Chyluria

CHYLURIA (from Greek chylus-milk juice and ouron-urine), the excretion of milky-white urine resembling lymph. This pathological type of urine is usually caused by the presence of emulsified neutral fats. In some animals, for example in dogs, fat droplets are normally found in the renal epithelium, but in humans neutral fat appears in urine only in the presence of pathological hyperlipemia, for example in diabetes, parenchymatous jaundice, lipoid nephroses, etc. (for details see Lipemia). However, in all these cases the milky-white color of the urine does not reach such a degree as in Chyluria. The latter is observed in an advanced degree in a tropical parasitic blood disease caused by the so-called filaria (Filaria Bancrofti). Individual cases of Chyluria without apparent parasitic etiology have also been observed in the temperate zone and even in the north. The degree of these Chylurias was to some extent dependent on the amount of fat consumed with food, as well as on the position of the body: remaining in bed sometimes led to the disappearance of Chyluria. The fat content in urine reached in individual cases 2% and higher. With true Chyluria one cannot confuse the excretion of lipoids (phosphatides, cholesterol and its esters) in various diseases, particularly in nephroses. It should however be noted that phosphatides were sometimes found in urine simultaneously with neutral fats in true Chyluria. A characteristic feature of chyluric urine is its resistance to decomposition; a case has been described of six-week preservation of chylous urine. There is no doubt that in individual cases chylous urine may be excreted from one kidney. Urine in Chyluria also contains protein in proportion to its quantity in lymph; it is also possible for foreign fats and lipoids (for example iodized fat, fish oil) to pass into the urine of chylurics.