From the Guidelines
Foamy urine is most commonly caused by the presence of protein in the urine, known as proteinuria, which can be a sign of kidney disease. When protein levels in urine are high, it creates a foam-like appearance similar to beaten egg whites. This can be a sign of kidney disease, as healthy kidneys typically don't allow significant amounts of protein to pass into urine. Other causes include dehydration, which concentrates your urine; rapid urination, which introduces air and creates bubbles; certain medications; urinary tract infections; or even normal variations in some people. If you notice persistent foamy urine, especially accompanied by swelling in your hands, feet, or face, fatigue, or changes in urination patterns, you should consult a healthcare provider. They may order tests like urinalysis to check for protein levels and assess kidney function, as recommended by the National Kidney Foundation practice guidelines for chronic kidney disease 1. While occasional foamy urine might not be concerning, persistent foam warrants medical evaluation to rule out kidney problems, diabetes, or high blood pressure, which are common underlying causes of proteinuria. Monitoring of proteinuria and/or albuminuria should be considered standard care for individuals with kidney disease, as it is an established risk factor for progression of chronic kidney disease (CKD) 1. In fact, reduction of proteinuria using ACE inhibitors or ARBs is associated with significant improvement in renal survival in patients with CKD, highlighting the importance of controlling proteinuria in the management of kidney disease 1. Therefore, if you are experiencing persistent foamy urine, it is essential to consult a healthcare provider to determine the underlying cause and receive appropriate treatment to prevent further kidney damage. Some key points to consider include:
- Proteinuria is a common cause of foamy urine and can be a sign of kidney disease
- Other causes of foamy urine include dehydration, rapid urination, certain medications, and urinary tract infections
- Persistent foamy urine warrants medical evaluation to rule out kidney problems, diabetes, or high blood pressure
- Monitoring of proteinuria and/or albuminuria is essential in the management of kidney disease
- Controlling proteinuria using ACE inhibitors or ARBs can improve renal survival in patients with CKD 1.
From the Research
Causes of Foamy Urine
- Proteinuria, or the presence of excess protein in the urine, can cause foamy urine 2, 3, 4, 5, 6
- Chronic kidney disease (CKD) is a common cause of proteinuria, and can lead to foamy urine 2, 3, 5, 6
- Other conditions, such as diabetic nephropathy and IgA nephropathy, can also cause proteinuria and foamy urine 2, 4
Treatment and Management
- Angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) are commonly used to treat proteinuria and reduce foamy urine 2, 3, 4, 5, 6
- Combination therapy with ACEIs and ARBs may be effective in reducing proteinuria, but can increase the risk of adverse events such as hyperkalemia and progressive renal impairment 2, 3, 5
- Mineralocorticoid receptor blockers (MRBs) may also be used to reduce proteinuria, but their effectiveness and safety are still being studied 5
Prognosis and Outcomes
- Proteinuria is a significant risk factor for cardiovascular disease and progression of kidney disease 3, 4, 6
- Reducing proteinuria through treatment can improve outcomes and slow disease progression 2, 4, 6
- Foamy urine can be a sign of underlying kidney disease, and prompt evaluation and treatment can help prevent long-term damage 2, 3, 4, 5, 6