Turbid urine is also known by many other names like foamy Urine, cloudy urine, and albinuria. It is a presentation of many types of diseases or disorders. Turbid urine is mainly caused by disorders of the urinary tract which includes the kidneys, ureters, bladder and the urethra. Any type of infection affecting the urinary tract can lead to turbid urine. Also, swelling or inflammation of the urinary tract can produce cloudy urine.

Some disorders of the reproductive tract can also lead to urine being turbid. In some people, some systemic diseases can also lead to the formation of turbid urine. Normally, the color of your urine is either transparent or clear or light yellow. If the appearance of the urine becomes turbid or cloudy, it is not normal. It certainly indicates a disorder. So, you will need to consult your doctor and get your urine tested. Your doctor will provide appropriate treatment based on the condition that you are suffering from.

Turbid urine causes:

There are many causes of cloudy or turbid urine as we have just mentioned. Let us explore them in detail.

1. Urinary tract infection:

Urinary tract infection is abbreviated as UTI. UTI is the most common cause of turbid urine. Many people suffer from UTI on a day to day basis. Many of the patients seen by a general physician or general practitioner are sufferers of UTI’s.

Women tend to develop UTI more commonly than men. This is due to the fact that women have short urethra through which the microbes or bacteria causing UTI can easily enter the urinary tract. UTI can also occur more commonly in people having Diabetes, people maintaining poor personal hygiene, people with indwelling urinary catheters, etc.

UTI can affect any part of the urinary tract including the urethra, bladder, ureter, and kidneys. The infection of the lower parts of urinary tract like urethra and bladder is very common. The UTI affecting the urinary bladder causes inflammation of the bladder and it is called cystitis.

The inflammation of the kidneys caused by UTI is called pyelonephritis, which is a serious or emergency condition. UTI is most commonly caused by a bacteria called E.coli or Escherichia coli. It can also be caused by a bacteria called Staphylococcus saprophyticus in sexually active young women.

UTI symptoms:

• Burning sensation while passing urine
• Frequency of urination or passing urine very frequently
• Passing only small quantities of urine each time
• Urgency of urination or urge to urinate very fast
• Hematuria or passing blood in urine or red urine
• Turbid urine or cloudy urine due to presence of pus cells in urine
• Pain while urination
• Low-grade fever
• Pelvic pain or lower abdominal pain (Especially in cystitis)
• Nausea and vomiting

UTI treatment:

If you are suffering from symptoms of UTI and have turbid urine, u will need to consult your doctor. Your doctor will order a test called CUE or complete urine examination. If there is a presence of pus cells in the urine more than the laboratory reference range, it will confirm the presence of UTI.

If you have UTI, your physician will prescribe antibiotics like Norfloxacin or Nitrofurantoin, as UTI is caused by bacteria like E.coli. You will also be prescribed Cital syrup or Citralka, etc which is a urinary alkalizer. You might also be given tablets like Flavospas or Urispas which will help in reducing the urinary colic. You might also be prescribed analgesics or smooth muscle relaxants like Dicyclomine, etc. You will also need to drink plenty of water to flush out the bacteria from your urinary tract.

2. Pyelonephritis:

Pyelonephritis is the inflammation or swelling of the kidneys caused by bacterial infections like E.coli. This is mostly caused by the spread of the bacteria from a lower urinary tract infection to the kidneys. It is not a very common condition. But, this condition cannot be neglected at all. If you have turbid urine and have any of the symptoms of Pyelonephritis, you will have to consult your physician immediately as it is an emergency.

Pyelonephritis symptoms:

• High fever > 102 F
• Chills or Rigors
• Turbid urine or Cloudy urine
• Hematuria or blood in urine
• Pus cells in urine
• Urine smelling like Fish
• Flank or Loin pain
• Tenderness at costovertebral angle (pain when pressed at the renal angle)
• Burning urination
• Frequency of urination
• Nausea and vomiting
• Urgency of urination

Pyelonephritis Treatment:

Pyelonephritis needs to be treated with antibiotics for 2 weeks. It is treated with any antibiotic like Norfloxacin or Ciprofloxacin or Cotrimoxazole, etc based on the reports of the urine culture and antibiotic sensitivity test. You might need IV or antibiotics if your condition is severe. So, you might be admitted to a hospital to get IV antibiotics and other treatment. You might also be given IV fluids to maintain adequate hydration.

3. Cystitis:

Cystitis is also a type of UTI. It is caused by bacteria like E.coli and there is inflammation or swelling of the urinary bladder in this condition. Cystitis has symptoms similar to UTI. In addition to those symptoms, cystitis also has pain in the lower part of the abdomen or pelvic pain. It is also diagnosed with CUE or complete urine exam just like UTI. There is no separate test for Cystitis. The treatment of cystitis is also similar to UTI.

