Bubbles in urine: What it could mean, according to a kidney doctor
Occasional instances of foamy pee are common for everyone. But sometimes, those extra bubbles in the toilet water are a sign of a more serious condition, such protein in the urine, which can be caused by diabetes or other causes of chronic kidney disease (CKD; see below). This is according to Dr Andrew Stein, a kidney specialist and one of MyHSN’s editors.
Foamy urine is when bubbles mostly or even completely cover the toilet water when you pee.
What is foamy urine?
Foamy urine is when there are lots of bubbles in toilet water when you urinate (pee).
It’s pretty common for foamy urine to occur. Sometimes, when you really have to go, the speed and force of your urine stream causes lots of bubbles to appear. Or if you use a toilet cleaner, your pee may be foamy until you flush all the chemicals away. Foamy urine can also be a sign of dehydration and that you should drink more water.
But if you regularly have foamy urine, or if your pee looks very foamy – think the top of a beer – it might be a sign that something is wrong, and you should see a doctor.
There are lots of different names or descriptions for foamy urine/pee. These may include:
- Foamy pee.
- Bubbly urine.
- Fizzy urine.
- Frothy urine.
How much foam in urine is normal?
It’s common to have foamy urine without it being a sign of something wrong. Bubbles may mostly or even completely cover the surface of the toilet water when you pee every once in a while. But you see your GP if this happens regularly – especially if it takes more than one flush to get rid of all of the bubbles or the bubbles look very frothy and white.
What does foamy urine indicate?
If you regularly have foamy urine or if your pee gets foamier over time, it may be a sign that there’s a high level of protein in your pee (proteinuria). Excess protein in your pee can be a sign of conditions that directly affect your kidneys, such as diabetes, lupus or chronic glomerulonephritis.
How do doctors measure protein in the urine?
We do a test called a urinary ACR (or uACR). This stands for the urinary albumin-creatinine ratio. Albumin is a protein, and this number reflects the amount of protein in the urine.
All humans have a little protein in the urine. But if it goes up, its is a sign of strain on the kidneys, and sometimes chronic kidney disease (CKD). And at higher levels, can cause frothy urine and bubbles.
A ‘normal’ uACR level is less than 3 mg/mmol. So, for this test, a lower number is better.
A uACR level higher than 3 mg/mmol, is called ‘microalbuminuria’ (small amounts of albumin in the urine).
If the ACR is > 50, the urine may become frothy, and you should see a kidney specialist (nephrologist) soon.
If the ACR is very high (>220) we call this nephrotic syndrome, and you will be quite unwell (usually with leg swelling and high blood pressure). If this is the case, ou should see a kidney specialist (nephrologist) soon.
Is foamy urine a symptom of chronic kidney disease (CKD)?
No. It isn’t normally. Foamy urine is not normally a feauture of CKD – especially in its earlier stages (CKD1-3). But if you have high levels of protein in your urine – in some causes of CKD, such as diabetes, lupus and chronic glomerulonephritis – you may have foamy urine.
