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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 was not due to proteinuria.Also have stage 2 NAFLD.What might be the reason of such bubbly urine ?
Answers (16)
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The reassuring part first: you have already done the tests that matter. Urine routine with no protein, normal serum creatinine, normal urea and potassium, a normal 24-hour urine protein a year ago when the same symptom occurred, a normal kidney ultrasound, and no swelling anywhere â that combination makes diabetic kidney disease or any significant proteinuria very unlikely as the cause of your bubbly urine. A nephrologist reaching the same conclusion adds weight to it. Foamy urine that comes and goes, is worse when the stream is forceful or the urine is concentrated, and clears with more water intake, is usually physiological â a matter of urine concentration and surface tension, sometimes helped along by toilet cleaner residue in the bowl. That said, with 7 years of diabetes and 3 years of hypertension you are in the group where early kidney damage must be tracked, and the single test that catches it earliest â the urine albumin-to-creatinine ratio (ACR) on an early morning sample â is far more sensitive than the routine "urine albumin: nil" you have had. If that has not specifically been done, it is the one test I would want. Your stage 2 fatty liver is a marker of insulin resistance and adds to overall cardiovascular and kidney risk, so it belongs in the same conversation.
Next Steps
1) Get an early morning urine albumin-creatinine ratio (ACR) â normal is under 30 mg/g; if it is 30-300 it means early diabetic kidney disease and changes your treatment. Repeat it twice over 3 months before concluding, since exercise, fever or high sugar can transiently raise it. 2) Alongside: serum creatinine with eGFR, HbA1c, fasting lipid profile, and a repeat urine routine with microscopy. Since you have fatty liver, also LFT. 3) Keep the targets tight â HbA1c under 7%, BP under 130/80. If your ACR is even mildly raised, ask your physician about an ACE inhibitor or ARB (e.g. telmisartan/ramipril) for the blood pressure, and about an SGLT2 inhibitor (dapagliflozin/empagliflozin) â these two classes specifically protect the kidney and also help the fatty liver. 4) Practical measure for the foam itself: drink 2.5-3 litres of water spread through the day and see whether the foam disappears; if it vanishes with hydration and there is no protein, it is benign. Also check whether your toilet has cleaner/detergent in the bowl. 5) Reduce salt to under 5 g/day, avoid protein supplements and NSAID painkillers, walk 30-40 minutes daily, and aim for gradual weight loss for the fatty liver. 6) Repeat kidney monitoring at least once a year â or 3-6 monthly if ACR is abnormal. Please feel free to consult me on Practo with all your reports (including the old 24-hour protein and the nephrologist's notes) so I can compare them side by side and tell you what genuinely needs action, or visit me at Synergy Multispeciality Hospital, Miraj, if you are able to travel.
Health Tips
Word of caution: see a doctor promptly if the foam becomes persistent and does not clear with hydration, or if you develop puffiness around the eyes in the morning, swelling of the feet, reduced or frothy dark urine, blood in urine, burning while passing urine with fever, unexplained breathlessness, or a rising creatinine. Avoid painkillers such as ibuprofen/diclofenac, unproven herbal or ayurvedic "kidney" remedies and high-dose protein powders â these are common causes of avoidable kidney injury in diabetics.
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You had changed all as test n doctor, everything ok.
So take it easy
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Kindly do connect and consult for better treatment
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Contact me through Practo for treatment and guidance.
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Could be very early sign of diabetic or hypertensive kidney disease
Medication history needed
Lifestyle modifications needed
Kindly consult for further advice
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Drink more water.Please consult a nephrologist
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If you would like to discuss your concern in more detail, please feel free to contact me on WhatsApp at nine one one nine two five five six nine nine. Alternatively, you can connect with me through the Practo app for a detailed consultation
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kindly do connect and consult with me for better treatment plan and advice on your case via PRACTO app
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Requires a proper assessment to understand the underlying cause and guide you.
Please book a consultation for a detailed evaluation, personalized treatment plan and further advice.
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Urologist
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Wat medicines you are taking at present? Kindly consult with me on 94 two six eight six 78 nine six.
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Dr. Rohan Gumber
General Physician
1 yrs exp
Sri Ganganagar
If you would like to discuss your concern in more detail, please feel free to contact me on WhatsApp at eight six one nine six six nine nine zero six. Alternatively, you can connect with me through the Practo app for a detailed consultation
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Dr. Gaurav Jaiswal
General Physician
7 yrs exp
Jhansi
Avoid fried and spicy food
Water intake more
Green leafy vegetables more
Fiber meal
Walk
Do connect and consult
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Dr. Vetsa Sri Krishna Chaitanya
General Physician
7 yrs exp
Rajahmundry
Need a few more details please consult for further evaluation and treatment
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Dr. Ashita Kuruvilla
General Practitioner
8 yrs exp
Kolkata
Need few more details for further evaluation. Kindly consult
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Dr. Anuj Mothsra
General Practitioner
7 yrs exp
Jhunjhunu
Can help you, kindly consult and provide detailed history for proper diagnosis and further management
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