Chyluria: What It Is, Why Your Urine Turns Milky White, and How It Gets Treated
Updated: 2 days ago
Medically reviewed by Dr. Baraa Alnahhal, MD · Last reviewed: October 17, 2026
Quick Answer
Chyluria is a condition in which chyle, a milky lymph fluid mixed with intestinal fats, leaks into the urine and makes it look milky white [1] [2]. It is caused by parasites, mainly a roundworm, or by surgery, abdominal injury, tumors or pregnancy [1]. Most cases respond to a strict low-fat, high-protein diet, fluids and rest, with sclerotherapy or surgery for stubborn cases [1].
What the research says
Where you live changes the most likely cause. A review of world literature reported that, worldwide, chyluria is most commonly associated with the filarial parasite and is prevalent in Asia (most extensively India, but also China and Taiwan), whereas in the UK, Europe and North America, where the condition is rare, non-parasitic causes predominate; management depends on the cause and severity (Stainer et al., Ther Adv Urol, 2020) [2].
Diet alone has worked in a reported case. In a case report of a 30-year-old woman whose chyluria relapsed after laser cauterization of kidney lesions, a low-fat, high-protein diet with an essential-fatty-acid source brought remission that held over the long term; this is evidence from one patient, not a trial (Triffoni-Melo et al., Ren Fail, 2014) [3].
What Is Chyluria?
Chyluria (pronounced "kye-lurr-ee-uh") is a condition in which you have chyle ("kyle") in your urine. Chyle is fluid from your lymph nodes that looks milky because fats from your intestines have mixed with it [1].
Here's how the normal process works: your lymph vessels carry lymph and fats to your bloodstream, and your bloodstream delivers them to different parts of your body. If your lymph vessels aren't working correctly, chyle can't reach your bloodstream, so it leaks somewhere else in your body instead. When it leaks into your kidneys, it leaves your body through your urine [1].
What does it mean when your pee is milky white? Milky white urine can mean chyle has leaked into your urinary system, but infection or minerals in the urine can also make urine look cloudy or milky [1]. It mixes with your urine and leaves your body when you use the bathroom.
Chyluria happens when lymph vessels leak milky chyle into the kidneys, where it mixes with urine and leaves the body as milky white urine.
Who Does Chyluria Affect?
Anyone can get chyluria. You're more likely to have parasitic chyluria if you live in, or have spent time in, South America, sub-Saharan Africa, and Southeast Asia, especially India, where the parasites that cause chyluria are more common [1] [2]. It typically affects people between ages 20 and 40, though providers have also documented parasitic chyluria in children as young as 5 [1].
How common is chyluria? It's a relatively rare condition. Even in areas where it's more common, there are still fewer than 100 cases per year [1].
Is chyluria contagious? No. You can't spread it to another person through close contact [1].
How Does Chyluria Affect My Body?
Chyluria may cause malnutrition (not getting enough nutrients) and vitamin deficiencies, because fats and nutrients keep leaving your body in your urine [1].
What Are the Symptoms of Chyluria?
The primary and most noticeable symptom of chyluria is urine that looks milky white [1] [2]. Other symptoms include:
Symptom | What it feels or looks like |
Milky white urine | The main sign; urine looks like milk |
Frequent urination | Peeing a lot |
Painful urination (dysuria) | Pain when you pee |
Blood in urine (hematuria) | Red or pink-tinted urine |
Lower back pain | Aching in the lower back |
Weight loss | Losing weight without trying |
Below-average growth | Mostly noted in children |
Fatigue | Feeling tired all the time |
Chills | Feeling cold and shivery |
Peripheral edema | Swelling in your arms and legs |
What Causes Chyluria?
Chyluria has parasitic and non-parasitic causes.
