Considerations

Tell your health care provider about any changes in urine color that do not go away, or that do not seem to be caused by a food or drug. This is very important if the urine changes color for longer than a day or two, or you have repeated episodes.

Causes

Some dyes used in food may be released in the urine. A wide variety of drugs can change the urine color.

Diseases that can change the urine color include:

• Acute cystitis
• Acute glomerulonephritis
• Acute tubular necrosis
• Acute unilateral obstructive uropathy
• Alport syndrome
• Carcinoma of the urinary bladder
• Chronic glomerulonephritis
• Chronic prostatitis
• Endocarditis
• Hepatitis
• Nephrolithiasis (kidney stones)
• Prostate cancer
• Renal cell carcinoma
• Rhabdomyolysis

Cloudy or milky urine is a sign of a urinary tract infection, which may also cause a bad smell. Milky urine may also be caused by bacteria, crystals, fat, white or red blood cells, or mucus in the urine.

Dark brown but clear urine is a sign of a liver disorder such as acute viral hepatitis or cirrhosis, which causes excess bilirubin in the urine.

Pink, red, or lighter brown urine can be caused by:

• Beets, blackberries, or certain food colorings
• Hemolytic anemia
• Injury to the kidneys or urinary tract
• Medication
• Porphyria
• Urinary tract disorders that cause bleeding, such as cystitis, an enlarged prostate, a kidney or bladder tumor, tuberculosis, bladder stones, kidney infection, or kidney cancer such as Wilms' tumor (in children) or hypernephroma

Dark yellow or orange urine can be caused by:

• B complex vitamins or carotene
• Medications such as phenazopyridine (used to treat urinary tract infections), rifampin, and warfarin
• Recent laxative use

Green or blue urine is due to:

• Artificial colors in foods or drugs
• Bilirubin
• Medications including methylene blue
• Urinary tract infections

When to Contact a Medical Professional

Make an appointment with your health care provider if you have:

• Abnormal urine color that cannot be explained and does not go away
• Blood in your urine, even once
• Clear, dark-brown urine, especially if you also have pale stools and yellow skin and eyes
• Pink, red, or smoky-brown urine that is not due to a food or medication

What to Expect at Your Office Visit

The health care provider will perform a physical exam, which may include a rectal or pelvic exam. You will be asked questions about your medical history and symptoms, including:

• Time pattern
  • When did this color change begin?
  • Did this begin suddenly?
• Quality
  • What color is your urine?
  • Is it always the same color throughout the day?
  • Do you urinate more or less often than usual?
  • Can you see blood in the urine?
  • Is the urine an unusual odor?
• Factors that make it worse
  • What medicines do you take?
  • Have you eaten foods such as colored candy, beets, berries, or rhubarb?
• Other
  • What other symptoms do you have? (For example, pain when urinating, abdominal pain, back pain, or fever)
  • Are you drinking fewer fluids or are less thirsty?
  • Do you have a decreased appetite?
  • Have you had any urinary problems or kidney problems?
  • Do you have any allergies?

Tests that may be done include:

• Blood tests, including liver function tests
• Ultrasound of kidneys and bladder
• Urinalysis
• Urine culture for infection

Alternative Names

Discoloration of urine

References

Gerber GS, Brendler CB. Evaluation of the urologic patient: History, physical examination, and the urinalysis. In: Wein AJ, ed. Campbell-Walsh Urology. 9th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 3.

Landry DW, Bazari H. Approach to the patient with renal disease. In: Goldman L, Schafer AI, eds. Cecil Medicine. 24th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 116.

Updated: 4/16/2012

Reviewed by: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; Scott Miller, MD, Urologist in private practice in Atlanta, Georgia. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.