What is chyluria?

Chyluria is a rare condition in which lymphatic fluid leaks into the kidneys and turns the urine milky white.  It is most commonly associated with the parasitic infection Wuchereria Bancrofti, but can also have non-infectious causes.

Chyluria is a lymphatic flow disorder. This group of diseases is characterized by abnormal circulation of lymph fluid. Lymph vessels carry lymph fluid to veins, where it returns to the bloodstream. The fluid plays a crucial role in immune function and fat and protein transport.

When something disrupts or damages normal lymphatic flow, it can cause leakage of lymphatic fluid into the kidneys.

The lymphatic system plays a crucial role in immune function and in the delivery of vital nutrients to the body. Functioning almost like a sponge, the lymphatic system absorbs excess lymph fluid — watery fluid containing protein, electrolytes, cells and other substances — from the body’s organs and returns it to the blood stream. 

Causes of chyluria

Chyluria has several potential causes, including:

• Parasitic infection (Wuchereria bancrofti)
• Congenital lymphatic malformations such as lymphangiomatosis
• Tumors
• Trauma
• Congenital syndromes such as Gorham-Stout, Noonan and Turner syndromes
• Lymphatic to vesical fistulae

Signs and symptoms of chyluria

Chyluria causes people to pass urine that is milky white. Other symptoms include pain during urination, blood in the urine and more frequent urination.

Diagnosis

Doctors use a combination of imaging and laboratory tests to diagnose chyluria. Tests may include:

• X-ray
• Computed tomography (CT)
• Ultrasound
• MRI
• Sampling of the urine for the presence of lymph fluid

Additionally, lymphatic imaging modalities, such as intranodal lymphangiography and dynamic contrast magnetic resonance lymphangiography, might be used to determine the exact source of the lymphatic leak.

Treatment of chyluria

Treatment of chyluria depends on its cause. Patients are treated by a team of experts who specialize in lymphatic imaging and interventions through the Jill and Mark Fishman Center for Lymphatic Disorders. The team will determine the best treatment approach for each patient’s condition.

When lymphatic imaging is able demonstrate the source of the leak leading to chyluria it can be sealed using an embolization procedure.

Long-term outlook

Many patients with chyluria can be cured. Still, some causes of chyluria are more challenging. Experts at the Lymphatic Center have been developing new imaging and treatment options for these patients.

Follow-up care

Most of the follow-up care will be done by your or your child’s primary physician in coordination with our team for special needs related to the procedure or the lymphatic disorder. This can include recommendations for new medications, medication weans or diet recommendations.