The Urine Rainbow, a thread.. starting with purple!

This happens rarely with certain kinds of bladder infections in chronically catheterized patients. (Image from NEJM).

I’ve also attached an article that describes a case study and more details. 1/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3147034/

Here the colors are layered. Ever seen urine look like this before?

This is a result of a blue dye administration during surgery. The layering is due to the timing of the dye infusion. The image is from the following article, fascinating! 2/

https://www.apicareonline.com/intraoperative-multi-colored-urine/

Propofol is an anesthetic/hypnotic used for induction and maintenance of general anesthesia as well as sedation in ICU patients. Oh, and it turns your pee green (as do many other things). 3/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3766788/

Dark brown or “tea colored” urine can be caused by many conditions, including liver failure, rhabdomyolysis (muscle breakdown), urinary tract infections, tubular necrosis, nephritis, severe dehydration, and certain foods/colorings. 4/

A bright pink urine sediment has been described in the setting of propofol administration with excretion of uric acid. (Image is from the article. Kinda looks like it’s sticking its tongue out at you doesn’t it?) 5/

https://www.kireports.org/article/S2468-0249%2818%2930238-9/pdf

White urine can be caused by pyuria (severe urinary tract infection and pus, like the image below), or chyluria (excretion of chyle, a body fluid consisting of lymph and emulsified fats). 6/ https://www.researchgate.net/publication/305687802_Milky_White_Urine_a_look_into_the_differentials

Red urine can obviously be caused by blood. But, less obviously, it can be caused by certain foods (hello beets, my favorite vegetable) and certain medications. 7/

Blue urine can be caused by dyes and medications, and black urine is associated with a condition called alkaptonuria.

That’s it for our little detour into the weird and wonderful world of multicolored urine, for now.

Thanks for making it this far, now for a little secret... 8/

GLITTERING GOLD URINE! This has only been described in unicorns, but every nephrologist dreams of seeing this on urinalysis. (Ok, so urine can “glitter” with crystals in the sediment, and “glitter cells” are real things, but I feel obligated to say that unicorns are REAL too.)

Ok so this was an amazing photo also and had to be included. If you have any photos and stories of strange-looking urine (without any HIPAA data) send them my way! https://twitter.com/cathlott/status/1156752025796976640?s=21