Dehydration — Especially Risky in the Young and Elderly. Many people know that darker-colored. 16M Occasional Cloudy Urine. So every like 2 weeks or so my urine will be cloudy once and then the next time I urinate it will be normal. What could be causing this. “Urine should not be cloudy unless there is a problem,” David Kaufman, M.D., director of Central Park Urology, a division of Maiden Lane Medical, tells SELF. Here are a few reasons why your.

Urinary tract infections (UTIs) are very common infections of the urinary system.

Case Description

A 40-year-old woman presented to her physician with complaints of intermittent flank pain. A urine sample was submitted for routine urinalysis. The patient's sample (left) was notable for a milky white appearance after centrifugation (Fig. 1; a normal urine sample is shown at right). The patient was born in India but moved to the US 10 years ago. She has a 5-year self-reported history of occasional cloudy urine with passage of small blood clots.

A urine sample from the patient following centrifugation (left) and a normal urine sample (right).

Questions

1. What is responsible for the milky appearance of this urine sample?

2. How can the cause of the milky appearance be identified?

3. Does the cause of the milky appearance interfere with urinalysis?

The answers are on the next page.

Answers

The thick milky white appearance of the urine is highly suggestive of chyluria. Upon standing, the urine may eventually separate into 3 layers: a top layer of chylomicrons, a middle layer rich in protein, and a bottom layer containing fibrin clots and cellular debris (1). The most common cause of chyluria is lymphatic filariasis, a parasitic disease considered endemic in tropical and subtropical regions. Lymphatic obstruction leads to formation of a lymphaticourinary fistula, causing excretion of chyle into the urinary tract. In this patient, quantification of urine triglycerides, cholesterol, and lipoprotein electrophoresis confirmed the appearance of chylomicrons in the urine. Alternatively, chylomicrons can be extracted with chloroform or ether. The triglyceride-rich lipids should not affect urine dipstick or automated urinalysis results, and chylomicrons exhibiting Brownian motion may be visible by manual microscopy. After renal pelvic sclerotherapy, most patients become symptom free. Recurrence is noted in 15% to 20% of cases, and that may require laparoscopic surgical correction (1, 2).

Author Contributions:All authors confirmed they have contributed to the intellectual content of this paper and have met the following 3 requirements: (a) significant contributions to the conception and design, acquisition of data, or analysis and interpretation of data; (b) drafting or revising the article for intellectual content; and (c) final approval of the published article.

Authors' Disclosures or Potential Conflicts of Interest:No authors declared any potential conflicts of interest.

Role of Sponsor: The funding organizations played no role in the design of study, choice of enrolled patients, review and interpretation of data, or preparation or approval of manuscript.

References

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Occasional Milky Urine