Parasitic Causes
The roundworm Wuchereria bancrofti causes 95% of parasitic cases, an infection called filariasis. The other 5% of cases come from:
Parasite or infection | Notes |
Taenia echinococcus | A tapeworm parasite |
Taenia nana | Another tapeworm parasite |
Ankylostomiasis | A hookworm infection |
Trichinosis | An infection from undercooked meat |
Malaria | A mosquito-borne infection |
Non-Parasitic Causes
Non-parasitic cause | Description |
Abdominal trauma | Injury to your abdomen |
Surgery | Including partial nephrectomy (removal of part of a kidney) and scoliosis surgery |
Infections | Other infections that affect the lymphatic system |
Abdominal lymph node enlargement | Swollen lymph nodes in the abdomen |
Tumors | Abnormal growths that block lymph flow |
Radiation | Radiation exposure to the area |
Abscesses | Pockets of infection |
Lymphangioma of the bladder or kidney | An abnormal growth of lymph vessels |
Thoracic duct stenosis | Narrowing of the main lymph vessel of the body |
Pregnancy | Can pressure lymph vessels |
Chyluria has parasitic causes (mostly filariasis spread by mosquito bites) and many non-parasitic causes.
How Is Chyluria Diagnosed?
A healthcare provider diagnoses chyluria by asking about your symptoms and ordering tests [1]. Several tests help confirm the diagnosis and show how chyle is entering your urine:
Test | What it does |
Urinalysis | You provide a urine sample; the provider checks its color and appearance, and a lab tests it for chyle |
Imaging tests | CT scan, lymphangiogram, MRI, X-ray, or ultrasound to view the urinary and lymphatic systems |
Triglycerides test | Triglycerides (a type of fat) are present in all chyluria cases; even in mild cases where your urine doesn't look milky, triglycerides can confirm the diagnosis |
Laparoscopy | A minimally invasive procedure that helps find the source of the lymphatic leak; a small abdominal incision allows a thin camera-tipped rod (laparoscope) to look at your organs |
How Is Chyluria Treated?
Your provider may recommend conservative, minimally invasive, or invasive treatments.
Conservative Treatment
More than 70% of chyluria cases respond well to conservative treatment. Your provider may first recommend rest, increased fluids, and a strict diet. Limiting fat in your diet helps your body make less chyle [1]. Your provider may also recommend parenteral nutrition: receiving your caloric and nutritional needs through intravenous (IV) fluids [1]. Certain medications can also help treat chyluria (see below).
Minimally Invasive Treatment
If you don't respond to conservative treatment, sclerotherapy is a minimally invasive option. Your provider injects a special solution (a sclerosant) into the center of your kidney (the renal pelvis). The most common sclerosant is silver nitrate [1], but other common options include:
Sclerosant | Example |
Silver nitrate | The most common option |
Povidone iodine | An antiseptic solution |
Sodium iodide | An iodine-based solution |
Potassium bromide | A bromide solution |
Dextrose | A sugar solution |
Hypertonic solution | A high-concentration solution |
Invasive Treatment
If conservative and minimally invasive treatments don't work, your provider may recommend more invasive options, such as surgery [1].
What Should I Eat If I Have Chyluria?
Your provider may recommend a strict low-fat, high-protein diet with lots of leafy greens and vitamins A, D, E, and K [1].
Food group | Examples |
Fish | Especially cod, haddock, halibut, and tilapia |
Poultry | Skinless white-meat turkey and chicken |
Meat | Sirloin steak |
Legumes | Lentils; black beans, chickpeas, garbanzo beans, kidney beans, and navy beans |
Plant proteins | Tofu |
Dairy | Low-fat dairy |
Other | Seeds and nuts |
You should limit your fat intake to less than 25 grams per day. Most people only need to maintain this low-fat, high-protein diet for a few weeks [1]; your provider will tell you when you can eat more fat again.
Chyluria treatment moves from conservative care to sclerotherapy to surgery, with a low-fat, high-protein diet as the first step.
What Medications Are Used to Treat Chyluria?
Medications used to treat chyluria include ezetimibe, which blocks cholesterol absorption, along with anti-parasitic medications and an antibiotic used for parasitic infections [1].
Medication | What it does |
Ezetimibe (Zetia) | Blocks your small intestine from absorbing cholesterol |
Ivermectin (Stromectol) | An anti-parasitic medication |
Diethylcarbamazine (Hetrazan) | An anti-parasitic medication |
Albendazole (Albenza) | An anti-parasitic medication |
Benzathine penicillin | An antibiotic sometimes used in filariasis to prevent bacterial skin and lymph infections; it does not kill the worms |
How Soon After Treatment Will I Feel Better?
