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Cloudy Urine: Causes, Diagnosis And Treatment
The colour and odour of urine is a central and critical diagnostic tool. Because it acts as an indicator of the health condition of an individual and can point out the development or presence of any health issues. The urine of a healthy person is normally a straw yellow colour and if it comes in any other shade, darker or lighter - it is an indication of a health issue [1] .
Cloudy urine is one amongst the major indicators of urinary tract infection (UTI), the most common bacterial infection affecting women. However, it does not mean that only women have it because cloudy urine in men and children certainly occurs as well [2] . And it is to be noted that cloudy urine is not only caused by UTIs, as there are various other reasons such as dehydration, kidney problems etc.
Causes Of Cloudy Urine
A difference in the healthy colour of your urine can be caused by the following reasons [3] , [4] ,[5] :
1. Dehydration
If the urine is dark in colour, it can be easily asserted that the cloudy urine is the result of dehydration - when a person fails to consume the required amount of liquids. Very young and very old people are increasingly prone to the risk of dehydration (which can be caused as a result of diarrhoea, vomiting, or a fever).
2. Urinary tract infection (UTI)
One of the most common causes of cloudy urine, UTIs cause cloudy or milky urine. The urine can also have a foul smell. The infection can cause the discharge of pus or blood into the urinary tract which gives the urine the cloudy look. It can also be caused as a result of a buildup of white blood cells. A specific type of UTI, called cystitis causes cloudy urine along with painful urination. A UTI can cause a constant need to urinate, trouble urinating large amounts or emptying the bladder, burning pain while urinating, foul-smelling urine and pain in the pelvis, lower abdomen, or lower back [6] .
3. Kidney infection
Most infections affecting your kidney begins as a urinary tract infection and can spread and worsen with the lack of proper treatment. Kidney infections can cause cloudy urine as the infection produces pus, which gets combined with the urine. Similar to the symptoms of urinary tract infections, kidney infections can cause a fever, chills, cramps, fatigue, nausea and vomiting, back pain, and dark, bloody, or foul-smelling urine [7] . It can also be caused by kidney stones.
4. Sexually transmitted infection (STI)
One of the most common infections out there, STIs are prevalent even in developed countries. Gonorrhoea and chlamydia are some of the major causes of cloudy urine because these two infections make your immune system fight against the infections by producing white blood cells that can get mixed with the urine; thereby giving it a cloudy appearance [8] .
5. Vulvovaginitis
An inflammation in the vagina or the vulva, vulvovaginitis can cause cloudy urine. Caused by bacterial infections and fungal attacks, this inflammation can also be triggered by certain ingredients in soaps, detergents, fabric softeners, care products etc. Vulvovaginitis can cause itchiness around the vulva, foul-smelling vaginal discharge, thin, pale, watery discharge, discoloured discharge, a fishy odour that gets worse after sex and painful urination [9] . Cloudy urine can also be caused due to prostatitis (an inflamed prostate) which causes painful ejaculation, abdominal pain and blood in urine[10] .
6. Diet
Your food habits can also be the cause of cloudy urine. According to various studies, it has been pointed out that a person's diet can cause their urine to be cloudy. That is a person who consumes high amounts of phosphorus or vitamin D will have cloudy urine as the kidney pushes out the excess amount of phosphorus through urine [11] .
7. Diabetes
In some cases, cloudy urine can be the cause of diabetes or diabetic kidney disease. It can be due to the fact that your body will attempt to remove the excess amount of sugar from your body through urine [12] .
Diagnosis Of Cloudy Urine
The doctor will require a sample of your urine to examine the condition. They will also send the sample for further tests to understand the underlying cause.
Treatments For Cloudy Urine
Depending upon the cause of the condition, the doctor will choose the proper treatment method [13] ,[14] , [15] ].
- For dehydration: You will be required to drink more fluids and eat foods that have rich water content. If the condition is severe, you will have to be hospitalised.
