### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
About 4 months ago, I noticed white tissue like particles in my urine.  It is very visible and is in my urine EVERYDAY, its not always present everytime I use the bathroom.  I went to have my urine tested and that moment there were no particles present at the time of that urinalysis.  I was given a strainer to catch the particles to be analyzed.  I was told by the doctor the lab results showed that as protein.  They sent me to a urologist and again they did a pee test and there were no particles present, so they want me to do a 24hr test.  What can be causing this? I didnt have any pain associated with it. Although, about 2 weeks ago I have started having flank pain on both sides.  I am a 28yr old female, with high blood pressure(on medicine and under control right now), I take Yaz, and I am on Synthroid.  Both Kidney disease and heart disease run in my family.

### output:

Hi, White urine or particles in urine generally suggestive of either UTI(pus) in urine or protein in urine. As your one report suggestive of protein urea. But according to your description, its transient. Generally transient or intermittent protein urea is a common condition called orthostatic protein urea means protein loss with postural variation. This is normal physiological condition and not to be worry about it. But you also mentioned pain in bilateral flank region also, and you are hypertensive along with taking of steroids. These all are high risk conditions for protein loss. So you should be evaluated thoroughly father this is physiological protein loss or pathological. You get Urine protein creatinine ratio and 24 hours urine test to decide the severity of protein loss. This will also help to find out the cause of protein loss. If both reports come inconclusive then better go for USG abdomen for kidney size and other pathology. And after then go for kidney biopsy to find out the exact pathology. Meanwhile, you control your blood pressure and gradually tapper the dose of steroid along with diet modification with high proteins. Thank you