Depending on the type of treatment, most people feel better within a few days or weeks [1].
What Is the Difference Between Lymphuria and Chyluria?
Lymphuria is a condition in which there's lymph in your urine but no fats. Chyluria means lymph and fats are in your urine.
What is the prognosis for chyluria?
If you have chyluria, your chances of recovering are good [1].
Treatment path | Success rate |
No treatment (resolves on its own) | Up to 50% of cases |
Conservative treatment | Over 70% of cases |
Invasive treatments (surgery) | 95% success rate |
How Can I Reduce My Risk of Developing Chyluria?
The parasites that cause chyluria typically spread through mosquito bites, so preventing bites lowers your risk [1]. The best ways to prevent mosquito bites include:
Wearing long, thick pants and sleeves.
Sleeping in an air-conditioned room or under a mosquito net.
Wearing mosquito repellent on exposed skin.
Treating your clothing, tents, and net coverings with mosquito repellent.
You can also take medicines that kill microscopic worms [1].
When Should I See My Healthcare Provider?
See a healthcare provider right away if you notice any changes to the color of your urine, especially if you also notice that you're urinating more often or having pain while you pee [1].
What questions should you ask your healthcare provider about chyluria?
Useful questions about chyluria include how the diagnosis was made, whether treatment is needed, which type of treatment is recommended and whether chyluria can come back.
How do you know that I have chyluria?
If I don't have chyluria, what other condition might I have?
Do I need treatment, or do you think it'll go away on its own?
Do you recommend conservative, minimally invasive, or invasive treatment?
Can chyluria come back?
Can you recommend a dietitian?
What is the bottom line on chyluria?
Chyluria (chyle, or milky lymph fluid mixed with intestinal fats, in your urine) can be startling to see, but it's a rare and very treatable condition. It shows up most often as milky white urine, and it can be caused by parasites or by non-parasitic factors like surgery, injury, or tumors [1]. The good news is that the outlook is excellent: up to half of cases clear up on their own, more than 70% respond to conservative treatment, and invasive treatments succeed about 95% of the time [1]. If you notice any change in your urine's color, especially with more frequent urination or pain, see your healthcare provider promptly. A simple urine test can help confirm what's going on, and your provider can guide you through diet changes, medications, or procedures that match your situation.
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Frequently Asked Questions
What is chyluria?
Chyluria (pronounced "kye-lurr-ee-uh") is a condition in which chyle (milky fluid from your lymph nodes mixed with fats from your intestines) ends up in your urine.
Why is my urine milky white?
Milky white urine usually means chyle has leaked into your kidneys and is mixing with your urine. Several conditions can cause this, so it's worth seeing a healthcare provider for testing.
What is chyle?
Chyle is fluid from your lymph nodes that looks milky because fats from your intestines have mixed with it. It normally travels through your lymph vessels to your bloodstream.
How does chyle get into my urine?
If your lymph vessels don't work correctly, chyle leaks into other parts of your body instead of reaching your bloodstream. When it leaks into your kidneys, it exits through your urine.
Is chyluria contagious?
No. You can't spread chyluria to another person through close contact.
Who gets chyluria?
Anyone can get it. Parasitic chyluria most often affects people aged 20 to 40 and is more common in South America, sub-Saharan Africa, and Southeast Asia (especially India). It has also been documented in children as young as 5.
How common is chyluria?
It's relatively rare. Even in regions where it's most common, there are fewer than 100 cases per year.
What are the symptoms of chyluria?
The main symptom is milky white urine. Others include frequent urination, painful urination, blood in urine, lower back pain, weight loss, fatigue, chills, below-average growth in children, and swelling in the arms or legs.
What causes chyluria?
Parasitic causes (a roundworm causes 95% of parasitic cases) and non-parasitic causes such as abdominal trauma, surgery, infections, lymph node enlargement, tumors, radiation, abscesses, lymphangioma, thoracic duct stenosis, and pregnancy.
Which parasite most commonly causes chyluria?
