If you’re living with lupus, an autoimmune disease that can affect many parts of the body, you may experience symptoms that are unexpected and sometimes confusing. Lupus can cause issues such as skin rashes, kidney damage, and problems with your urine. Specifically, some MyLupusTeam members have noticed that their urine looks “oily.”

“This may be a weird question, but does anyone have oily urine?” one MyLupusTeam member asked. “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.”

What’s considered “oily” can vary from person to person. Some people notice a foamy appearance, a strong odor, or change in color. If you notice changes in your urine, it’s important to also take note of any other symptoms you’re experiencing.

“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.”

— A MyLupusTeam member

This article looks at three possible reasons someone with lupus may have oily-looking urine — and what steps to take next.

1. Lupus Nephritis

Lupus nephritis is a common complication of lupus, affecting 30 percent to 60 percent of adults with systemic lupus erythematosus (SLE, the most common form of lupus). It occurs when the immune system mistakenly attacks the kidneys, causing inflammation and potential damage to the organs’ blood vessels — which can affect urine consistency.

One of the main symptoms of lupus nephritis is proteinuria (excess protein in the urine), which can make urine appear foamy or frothy, which some people may describe as oily.

One of the main symptoms of lupus nephritis is excess protein in the urine, which can make urine appear foamy or frothy, which some people may describe as oily.

“Protein in the urine can produce bubbles that float on the top of your urine, creating a foamy appearance,” shared one MyLupusTeam member. “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 noted, “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 — Checks for protein and unusual substances in the urine
• Blood tests — Measure how well your kidneys are working
• Kidney biopsy — Uses a small tissue sample from the kidney to confirm the diagnosis and assess how much inflammation or damage is present

If you’re diagnosed with lupus nephritis, your doctor will likely monitor your kidney function regularly and prescribe medications to help control inflammation and prevent more damage. Prompt treatment for lupus nephritis is important. If left untreated, this condition could lead to kidney failure.

If you notice changes in your urine, especially frothiness or oil-like patches, tell your rheumatologist (a specialist in treating joint, muscle, and immune system conditions) or nephrologist (a specialist in kidney care). It’s important to address any potential kidney involvement as soon as possible.

2. Dehydration

Dehydration is a common and treatable reason for changes in urine color, odor, or consistency. When you’re dehydrated, your urine may smell stronger and look darker, which could resemble the color of oil.

Dehydration is a common and treatable reason for changes in urine color, odor, or consistency.

When your body is low on fluids, it reabsorbs more water from your urine to keep vital systems running. As a result, your urine becomes more concentrated with waste and salts, which can affect how it looks and smells.

If you’re not drinking enough water, increasing your fluid intake can help. Staying hydrated supports kidney health and helps your body flush out waste, which is especially important when you’re living with lupus.

If you’re concerned about the way your urine looks, try drinking a few glasses of water to see if your urine returns to its usual color and consistency. However, if you have trouble urinating or see blood in your urine, or if the changes don’t go away, be sure to reach out to your healthcare provider.

3. Other Kidney Problems

In addition to lupus nephritis, several other kidney problems can affect how your urine looks — including making it appear foamy or oily.

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, including what might appear to be foamy urine.

One of the major causes of glomerulonephritis is SLE, so it’s especially important for people with lupus to be aware of its common symptoms. These may include:

• Swelling (often in the legs, feet, or around the eyes)
• Fatigue (extreme tiredness that doesn’t improve with rest)
• Hypertension (high blood pressure)
• Bloody, foamy, or cloudy urine
• Less urine output than usual

Other kidney problems that may cause foamy or oily-looking urine include:

• Kidney stones, which can block the flow of urine and cause intense pain, blood in the urine, and sometimes a frothy appearance
• Nephrotic syndrome, a condition in which the kidneys leak too much protein into the urine
• Polycystic kidney disease (PKD), a genetic disorder that causes fluid-filled cysts in the kidneys and may lead to high blood pressure, back or abdominal pain, and blood in the urine

Although PKD is not caused by lupus, its symptoms can overlap with other kidney issues — so it’s important to let your doctor know about any changes in your urine, especially if you live with a condition like SLE.

Talk to Your Lupus Specialist

If you’re noticing changes in your urine — including an oily, foamy, or unusual appearance — it’s important to talk with your lupus specialist or healthcare provider. Because kidney problems like lupus nephritis are a known complication of SLE, it’s a good idea to check in and rule out serious health problems early.

Your healthcare team can identify the underlying cause and develop a treatment plan. Depending on the symptom’s cause, treatment may include medication, diet changes, or other therapies to protect your kidneys and overall health.

Join the Conversation

On MyLupusTeam, people share their experiences with lupus, get advice, and find support from others who understand.

Have you experienced oily urine while living with lupus? Let others know in the comments below.