Urine Colour Guide
| Urine Colour | Likely Cause | Action |
|---|---|---|
| Pale yellow / straw | Normal, well hydrated | No action needed |
| Dark yellow / amber | Dehydration — concentrated urine | Increase fluid intake; recheck after hydration |
| Orange | Very concentrated urine; rifampicin (TB drug); high-dose vitamin C | Check medications; hydrate |
| Brown / tea-coloured | Liver disease with bilirubin; haemolysis; rhabdomyolysis | Urgent — check LFT, bilirubin, CBC, CK |
| Red / pink | Haematuria (blood in urine); beetroot ingestion; porphyria | Urine microscopy to check for RBCs; further investigation if confirmed haematuria |
| Frothy / foamy | Proteinuria (protein leaking from kidneys) | Urine dipstick for protein, KFT, ACR |
| Cloudy / turbid | UTI (pus cells), phosphaturia (normal in alkaline urine) | Urine routine and culture |
Causes of Dark / Brown Urine
| Cause | Key Tests | Additional Clues |
|---|---|---|
| Dehydration | Urine specific gravity (high), serum sodium | No other symptoms; clears with hydration |
| Liver disease / Jaundice | LFT (bilirubin, ALT, AST, ALP), hepatitis serology | Jaundice (yellow eyes/skin), pale stools, right upper quadrant pain |
| Haemolysis (red blood cell breakdown) | CBC, LDH (elevated), haptoglobin (low), bilirubin (unconjugated elevated), peripheral blood smear | Anaemia with jaundice; can occur after infections, malaria, certain medications |
| Rhabdomyolysis (muscle breakdown) | CK (creatine kinase — very elevated), urine myoglobin, KFT | Muscle pain and weakness after extreme exercise, crush injury, or statin overdose; can cause acute kidney injury |
| UTI / Pyelonephritis | Urine routine and culture, CBC | Burning urination, frequency, fever, flank pain |
| Haematuria (blood in urine) | Urine microscopy for RBCs, cystoscopy if persistent | Kidney stones, UTI, bladder cancer (painless haematuria in older patients) |
Urgent — Seek Same-Day Medical Attention: Dark/brown urine + yellow eyes/skin (jaundice) + pale/clay-coloured stools is a classic triad of biliary obstruction or acute hepatitis. This combination requires urgent LFT and imaging. Also seek urgent care for dark urine after trauma or extreme exercise (rhabdomyolysis risk).
Questions to Ask Your Doctor
- Is this dehydration, or do we need blood tests to check liver and kidney function?
- Do my eyes look yellow — could this be jaundice?
- I recently had intense exercise / trauma — should we check CK for rhabdomyolysis?
- Should I have a urine microscopy to look for blood cells?
- If haematuria is confirmed, do I need cystoscopy to exclude bladder cancer?
Medical Disclaimer: This information is for educational purposes only. Dark urine can be a sign of serious medical conditions. Consult your doctor promptly, especially if combined with jaundice or pain.