4. Vaginal discharge:

In women vaginal orifice is located just near to the urethra. Some women might get excess vaginal discharge. This can be physiological due to hormonal changes or it can also be due to vaginal infections like Trichomoniasis, or Bacterial Vaginosis or vaginal candidiasis. While passing urine, this vaginal discharge can come out along with the urine and make the urine appear like turbid urine.

5. Proteinuria or Proteins in urine:

Proteins can be passed in the urine, which is called proteinuria. Proteinuria is caused by many different conditions like nephritic syndrome, nephritic syndrome or glomerulonephritis, Alport syndrome and many other causes. Even in pregnant women, proteinuria can occur in the second half of pregnancy. Cloudy urine can develop due to passage of the proteins in the urine.

6. Phosphate crystals in urine:

Presence of various crystals like phosphate crystals in urine can lead to turbid urine formation. Phosphate crystals in urine can be present due to intake of various foods like beetroot or milk with high content of phosphates in it.

7. Preeclampsia in Pregnancy:

In the second or third trimester of pregnancy, a condition called Preeclampsia can occur. In this condition, there is increased or high blood pressure or hypertension. There is also presence of proteins in the urine, or proteinuria. This leads to turbidity of urine or cloudy urine formation. If blood pressure is very severe, it can also lead to seizures or fits or convulsions, and it is called Eclampsia.

8. Dehydration:

Dehydration or loss of fluid from the body can occur due to various causes like excess perspiration or sweating, doing heavy exercises, staying in the sun for a long time, diarrhea, vomiting, intake of very less water, Diabetes, etc. In a person with dehydration, body tries to conserve the water by concentrating urine. This leads to turbid urine formation.

9. Sexually transmitted diseases:

Sexually transmitted diseases can also lead to cloudy urine formation. Sexually transmitted diseases like gonorrhea and Chlamydia can lead to the turbidity of urine. They are spread from person to person through unprotected sexual intercourse with a person suffering from a sexually transmitted infection or STI.

10. Chyluria:

Passage of lymph fluid in the urine is called chyluria. It is caused by abnormal connection of the lymphatic system with the urinary tract. Worms like Wucheraria bancrofti or Filarial worms can obstruct the lymphatic system. This can lead to the rupture of the lymphatic vessels. This leads to the leakage of the white colored lymphatic fluid into the urine. This leads to formation of turbid urine or cloudy urine.

Other causes of Turbid urine or cloudy urine:

• Renal failure or kidney failure
• Hematuria or blood in urine
• Presence of urate crystals in urine
• Presence of fat cells in urine
• Presence of colloidal particles in urine
• Presence of epithelial cells in urine
• Presence of calcium pyrophosphate crystals in urine
• Bladder stones
• Bladder cancer
• Goodpasture syndrome
• Retrograde ejaculation
• Urethritis
• Uric acid crystals
• Prostatitis
• Diabetes
• Heart diseases
• Hypertension
• Systemic lupus erythematosus or SLE
• Sickle cell anemia
• Leukemia
• Lymphoma

Turbid urine complications:

Turbid urine is produced by many different causes or disorders like we discussed above. These underlying causes can lead to many complications based on the disorders or disease. Some of the complications which underlying causes of turbid urine can lead to are:

• Diabetic ketoacidosis or DKA (Seen in Type 1 Diabetes)
• Hyperosmolar nonketotic coma (HONK) (Seen in Type 2 Diabetes)
• Eclampsia (Due to Preeclampsia in pregnant women)
• Shock
• Metastasis of cancer cells (If turbid urine is caused by any cancer like bladder cancer)
• Septicemia (Due to spread of the urinary infection into the blood)

Turbid urine treatment:

The treatment of Turbid urine is based on the underlying disorder causing turbid or cloudy urine. Let us see some examples.

• If Turbid urine is being caused by urinary infections like UTI or cystitis or pyelonephritis, you will be given antibiotics to treat the bacterial infection. You might need IV antibiotics if you are having pyelonephritis.
• If you are suffering from bladder cancer, you might need surgical treatment, radiotherapy, and chemotherapy.
• If you are suffering from conditions like nephritic syndrome, you will be given corticosteroids.
• If you have renal failure, you will need to undergo dialysis treatment. You might also need kidney transplantation if your renal function doesn’t return to normal or improve with dialysis.
• If a pregnant woman is suffering from preeclampsia, she needs prompt control of blood pressure with antihypertensive drugs.
• Make sure to drink plenty of fluids or water throughout the day to avoid and treat dehydration.
• Cranberry juice intake can help you with reduction of symptoms of urinary tract infections or UTI. But you will need to consult your doctor and take advice regarding its intake.

You people have seen all the different causes of turbid urine, their symptoms, complications and also the treatment options. If you have turbid urine, you will need to consult your doctor and get yourself tested and take appropriate treatment.

References:

1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4421556/
2. http://www.medicinenet.com/cloudy_urine/symptoms.htm
3. https://www.healthgrades.com/right-care/kidneys-and-the-urinary-system/cloudy-urine–causes

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