The roundworm Wuchereria bancrofti causes 95% of parasitic cases. This infection is called filariasis.
Can surgery cause chyluria?
Yes. Surgery, including partial nephrectomy (removal of part of a kidney) and scoliosis surgery, is one of the non-parasitic causes of chyluria.
How is chyluria diagnosed?
Through urinalysis (a urine test for chyle), imaging tests (CT scan, lymphangiogram, MRI, X-ray, ultrasound), a triglycerides test (triglycerides are present in all cases), and sometimes laparoscopy to locate the lymphatic leak.
Can chyluria be confirmed if my urine doesn't look milky?
Yes. In mild cases, your urine may not look milky white, but triglycerides will still be present, and their presence can confirm chyluria.
What is a laparoscopy?
A minimally invasive procedure where a provider makes a small abdominal incision and inserts a thin, camera-tipped rod (laparoscope) to look at your organs and find the source of a lymphatic leak.
What is the first treatment for chyluria?
Conservative treatment: rest, increased fluids, and a strict low-fat diet. More than 70% of cases respond well to this approach.
What should I eat if I have chyluria?
A strict low-fat, high-protein diet with lots of leafy greens and vitamins A, D, E, and K. Examples include white fish (cod, haddock, halibut, tilapia), skinless white-meat poultry, sirloin, lentils, beans, tofu, low-fat dairy, and seeds and nuts. Keep fat under 25 grams per day.
How long do I need to follow the low-fat diet?
Most people only need to maintain it for a few weeks. Your provider will tell you when you can increase your fat intake again.
What medications are used for chyluria?
Ezetimibe (blocks cholesterol absorption in the small intestine) and anti-parasitic medications such as ivermectin, diethylcarbamazine and albendazole. Benzathine penicillin, an antibiotic, is sometimes used to prevent bacterial infections in filariasis.
What is sclerotherapy for chyluria?
A minimally invasive treatment where a provider injects a special solution (sclerosant) into the center of your kidney (renal pelvis). The most common sclerosant is silver nitrate; others include povidone iodine, sodium iodide, potassium bromide, dextrose, and hypertonic solution.
Is surgery ever needed for chyluria?
Yes, if conservative and minimally invasive treatments don't work. Invasive treatments (like surgery) have a 95% success rate.
What is the prognosis for chyluria?
Good. Up to 50% of cases resolve without treatment, over 70% resolve with conservative treatment, and invasive treatments succeed about 95% of the time.
What is the difference between lymphuria and chyluria?
Lymphuria means there's lymph in your urine but no fats. Chyluria means there's both lymph and fats in your urine.
How can I prevent chyluria?
The parasites that cause it spread through mosquito bites. Prevent bites with long thick pants and sleeves, mosquito nets, air-conditioned rooms, and repellent on skin and clothing. You can also take medicines that kill microscopic worms.
Can chyluria cause malnutrition?
Yes. Chyluria may cause malnutrition and vitamin deficiencies, which is one reason a high-protein, vitamin-rich diet is part of treatment.
When should I see a doctor about my urine color?
Right away if you notice any changes to the color of your urine, especially if you're also urinating more often or having pain while you pee.
How soon will I feel better after treatment?
Depending on the treatment type, most people feel better within a few days or weeks.
Related Reading
Content reviewed and produced following the Rinnit editorial framework. Last updated: October 13, 2026.
This article is for general informational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read here. If you think you may have a medical emergency, call your local emergency number immediately.
References
Cleveland Clinic. Chyluria. Cleveland Clinic. Last updated September 12, 2022. https://my.clevelandclinic.org/health/diseases/24171-chyluria
Stainer V, Jones P, Juliebø SØ, et al. Chyluria: what does the clinician need to know? Ther Adv Urol. 2020;12:1756287220940899. PMID 32728391. https://doi.org/10.1177/1756287220940899
Triffoni-Melo AT, Diez-Garcia RW, Barros Silva GE, et al. Good response of low-fat/high-protein diet in a patient with chyluria. Ren Fail. 2014;36(3):453-456. PMID 24329493. https://doi.org/10.3109/0886022X.2013.865485
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