Proteinuria is the common clinical symptom and abnormality in laboratory test of renal failure and patients often will find their urine is foamy and at the same time back pain, tiredness, general ill feelings are often accompanied. Proteinuria is characterized by bubbles in urine and it means that there are more than normal proteins are leaked into urine.
Under normal circumstances there can be protein in urine, but the amount is small and usually daily urinary protein is less than 150mg. In case of chronic renal failure, more than 150mg proteins will be discharged into urine and in some conditions it can be more than 3.5g and that is why urine will be foamy. And loss of proteins will make patients feel lack of energy, fatigue and tired.
Foamy urine can be seen even in the early stage of renal failure and it is often seen by the patients as an indicator of their illness conditions.
To have effective treatments for alleviating foams in urine, we need first to know what caused excessive protein leakage in urine because there are a variety of causes and different types of proteinuria according to different underlying causes of renal failure.
Usually proteinuria can be classified into glomerular proteinuria and tubular proteinuria according to which part of their kidneys are damaged.
Increased glomerular permeability can cause more proteins to be filtered out the kidneys and when it is beyond the re-absorption ability of the renal tubules, there will be more than normal proteins in urine.
As for tubular proteinuria, it is due to damages of epithelial cells in renal proximal convoluted tubules. As a result, re-absorption ability will be damaged and reduced and more proteins will be leaked into urine.
From the above analysis, we can see why proteinuria is often accompanied by hematuria (blood in urine). Under normal circumstances, red blood cells and middle-molecular and macromolecular proteins can not pass through glomerular filtration membrane and they can be re-absorbed back in renal tubules. However in case of renal failure, they will be discharged into urine and instead other metabolic wastes and toxins that are supposed to be cleared outside will stay in the blood stream can cause a series of symptoms and abnormalities in laboratory tests such increased blood pressure and serum creatinine level, decreased plasma albumin, etc.
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