Bubbles or foams in urine is one common urinary changes in renal failure patients. It is called proteinuria in clinic which is closely linked to glomerular barrier functions.
Of cause, bubbles or foams in urine does not definitely mean kidney disease. If the bubbles disappear after hours or days, it can be due to rapid urination, dehydration, sexual intercourse, pregnancy, too much intake of meat products and high-protein foods, etc.
However if foams in urine last for long time without any alleviation, it is mostly caused by renal damages or renal injuries. If routine urine test shows urinary protein is positive, it is proteinuria which has much to do with the progression of kidney disease, therefore early and proper treatments should be received.
To have effective treatments, we need first make clear the root cause of proteinuria. Proteinuria is mainly classified into glomerular proteinuria and renal tubular proteinuria according to which part of the kidneys are damaged.
Renal glomeruli is net of blood vessels in the kidneys which filter and purify the blood by discharging metabolic wastes such as creatinine, urea nitrogen, uric acid, pigments and some electrolytes. Normally, proteins and red blood cells in the blood can not pass through glomeruli due to mechanical barrier and charge barrier. However when renal glomeruli are damaged, proteins and red blood cells will be leaked out and pass into urine. Abnormal proteins in urine will cause a lot of bubbles in urine.
Glomerular proteinuria can be selective and non-selective. The former is more common among nephrotic syndrome with urinary protein qualitative between +++ to ++++ and urinary protein quantitative more than 3.5g/24h. Non-selective proteinuria means that glomerular capillary walls are severally damaged. It is more common in primary and secondary glomerular diseases.
Renal tubular proteinuria
When renal tubules are inflamed, poisoned or involved in secondary glomerular diseases, its resorption function will be inhibited and some micromolecular proteins leaked through glomeruli can not be re-absorb. In this condition, urinary protein qualitative is + or ++ and urinary protein quantitative is 1-2g/24h.
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