Macroscopic Urinalysis

  • Josefine NeuendorfEmail author


Urine sediment analysis always includes an evaluation of “urine character.” This means that the odor, color, and cloudiness of a urine sample requires evaluation.


The odor Color Cloudiness of a urine sample Bacteria Drugs Food 

4.1 Color

Depending on concentration, urine is light yellow to dark yellow in color. A noticeable deviation in color from the norm can indicate pathology or be harmless in nature.

4.1.1 Some Examples

  • Colorless to light yellow

    Cause: polyuria, glycosuria in diabetes mellitus

  • Dark yellow to orange

    Cause: oliguria, anuria, vitamin preparations

  • Dark yellow to brownish-yellow

    Cause: hemoglobin and hemoglobin degradation products (bilirubin, porphyrins), drugs

  • Milky/cloudy

    Cause: leukocyturia, salts, crystals

  • Red to reddish-brown

    Cause: erythrocytes, myoglobin, urates, drugs, beetroot

  • Dark brown to black

    Cause: erythrocytes, massive hemolysis

4.2 Odor

Certain foods, drugs, and bacteria alter the typical odor of urine.

4.2.1 Some Examples

  • Extremely intensive odor

    Cause: garlic, asparagus

  • Smells like chocolate, highly aromatic

    Cause: vitamin preparations, tropical fruits, spices

  • Smells of ammonia

    Cause: urea-splitting bacteria

  • Smells foul, putrid

    Cause: urinary tract infection

  • Smells of fruit, acetone

    Cause: ketonuria

4.3 Cloudiness

Fresh urine at body temperature is normally clear. The colder and more concentrated a urine sample becomes, the more salts and crystals precipitate and cause turbidity or cloudiness. Urine also becomes visibly cloudy in the case of a pathological accumulation of bacteria or pyuria.

Only by analyzing solid components in urine (as in urinary sediment analysis) is it possible to conclusively identify the cause of cloudiness.

4.3.1 Some Examples

  • Milky white

    Cause: bacteriuria, pyuria, phosphaturia, vaginal secretion

  • Reddish (brick dust) upon cooling

    Cause: uraturia

  • Red to reddish-brown

    Cause: macrohematuria

  • Fat layer on the surface

    Cause: lipiduria in nephrotic syndrome, ointments, suppositories

Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  1. 1.Neuendorf Labordiagnostik WieslochGermany

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