Overview
The colour and consistency of a patient's urine can provide significant information regarding the cause of their urinary complaint.
Urine Colour
Urine is normally clear and pale yellow. Dark yellow or brown urine is classically a sign of dehydration, though urine may be a variety of colours that suggest underlying pathology.
Interpretation
- Clear urine - high fluid intake, diabetes insipidus, diabetes mellitus, diuretic use
- Yellow / orange urine - concentrated urine (dehydration), bilirubin
- Brown urine - very concentrated urine (dehydration), haemoglobin (haemolysis), metastatic melanoma
- Black urine - iron, L-dopa, metastatic melanoma, porphyria
- Red urine - blood, haemoglobin (haemolysis), myoglobin (rhabdomyolysis), porphyria, beetroot, malingering
- White urine - lipiduria, propofol infusion, proteinuria, pyuria (UTI), minerals (calcium, oxalate, phosphate)
- Blue / green urine - amitriptyline, indomethicin, porphyria, pseudomonal infection, food dye
- Purple urine - purple urine bag syndrome (UTI causing metabolism of tryptophan to indole then indicant)
Urine Consistency
Interpretation
- Cloudy / turbid - suggests pyuria (infection / inflammation), chyluria, lipiduria, calcium phosphate crystals
- Frothy - suggests proteinuria
Urine Smell
Urine smell has historically been useful, however is currently rarely used in clinical practice.
Interpretation
- Strong urine smell - concentrated urine (e.g. dehydration)
- Sweet smell - diabetic ketoacidosis
- Ammonia smell - urinary tract infection
- Strong asparagus smell - normal following asparagus ingestion
- Faecal smell - colovesical fistula
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