Turbid Urine: Possible Causes and Treatments

The turbid urine and occasionally fetid may be a sign of severe disease of the urinary tract. This sign is underestimated by most patients when in fact it should be a warning signal, since it indicates that something is not right in our body.

Urine is the result of a complex filtration process that takes place in the kidneys; it is composed mainly of water and some solutes (products of excretion), which are present in such a quantity that they do not modify the transparency of the water that is part of the urine.

When for some reason the amount of solutes increases or there is presence of materials that normally would not be in the urine, it is no longer transparent and takes on a cloudy appearance, as if there were some kind of dissolved material visible in it.

In the biochemical field, this is due to an increase in the concentration of certain solutes such as proteins, the presence of materials that are not normally in the urine (such as urate crystals) or an increase in the number of cells (which it is usually very low).

The simple urine test often gives a very clear idea of ​​what is happening in the microscopic and chemical areas in the urine, so that the doctor can guide the diagnosis quite accurately from the results of this test.

Possible causes

Urine can become cloudy due to multiple conditions, which would occupy a complete volume of a urology book. Hence, in this post we will focus on the most frequent causes, among which are:

- Urinary infection.

- Hematuria (blood in the urine).

- Proteinuria (increase in the amount of protein in the urine).

- Diabetes.

- Kidney stones.

Of all the causes that can make urine turbid, infections are by far the most frequent; however, other conditions should not be underestimated since, when present and not diagnosed in time, there may be irreversible damage to the urinary tract.

Urinary infection

Urinary tract infections are the most common cause of cloudy urine. In these cases the presence of a large number of bacteria, dead urothelium cells, cells of the immune system (white blood cells) as well as chemical substances such as antibodies, make the urine no longer transparent.

In the most severe cases where pus is detected in the urine (pyuria), the urine is no longer cloudy, but completely loses its transparency.

All urinary tract infections - both low (cystitis) and high (pyelonephritis) - present with changes in the transparency of urine, which also becomes foul.

Although most people associate dysuria (burning during urination) with urinary tract infections, this symptom is sometimes absent and the only indication of a urinary tract infection is turbid urine, particularly in very young infants and older adults, especially those with some degree of cognitive deficit.

Hematuria

Hematuria is the presence of red blood cells in the blood. In cases of macroscopic hematuria (where the amount of blood is considerable) the urine becomes red; however, these are not the majority of cases, with microhematuria being more frequent.

It is known as microhematuria to the presence of red blood cells in the urine (these cells are usually not present in the urine or do so in extremely low amounts), which makes the urine is turbid.

The more red blood cells the more turbid the urine. However, in these cases it is essential to identify the cause to start treatment, since the causes of microhematuria range from urinary infections to kidney cancer, through kidney stones and inflammatory kidney disease (nephritis).

Proteinuria

It is known as proteinuria to increase the amount of protein in the urine, mainly albumin. While the presence of a certain amount of protein in the urine is normal, it should not exceed the levels considered normal.

When this happens it is because there are damages in the renal pores, which allow an amount of proteins higher than normal to escape from the bloodstream to the urine.

This is due to multiple causes, ranging from nephrotic syndrome to hypertensive nephropathy, through a myriad of kidney diseases that occur with proteinuria.

Diabetes

Diabetes is one of the most common causes of proteinuria due to the development of diabetic nephropathy.

In addition, in cases of decompensated or poorly controlled diabetes, excess blood sugar begins to be excreted in the urine, a phenomenon known as glycosuria.

Since normal levels of glucose in the urine are very low (sometimes undetectable), the presence of glucose molecules in the urine often causes it to become cloudy.

As with hematuria and proteinuria, the higher the concentration of the solute (in this case, glucose), the rougher the urine.

Kidney stones

Kidney stones are due to an increase in the presence of urate crystals in the urine. The more crystals there are, the more amounts of stones will form, but in addition, the concentration of crystals in the urine will increase.

These crystals work just like any other solute (red blood cells, pus, proteins, etc.), so that the higher the concentration, the more turbid the urine will be.

If we add to this the fact that kidney stones are usually associated with a higher frequency of urinary infections, the conditions are given so that the urine of patients with this condition is cloudy.

Treatment

A good strategy in any of the cases is to increase the water consumption since the solutes are diluted and the urine tends to be more crystalline.

However, this strategy is useful only to prevent the damage of the urinary tract from spreading and in no case does it solve the problem; it can even aggravate it, as in cases of nephrotic syndrome; therefore, it is mandatory to consult a specialist whenever the urine becomes cloudy.

After a thorough clinical examination and the performance of some tests it will be possible to establish the diagnosis with certainty, and from there decide which is the best treatment.

As is often the case with the nonspecific symptoms that may be present in different diseases, the specific treatment will depend on the cause of the problem.

In cases of infections, the administration of appropriate antibiotics will be sufficient. On the other hand, when there is renal lithiasis (stones or stones) some type of invasive intervention may be necessary to remove the stones, as well as the administration of drugs that limit the formation of crystals in the urine.

Kidney diseases

In cases of kidney diseases such as nephritis, diabetic nephropathy or hypertensive nephropathy, it will be necessary not only to treat the kidney condition but also to control the underlying disease that produced it.

References

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