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Urine - abnormal color

Definition

The usual color of urine is straw-yellow. Abnormally-colored urine may be cloudy, dark, or blood-colored.

Causes

Abnormal urine color may be caused by infection, disease, medicines, or food you eat.

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. It can also indicate severe dehydration or a condition involving the breakdown of muscle tissue known as rhabdomyolysis.

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

• Medicines

• Porphyria

• Urinary tract disorders that cause bleeding

• Blood from vaginal bleeding

• Tumor in the bladder or kidneys

Dark yellow or orange urine can be caused by:

• B complex vitamins or carotene

• Medicines 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 medicines

• Bilirubin

• Medicines, including methylene blue

• Urinary tract infections

When to Contact a Medical Professional

See 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

• Pink, red, or smoky-brown urine that is not due to a food or medicine

What to Expect at Your Office Visit

Your provider will perform a physical exam. This may include a rectal or pelvic exam. Your provider will ask you questions about your symptoms such as:

• When did you first notice a change in urine color and how long have you had the problem?

• What color is your urine and does the color change during the day? Do you see blood in your urine?

• Are there things that make the problem worse?

• What types of foods have you been eating and what medicines do you take?

• Have you had urinary or kidney problems in the past?

• Are you having any other symptoms (such as pain, fever, or increase in thirst)?

• Is there a family history of kidney or bladder cancers?

• Do you smoke or are you exposed to significant second hand tobacco?

• Do you work with certain chemicals such as dyes?

Tests that may be done include:

• Blood tests, including liver function tests

• Ultrasound of kidneys and bladder or CT scan

• Urinalysis

• Urine culture for infection

• Cystoscopy

• Urine cytology

References

Elsamra SE. Evaluation of the urologic patient: history and physical examination. In: Partin AW, Domochowski RR, Kavoussi LR, Peters CA, eds. Campbell-Walsh-Wein Urology. 12th ed. Philadelphia, PA: Elsevier; 2021:chap 1.

Gharavi AG, Landry DW. Approach to the patient with renal disease. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 100.

Review Date: 7/1/2023

Reviewed By: Kelly L. Stratton, MD, FACS, Associate Professor, Department of Urology, University of Oklahoma Health Sciences Center, Oklahoma City, OK. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.