Foamy Urine and Protein in Urine: Causes, Urine Testing and Next Steps

What it involves

MedlinePlus explains that the urine protein dipstick test measures the presence of all proteins, including albumin, in a urine sample. Small amounts of protein are normally present in urine. Larger amounts can mean the kidneys are not filtering properly. The medical terms are proteinuria and albuminuria, and a provider may order a dipstick, a more sensitive albumin test or a 24-hour collection.

Who this is for

• Adults who keep noticing foamy or bubbly urine that does not clear after a few days.
• People with diabetes or high blood pressure who need regular kidney screening.
• Patients with swollen ankles, puffiness around the eyes or unusual tiredness.
• Anyone whose urine test at another office showed protein and who wants follow-up.

What to expect

• Questions about how long you have noticed foam, your fluid intake, medicines, diabetes and blood pressure
• A urine sample, including a dipstick check, and blood work to look at kidney function
• A review of anything that can temporarily affect the result, such as dehydration or infection
• A plan to repeat the test, treat the cause, or refer you to a kidney specialist if needed

Foam versus protein

Foam in the toilet is a visual clue, not a diagnosis. A strong stream hitting the water, a full bladder or dehydration can all make bubbles that fade within a minute or two. Protein is a measurement, and only a urine test can confirm it. If the foam is new, stays for a long time and shows up at most trips to the bathroom, it is reasonable to ask for a test, especially when you also have swelling or a history of diabetes or high blood pressure.

How the urine test works

The MedlinePlus encyclopedia explains that after you provide a sample, the provider uses a dipstick with a color-sensitive pad, and the color shows the level of protein. If needed, you may be asked to collect urine at home over 24 hours. The test involves normal urination, with no discomfort and no risks. A routine dipstick can miss small amounts, so a urine microalbumin test may be used to detect small amounts of albumin. The urinalysis explainer describes the wider panel.

What can change the result

Several things can interfere with a urine protein result, according to MedlinePlus: dehydration, strenuous exercise, a urinary tract infection, fluid from the vagina that gets into the sample, and contrast dye from a radiology scan within the previous three days. Different medicines can also change the result. Tell the provider what you take, and do not stop a medicine before talking to the office. A single positive result is often repeated before anyone draws a conclusion.

What higher protein levels may mean

The encyclopedia lists causes of larger amounts of urine protein: heart failure, kidney problems such as kidney damage, diabetic kidney disease and kidney cysts, dehydration, multiple myeloma, problems during pregnancy such as preeclampsia, and urinary tract problems such as a bladder tumor or infection. The test is most often done when a provider suspects kidney disease, and it is used as a screening test in people with diabetes. Kidney disease is covered in the chronic kidney disease guide.

Blood tests and ongoing follow-up

Urine protein is only half the picture. Blood work shows how well the kidneys are clearing waste, and the kidney function tests page explains the numbers a provider reviews. Blood work is among the services the practice lists. If you have diabetes, regular urine and blood checks are part of staying ahead of kidney damage, which the diabetes management page describes. High blood pressure also strains the kidneys and is followed at routine visits.

When to be seen sooner

See a provider promptly if foamy urine comes with swelling in the legs, face or around the eyes, blood in the urine, burning, back or side pain, fever, or unusual tiredness. The blood in urine guide covers that symptom, and the leg swelling guide covers fluid buildup. Trouble breathing, chest pain or confusion needs emergency care. In pregnancy, protein in the urine with high blood pressure or severe headache should be reported to an obstetric provider immediately.

Sources

• MedlinePlus: Urine protein dipstick test (encyclopedia)
• MedlinePlus: Chronic kidney disease (encyclopedia)