Urine for Chyle

Suspect chyluria if urine is milky. Testing: inspect grossly (post‑prandial), dipstick and microscopy for fat globules; centrifuge—chylomicrons remain in the supernatant; ether test: addition of ether clears turbidity (lipid dissolves); Sudan III/Oil Red O stain for fat; measure urinary triglycerides/chylomicrons (lipoprotein electrophoresis). A fat‑challenge increases sensitivity; consult a clinician for confirmation and imaging.

Chylous urine is urine that appears milky or cloudy due to chyle—lymph fluid rich in fat (chylomicrons). It reflects an abnormal connection between lymphatic and urinary systems from causes like trauma, surgery, malignancy, congenital lymphatic issues, or parasitic infection. Diagnosis uses urine microscopy and fat/chylomicron testing; management targets identifying and treating the underlying cause.

Test pleural or peritoneal fluid for chyle by assessing macroscopic appearance (milky). Measure triglycerides — levels >110 mg/dL indicate chylous effusion; 50–110 mg/dL is indeterminate. Confirm with lipoprotein electrophoresis showing chylomicrons. Supportive findings: lymphocyte-predominant cell count, positive fat stain (Sudan III), and a low cholesterol-to-triglyceride ratio; high cholesterol suggests pseudochyle.

Chyle is a milky fluid formed in the small intestine during fat digestion. It contains lymph mixed with emulsified fats (chylomicrons), proteins, and immune cells absorbed via intestinal lacteals. Chyle travels through the lymphatic system—via the thoracic duct—into the bloodstream, carrying dietary fats. Leakage of chyle into body cavities (chylous effusion) requires medical evaluation.

Chyle in urine (chyluria) makes urine look milky, cloudy, or creamy white, often with a frothy or opaque appearance. It may separate on standing into a creamy top layer and clearer urine beneath, and can be intermittent. Occasionally the urine is tinged pink or red if blood is present. The milky/cloudy appearance is due to lymph and fat particles in the urine.

To check urinary calcium, ask your doctor to order a 24‑hour urine calcium test or a spot urine calcium-to-creatinine ratio. For a 24‑hour collection, discard the first morning void, then collect all urine for the next 24 hours including the final morning sample; keep the container refrigerated. Return it to the lab. Results are mg/day (or mmol/day); report supplements, diet and medications.