What is the cause of dark brown urine, also known as amber or tea-colored urine (Hematuria)?

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Last updated: February 27, 2025View editorial policy

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Differential Diagnosis for Dark Brown Urine

  • Single most likely diagnosis
    • Dehydration: This is often the most common cause of dark brown urine, as it results from a concentrated urine output due to insufficient fluid intake or excessive fluid loss.
  • Other Likely diagnoses
    • Urinary Tract Infection (UTI): A UTI can cause changes in urine color, including dark brown, due to the presence of blood, bacteria, or other substances.
    • Kidney Stones: Kidney stones can cause blood to appear in the urine, leading to a dark brown color.
    • Liver Disease: Certain liver conditions, such as hepatitis or cirrhosis, can cause changes in urine color due to the buildup of bilirubin.
  • Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
    • Rhabdomyolysis: This is a serious condition where muscle tissue breaks down, releasing myoglobin into the bloodstream, which can cause dark brown urine. If left untreated, it can lead to kidney failure.
    • Malignant Melanoma: In rare cases, melanoma can cause dark brown urine due to the presence of melanin. Early detection is crucial for treatment.
  • Rare diagnoses
    • Alkaptonuria: A rare genetic disorder that affects the breakdown of certain amino acids, leading to dark brown urine due to the accumulation of homogentisic acid.
    • Porphyria: A group of rare genetic disorders that can cause changes in urine color, including dark brown, due to the buildup of porphyrins.
    • Blackwater Fever: A rare complication of malaria that can cause dark brown or black urine due to the presence of hemoglobin.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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