If you have lupus, an autoimmune disease that affects multiple parts of the body, you may experience a variety of symptoms that can be confusing and overwhelming. Lupus can cause problems with many organs and lead to, for example, rashes, kidney damage, and … oily urine? If you’ve ever noticed that your urine looks oily, you may be concerned that this is yet another lupus symptom.

One MyLupusTeam member asked, “This may be a weird question, but does anyone have oily urine? For about a week now, my urine has what looks like a layer or patches of oil floating to the top. No burning or smell accompanied by it.”

Oily urine looks and feels different for different people. In some cases, the urine may appear frothy or oily on the surface. In other instances, it may look cloudy or milky. Oily urine sometimes has a strong odor or is darker than usual. It’s important to take note of any other symptoms you’re experiencing along with changes in urine appearance.

This article explores five reasons someone with lupus may have oily urine and what to do about it.

1. Lupus Nephritis

Lupus nephritis is a common complication of lupus, affecting up to 60 percent of adults with systemic lupus erythematosus (SLE). It occurs when the immune system attacks the kidneys, leading to inflammation and damage of the blood vessels in the organ — which can affect urine consistency. One symptom of lupus nephritis is proteinuria (excess protein in the urine), which can make urine appear foamy, frothy, or oily.

One MyLupusTeam member explained, “Protein in the urine can produce bubbles that float on the top of your urine, creating a foamy appearance. This is one of the first signs of possible damage to your kidneys, so you need to let your doctor know about it.”

Another member shared, “I don’t know about oily urine, but frothy urine with bubbles means that protein is in your urine.”

Tests to rule out lupus nephritis include:

• Urinalysis (measures specific characteristics of urine)
• Blood tests
• Kidney biopsy

If you have lupus nephritis, your doctor will likely monitor your kidney function regularly and may prescribe medication to help manage your condition. If left untreated, lupus nephritis could eventually lead to kidney failure and have serious effects on your health. Let your nephrologist know right away if this symptom develops so that additional kidney damage can be prevented or slowed.

2. Infection

In people with lupus, inflammation in the body may lead to changes in urine color and texture. Infections in the urinary tract — including the urethra, bladder, and kidneys — are particularly common and can cause cloudy or oily urine. Approximately 36 percent of people living with lupus experience urinary tract infections (UTIs), which is significantly higher than the rate among the general population.

If you suspect you have an infection, it’s important to talk to your doctor right away before symptoms get worse. Most of the time, UTIs are easy to diagnose and treat. Your doctor may prescribe antibiotics or other medication to help clear the infection.

3. Medication Side Effects

Some medications commonly prescribed to people with lupus can also cause oily urine. For example, hydroxychloroquine (Plaquenil), which is used to treat lupus and other autoimmune conditions, can cause changes in urine color and texture.

Many other medications can also change the consistency and color of urine. For instance, water-soluble vitamins that aren’t properly absorbed into your body may cause a layer of oil on the surface of your urine. If you recently started any new vitamins or supplements, they may be the cause of this new symptom.

Medications that may make your urine foamy include drugs that treat UTIs, such as phenazopyridine (sold as Pyridium, Azo, and other brand names). If you’ve been treated for a UTI recently, the drug may be causing urine changes.

If you’re taking medication for lupus or other conditions and notice oily or foamy urine, talk to your doctor about side effects and potential ways to manage them.

4. Dehydration

Symptoms of dehydration include urine that appears darker, smells stronger, and looks oily. Being low on body fluids is one of the most common (and fixable) causes of changes in urine color, odor, and consistency.

When you’re dehydrated, your body reabsorbs much of the water that would normally exit via your urine. With less water diluting it, urine has a higher concentration of solutes that can change its color and texture.

If you’re not drinking enough water, it’s important to increase the amount of fluid you consume to avoid dehydration. Drinking plenty of water can also help flush toxins from your body and support kidney function, which is important while living with lupus.

If you’re concerned about the appearance of your urine, drink a few glasses of water and see if your urine goes back to normal. However, if you have trouble urinating or see blood in your urine, or if the problem persists or worsens, do not hesitate to seek medical help.

5. Other Kidney Problems

In addition to lupus nephritis, a variety of other kidney problems can cause oily urine. For example, glomerulonephritis occurs when the tiny blood vessels in the kidneys become inflamed and damaged. This condition can lead to changes in urine color and texture that usually include foaminess. One of the major causes of glomerulonephritis is SLE, so it’s important to be aware of common symptoms if you’ve been living with lupus for a while. Glomerulonephritis is usually accompanied by swelling, fatigue, high blood pressure, blood and protein in the urine, and reduced urine output.

Other kidney problems that can cause oily or frothy urine include kidney stones and polycystic kidney disease. Kidney stones block urine from passing through your urinary tract, causing massive pain in the lower abdomen, blood in the urine, and sometimes a frothy appearance. Polycystic kidney disease is not associated with lupus but is usually accompanied by high blood pressure, back and abdominal pain, and blood in the urine.

Talk to Your Lupus Specialist

If you are experiencing changes in your urine consistency, including an oily appearance, talk with your doctor right away. Given the risk of kidney complications in people with SLE, it’s a good idea to rule out potentially life-threatening health problems such as lupus nephritis. Your health care team can help determine the underlying cause and develop a treatment plan.

Depending on the symptom’s cause, treatment may involve medication, lifestyle changes, or other interventions. In some cases, oily urine may indicate a serious kidney problem, so it’s important to seek medical attention as soon as possible.

Talk With Others Who Understand

MyLupusTeam is the social network for people with lupus and their loved ones. On MyLupusTeam, more than 222,000 members come together to ask questions, give advice, and share their stories with others who understand life with lupus.

Have you experienced oily, frothy, or milky urine while living with lupus? Did you find out what was causing this symptom? Share your experience in the comments below, or start a conversation by posting on your Activities page.