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QUESTION: Hello Dr Leslie,

I am 23 years old, had normal blood pressure at my last physical, and I exercise regularly.

I noticed lately that my urine is cloudy. I put vinegar in it to test it, and it cleared up. I know this means it was excess phosphorus.

I have read the causes for this are always serious, especially if it happens consistently. Anytime I have dairy or a decent sized meal this seems to happen.

I have read it is due to deficiencies, hyperparathyroidism, and even renal failure.

Is it true that if I have phosphaturia there is always an underlying dangerous cause? I am very nervous, and the test results from my last urinalysis did not have bloodwork done alongside it, nor was the urine I provided cloudy that time (I was avoiding dairy and calcium/phosphorus rich foods).

I would sincerely appreciate any insight you have. Knowing that there's a chance it could be very normal and easily treatable would put me at ease.

ANSWER: Joe:

True hyperphosphaturia can only be determined by a 24 hour urine collection test which has not been done.  It's also untrue that this is only due to serious problems.  Most of the time, excess phosphate is only considered to be harmless debris possibly due to inadequate fluid or a bladder emptying issue.  Hyperparathyroidism and renal failure are unlikely and uncommon but can easily be detected with a simple blood test.  Have your physician consider getting a blood screen just to make sure and put your mind at rest.

---------- FOLLOW-UP ----------

QUESTION: Hello again Dr Leslie,

Thanks for taking the time to answer my question. I have just one more.

I got my test results back. He said it looked normal (as i said I was avoiding certain foods) and that my specific gravity was (if I remember correctly) 1.030. What does this mean exactly?

I hope that means I am in the clear, but a blood test would definitely seal the deal for me. Any thoughts on getting him to order the test for me?

Thanks again Dr Leslie!

ANSWER: Joe:

A specific gravity of 1.030 indicates that the urine is relatively concentated, not enough water.  As far as talking your physician into ordering the blood test for you, use the material in my previous posting and ask him.

---------- FOLLOW-UP ----------

Cloudy Urine
Cloudy Urine  

Cloudy Urine
Cloudy Urine  
QUESTION: Sorry to bother you again, but I have one last request.

You say it is impossible to know for sure what is going on without a 24 hour urinalysis, but I have some image relating to what I am talking about I would like you to view. I did not include after pictures (post white vinegar addition), but I assure you they were clear as day after I added it.

What do you think of these photos? Should I be worried?

Thank you very much again Dr Leslie

Answer
Joe:

The images do not really provide any additional useful information so my previous recommendations remain unchanged.  Vinegar will tend to dissolve phosphates in the urine so this is evidence confirming that there are considerable urinary phosphates but is not diagnostic of anything one way or the other.  

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Stephen W. Leslie, MD

Expertise

Questions concerning erectile dysfunction, kidney stones and prostate disorders including prostate cancer. I have a special interest in kidney stone disease prevention.

Experience

Full time practicing urologist with 30 years experience. Associate Professor of Surgery and Chief of Urology at Creighton University Medical Center. Editor in Chief of eMedicine Urology internet textbook. Author of only NIH approved book written for patients by a urologist on the subject of kidney stones "The Kidney Stones Handbook". Inventor of the "Parachute" and "Escape" kidney stone baskets and the "Calculus" stone prevention analysis computer program.

Organizations
American Urological Association, Ohio State Medical Association, Sexual Medicine Society

Publications
Men's Health, Journal of Urology, Urology, Healthwatch Magazine, Emergency Medicine Monthly, eMedicine, "The Kidney Stones Handbook", and numerous articles in various newspapers. He is also the editor of the Urology Board Review by McGraw-Hill used by urologists to study for their Board Certification Examinations.

Education/Credentials
Graduate of New York Medical College with residencies completed at Metropolitan Hospital New York, Albany Medical Center and University of Wisconsin-Madison.

Awards and Honors
Thirlby Award of the American Urological Association. Rated as one the country's Best Urologists by the Independent Consumer's Research Institute

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