- For UTIs: The doctor will give you antibiotics for infections and in severe cases, the person will be required to take the drugs intravenously.
- For kidney stones: Most stones pass out of your system naturally. The doctor will prescribe painkillers if the pain is on a higher scale. In severe cases, the doctor will prescribe medications or shock wave therapy or surgery, depending on the size of the stones.
- For STIs: The treatment will be prescribed depending upon the type of infection. Mostly antibiotics are prescribed.
- For vulvovaginitis: The doctor will prescribe antifungal, antiviral or medications to treat the symptoms.
- For diabetes: This will require carrying out urine tests to check for damage in the kidney.
- [1] Etemadian, M., Haghighi, R., Madineay, A., Tizeno, A., & Fereshtehnejad, S. M. (2009). Delayed versus same-day percutaneous nephrolithotomy in patients with aspirated cloudy urine.Urology journal,5(1), 28-33.
- [2] Cheng, J. T., Mohan, S., Nasr, S. H., & D'Agati, V. D. (2006). Chyluria presenting as milky urine and nephrotic-range proteinuria.Kidney international,70(8), 1518-1522.
- [3] Schwartz, R. H. (1988). Urine testing in the detection of drugs of abuse.Archives of Internal Medicine,148(11), 2407-2412.
- [4] Barnett, B. J., & Stephens, D. S. (1997). Urinary tract infection: an overview.The American journal of the medical sciences,314(4), 245-249.
- [5] Hossan, S., Agarwala, B., Sarwar, S., Karim, M., Jahan, R., & Rahmatullah, M. (2010). Traditional use of medicinal plants in Bangladesh to treat urinary tract infections and sexually transmitted diseases.Ethnobotany Research and Applications,8, 061-074.
- [6] Ditchburn, R. K., & Ditchburn, J. S. (1990). A study of microscopical and chemical tests for the rapid diagnosis of urinary tract infections in general practice.Br J Gen Pract,40(339), 406-408.
- [7] Massa, L. M., Hoffman, J. M., & Cardenas, D. D. (2009). Validity, accuracy, and predictive value of urinary tract infection signs and symptoms in individuals with spinal cord injury on intermittent catheterization.The journal of spinal cord medicine,32(5), 568-573.
- [8] Leung, A. K. C., Wong, A. H. C., Leung, A. A. M., & Hon, K. L. (2018). Urinary tract infection in children.Recent patents on inflammation & allergy drug discovery.
- [9] Little, P., Rumsby, K., Jones, R., Warner, G., Moore, M., Lowes, J. A., ... & Mullee, M. (2010). Validating the prediction of lower urinary tract infection in primary care: sensitivity and specificity of urinary dipsticks and clinical scores in women.Br J Gen Pract,60(576), 495-500.
- [10] Komala, M., & Kumar, K. S. (2013). Urinary tract infection: causes, symptoms, diagnosis and it's management.Indian Journal of Research in Pharmacy and Biotechnology,1(2), 226.
- [11] Simerville, J. A., Maxted, W. C., & Pahira, J. J. (2005). Urinalysis: a comprehensive review.Am Fam Physician,71(6), 1153-62.
- [12] Drekonja, D. M., Abbo, L. M., Kuskowski, M. A., Gnadt, C., Shukla, B., & Johnson, J. R. (2013). A survey of resident physicians' knowledge regarding urine testing and subsequent antimicrobial treatment.American journal of infection control,41(10), 892-896.
- [13] Jump, R. L., Crnich, C. J., & Nace, D. A. (2016). Cloudy, foul smelling urine not a criteria for diagnosis of urinary tract infection in older adults.Journal of the American Medical Directors Association,17(8), 754.
- [14] Ward, F. L., & Scholey, J. W. (2017). Cloudy urine in the postpartum period.Kidney international,91(3), 760.
- [15] Sheerin, N. S. (2011). Urinary tract infection.Medicine,39(7), 384-389.
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