Nephrology/Cloudy urine

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Question
Good evening Dr Shah. I was diagnosed with IGA Nephropathy eleven years ago. I have persistent protein in my urine that has steadily been decreasing. I have 24 hour urine collections and creating clearance along with blood work once a year to monitor any changes. As it stands my kidney function, creatinine, and GFR are still within normal range. Blood pressure is under control--no edema. Over the last few months I've experienced intermittent issues with cloudy urine. I've been to the doctors and the urine cultures test fine. No evidence of infection. I have always had some foam as a result of the protein, but this is cloudiness. My nephrologist asked me to take a sample and add a little vinegar. When I did, it immediately cleared. He stated this means it is probably phosphate crystals.

I have noticed the cloudy urine always occurs after consuming dairy products. I've raised my concerns to my nephrologist as I know phosphate levels can be of concern with CKD, but he insists that the phosphate crystals, since they are related to diet, are benign. I guess I'm just curious as to why this never happened before. Is thus truly a benign reaction or is it indicative of a worsening problem in your opinion. I can be a bit of a worrier, but I also like to keep a handle on my health issues before things get out of hand, I'd appreciate any insight.

Answer
Sherri,

Thanks for your question on Allexperts.

Congratulations for being so conscientious about your condition and for taking good care of yourself. I wish all my patients were like you.

Regarding cloudy urine, I agree with your Nephrologist. The cloudy residue could be due to phosphate crystals. It is a benign condition and I would not worry too much about it. Please continue to regularly follow up with your Nephrologist.

Sincerely,

Dr. Shah  

Nephrology

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Dr. Shamik Shah, MD, DNB (Nephrology), ISN Fellow

Expertise

I can answer all questions related to kidney diseases, hypertension, plasmapheresis and kidney transplantation. I am an Indian-Board certified Nephrologist. I was a post-Doctoral Scholar at the Division of Nephrology & Hypertension,Department of Medicine, University of California, San Diego. My area of interest is Critical care Nephrology and Acute Kidney Injury.

Please mention the units in which your lab results were reported and the normal reference range for your laboratory.


Alternative Website
http://www.syndeohealth.com/doctors/shamik-shah/91

Experience

Ten years as a Critical Care & Transplant Nephrologist

Organizations
International Society of Nephrology
Indian Society of Nephrology
Indian Medical Association
European Renal Association


Publications
- Shah SH, Cerda J. Acute Tubular Necrosis; Lerma, Edgar V., Rosner, Mitchell eds. Clinical Decisions in Nephrology, Hypertension and Kidney Transplantation. Springer ISBN 978-1-4614-4453-4, pp. 191-198
- Shah SH, Cerda J. Management of Acute Kidney Injury; Lerma, Edgar V., Rosner, Mitchell eds. Clinical Decisions in Nephrology, Hypertension and Kidney Transplantation. Springer ISBN 978-1-4614-4453-4
- Cerda J, Tolwani A, Shah SH, Ronco C. Continuous Renal Replacement Therapies in Modeling and Control of Dialysis Systems edited by Azar AT, Springer-Verlag, Heidelberg, Germany (In Press)
- Shah SH, Cerda J, Kellum JA. Acute Kidney Injury in Special Circumstances. John Kellum, Jorge Cerda, eds. Renal and Metabolic Disorders, Oxford University Press (In press)
- Shah SH, Mehta RL. “Anticoagulation in CRRT: Is Citrate better?”; Vineet Nayyar Ed. Critical Care Update 2009, Jaypee Brothers (In press)
- Shah SH, Mehta RL. “Non-dialytic management of acute kidney disease”; Evidence based Nephrology, BMJ, (In press)
- Shah SH, Mehta RL. “Epidemiology of Community-acquired AKI”; Ronco C, Bellomo R, Kellum J Eds. Critical Care Nephrology, Saunders. ISBN 1-4160-4252-0
- Abdeen O, Shah SH, Mehta RL; “Dialysis therapies in the surgical intensive care unit”; William Wilson, Christopher Grande, David Hoyt Eds. Trauma: Resuscitation, Anesthesia, and Critical Care, Informa Healthcare, NY 2007. ISBN 0-8247-2920-X
- Shah SH, Mehta RL. Acute kidney injury in critical care: time for a paradigm shift? Curr Opin Nephrol Hypertens. 2006 Nov;15(6):561-5.
- Shah, SH, Soroko S, Lischer E, Mehta RL. Delivered vs. Prescribed dose of Dialysis in Hospitalized Patients: Results of an Audit. J Am Soc Nephrol 17(Abstracts Issue): 2006, 107A.
- Shah SH et al “Biochemical Nutritional Parameters in Non-vegetarian and Vegetarian CAPD patients” Perit Dial Int 2001; 21 Suppl 2: S1-182


Education/Credentials
MBBS, MD (Internal Medicine), Diplomate of National board (Nephrology), ISN Fellow

Awards and Honors
Educational Ambassador of the International Society of Nephrology 2010
Fellowship of the International Society of Nephrology 2005.
Young Investigator Award by the International Society of Peritoneal Dialysis 2001

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