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Bubbly Urine
I'm diabetic since 7 years & hypertensive since 3 years.Both of them are under well control.Recently noticing bubbly urine which often lessens or disappears by drinking more water.Test reports of urine acr,serum creatinine,blood urea & potassium done 6 months ago came absolutely fine & normal.Test report of USG (kub) done 1 year ago also came fine & normal.Also,no swelling in any part of the body. Experienced the same condition a year ago but the test reports of urine acr,24 hrs urinary protein,serum creatinine,blood urea & potassium done at that time came absolutely normal & a nephrologist confirmed that this is not due to proteinuria.Still taking telmisartan 40 mg for bp since many months.Also have stage 2 NAFLD.What might be the reason of such bubbly urine ?
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Bubbly Urine can be because of causes other than proteinuria.
You have already done the necessary tests which came out to be normal
Next Steps
Keep yourself adequately hydrated 3 to 3.5 lt water per day
Dont delay urination
Do the regular yearly Urine Routine, UPCR, and Urine for microalbumin as a part of diabetic yearly evaluation.
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A regular check on Urine microalbumin and creatinine ratio is required
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Bubbly or foamy urine is not always due to protein in the urine. It can occur because of a strong urine stream, concentrated urine/dehydration, or simply the way urine mixes with the water in the toilet. The fact that it often decreases after drinking water makes these benign causes possible.
However, since you have had diabetes from childhood and hypertension for many years, kidney screening should be continued even when serum creatinine is normal. Early diabetic kidney disease can present with albuminuria before kidney function becomes abnormal.
If your previous urine ACR was normal, significant albuminuria is less likely, but because your last testing was 6 months ago, it would be reasonable to repeat it if the symptom is recurring.
Next Steps
Please repeat first-morning urine ACR + urine routine/microscopy + serum creatinine/eGFR. First-morning urine ACR is the preferred sample for assessing albuminuria.
Continue monitoring your HbA1c and BP regularly and continue telmisartan as prescribed. If the ACR and eGFR remain normal, the bubbly urine is more likely to be a benign phenomenon.
Health Tips
Maintain adequate hydration, but there is no need to excessively increase water intake just to eliminate the bubbles. Consult your physician/nephrologist if the foam becomes persistent or is associated with facial/leg swelling, blood in urine, reduced urine output, or worsening BP.
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