Urine Transparency

Freshly voided urine is clear and transparent. Cloudy urine may be caused by crystals, deposits, white cells, red cells, epithelial cells or fat globules. Further evaluation with centrifugation, microscopic examination, heating or with ether generally determines the cause of the turbidity.

Substances that cause cloudiness but that are not considered unhealthy include mucus, sperm and prostatic fluid, cells from the skin, normal urine crystals, and contaminants such as body lotions and powders.


Causes of Turbid Urine

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Amorphous PhosphatesA normal constituent in alkaline or neutral urine
They dissolve upon addition of a dilute acid (e.g. acetic acid).
Amorphous UratesA normal constituent in acid urine
They often appear as yellow crystals
May be pink crystals ("brick dust") as a result of increased uroerythrin.
They dissolve upon warming to 40°C.
BacteriaOften seen as seen as a uniform cloud
They cannot be removed by ordinary filtration or centrifugation
Confirmed on microscopic examination
Blood (red blood cells)Usually associated with a reddish-brown, smoky appearance to the urine
Confirmed on microscopic examination or chemical tests for haemoglobin
Pus (white cells)May resemble amorphous phosphates to the naked eye
Microscopic examination confirms leucocytes.
Mucus and Epithelial CellsAppear as a faint cloud (nubecula) of mucus, leucocytes and epithelial cells upon cooling and standing
The nubecula of normal urine is probably due to nucleoprotein (phosphoprotein) and not a mucin or mucoid (glycoprotein)
Nebecula usually settles to the bottom, but in urine of high specific gravity may float near the middle.
Colloidal ParticlesCannot be cleared from urine by filtration, centrifugation or ether
These particles are not visible on microscopic examination
Fat GlobulesUsually give a milky appearance to urine
Confirmed on microscopic examination and can be removed by ether.

References and Links


CCC 700 6

Critical Care

Compendium

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

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