Normally, urine is some shade of yellow with acid urine usually a darker colour than alkaline urine. Pathologically, it may be any colour.

12
ColourCauses
Green
  • Drugs: Cimetidine, Promethazine, Amitriptyline, Flutamide, Indomethacin, Methocarbamol, Methylene blue, Mitoxantrone, Propofol, Phenylbutazone, Triamterene
  • Condition: Hartnup Disease, Indicanemia, Indicanuria
  • Infection: Pseudomonas Infection
  • Dyes: Carbolic Acid, Flavine derivatives, Indigo Blue, Methylene Blue, Resorcinol
  • Other: Clorets, Listerine, Magnesium Salicylate, Asparagus
  • Case: Verdant waste
  • Case: How Green is my urine
Orange
  • Drugs: Idarubicin, Ferrioxamine, Oxamniquine, Phenazopyridine, Rifampicin, Sulfasalazine, Warfarin
  • Food/supplements: Carotenes, B-complex vitamins, Senna, Rhubarb, Beets and blackberries
  • Condition (hypercarotenemia): Diabetes mellitus, hyperlipidemia, hypothyroidism, porphyria
  • Case: Where are the lemons?
Red
  • Stones: (calculi in the renal pelvis, ureter or bladder)
  • Malignancy: TCC, RCC, Wilms
  • Trauma: Blunt or penetrating trauma to the abdomen or pelvis; a catheter will commonly cause haematuria. BPH is a common cause of intermittent gross haematuria
  • Renal: Primary renal disease (e.g. glomerulonephritis; including IgA-related, membranous, mesangiocapillary, focal and minimal change). Renal disease associated with / due to / secondary to systemic vasculitis (e.g. SLE, polyarteritis nodosa), Papillary necrosis secondary to analgesic nephropathy or diabetic nephrosclerosis. Hereditary (e.g. Alport’s syndrome).
  • Infection: Pyelonephritis, UTI, pyonephrosis, cystitis, prostatitis, TB, schistosomiasis
  • Coagulopathy: Anticoagulation, Inherited defect (e.g. haemophilia, Von Willebrand’s), Acquired defect (e.g. DIC, thrombocytopenia).
Red-Brown
  • Drugs: Levadopa, nitrofurantoin, metronidazole
  • Condition: Rhabdomyolosis (myoglobinuria), bile pigment
  • Other: Fava beans
  • Case: Mahogany Myoglobinuria
Cherry red / Raspberry
  • Drug: Hydroxocobalamin, Sodium nitroprusside; amino-salicyclic acid derivatives – mesalazine/paraaminosalycylic acid/sulfasalazine; doxorubicin, ibuprofen, phenothiazines, phenolphthalein, propofol, rifampicin/rifampin
  • Diet: Beeturia, rhubarb, blackberries, food dyes
  • Condition: Cyanide toxicity; porphyria, urate crystals
  • Case: Raspberry urine?
Purple
  • Infection: Bacteria such as Providencia stuartii, Klebsiella pneumoniae, P. aeruginosa, Escherichia coli, and enterococcus species.
  • Condition: Hartnup Disease, Indicanemia, Indicanuria
  • Case: Tyrian Rage
Black


  • Drugs: Stimulant laxatives (e.g. cascara, senna)
  • Condition: Alkaptonuria, methemoglobinuria
  • Other: Melanin
  • Case: Brown/Black urine
Milky


Critical Care

Compendium

Emergency physician MA (Oxon) MBChB (Edin) FACEM FFSEM with a passion for rugby; medical history; medical education; and asynchronous learning #FOAMed evangelist. Co-founder and CTO of Life in the Fast lane | Eponyms | Books | Twitter |

Physician in training. German translator and lover of medical history.

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