normal range: 60-80)
-25-(OH) -vitamin D (D2+D3): 14,6 ng/mL (Normal range:
-PTH (parathormone): 44,1 pg/mL (Normal range:
-Serum Calcium: 99 mg/L (Normal range: 86-103)

Urine Analysis
Protein to Creatinine PCR (Spot Sample)
• Proteinuria: 118.8 mg/L (Normal range: <140.0)
• Urinary Creatinine: 2,040 mg/L (Normal range:
• Protein/Creatinine Ratio: 0.06 g/g (Normal range: <0.30)

Spot Crystalluria: NEGATIVE

Cytobacteriological Examination of Urine
• Appearance: Clear
• Color: Yellow
• pH: 7.0 (Normal range: 5.0-7.0)
• Glucose: Negative
• Proteins: Negative
• Blood: Negative
• Leukocytes: Negative
• Nitrites: Negative
Microscopic Examination
• Red Blood Cells: 0 /ML (Normal range: <5)
• Leukocytes: 2/ML (Normal range: <10)
• Casts: Absent
• Crystals: Absent
• Epithelial Cells: Absent
• Yeasts: Absent
Bacteriological Examination
• Culture: No bacterial growth detected
The main cause of frothy urine is abnormal urine protein. This is not the case here. Urinary sediments (such as that which would contribute to kidney stones) can cause cloudy and frothy urine. I am not sure why you would specifically be concerned about myeloma but I see no indication of that here.


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