Dark Urine: 7 Common Causes & What to Do

Medical review: Dr. Gonzalo Ramirez
General Practitioner and Psychologist
August 2022

Dark urine is usually a sign of concentrated urine from not drinking enough water. If you notice dark urine, you should increase your fluid intake to ensure your body is adequately hydrated. 

Other more serious conditions that can cause dark urine include urinary tract infections, kidney stones and liver problems.

If you notice other symptoms, like pain or burning with urination, lower back pain, fever and white stool, you should see a doctor for diagnosis and treatment as necessary. 

Imagem ilustrativa número 1

The main causes of dark urine are: 

1. Inadequate water intake

Not drinking enough water throughout the day is the most common cause of dark urine. Consuming less water will lead to more concentrated urine, giving it a darker appearance and a stronger smell. 

What to do: You should consume plenty of fluids throughout the day. You can drink water, teas, and natural juices and eat foods that are rich in water. Plenty of urine that is light in color is a sign that your body is adequately hydrated, which can contribute to normal body functioning.

2. Holding your urine

Holding your urine for a long time can also lead to dark urine. Substances that usually eliminated in the urine start to accumulate in the bladder, which can alter urine color. In addition, holding your urine can lead to other complications, like infections, incontinence and kidney stones. 

What to do: To prevent complications from folding your pee, you should use the toilet any time you feel you have to urinate, even if you bladder is not completely full. By urinating frequently, you can decrease the risk for accumulating substances along the urinary tract, and you can prevent bladder dysfunction that can happen over time.  

3. UTI

A urinary tract infection is another common condition that can cause dark urine, especially when people have chronic UTIs. UTIs can alter kidney function, which results in more concentrated urine with traces of blood. 

In addition to dark urine, a UTI can also cause symptoms like fever, pain and burning with urination, and a feeling of heaviness in the lower abdomen. Read more about common UTI symptoms and complete your online symptom quiz to assess your risk for a UTI. 

What to do: If you notice any symptoms of a UTI, you should see a doctor for testing and to start treatment as necessary. Treatment usually involves the use of antibiotics to treat the infection. You should also increase your fluid intake and maintain a healthy diet to speed up recovery. You can also prepare teas for UTIs, which are safe for use alongside medical treatment. 

4. Kidney stones

Kidney stones can also give urine a darker color, as this condition is often triggered by decreased fluid intake. Kidney stones can also lead to traces of blood in the urine, which can also make urine darker 

In addition to darker urine, kidney stones are also associated with symptoms like intense back pain and pain with urination. Learn more about what causes kidney stones and other symptoms that can emerge.

What to do: You should complete imaging tests to identify the location of the kidney stone and to assess its size. Once confirmed, the doctor can determine the best treatment approach, which may involve the use of anti-inflammatories to help relieve discomfort and medications that dissolve the stone, so that it can be eliminated through urine. 

In more serious cases, in which there are several stones or a very large stone, a small procedure may be necessary to remove it. 

5. Liver problems

Some liver conditions, like cirrhosis and hepatitis, can compromise liver function and cause dark urine. This occurs as a consequence of inflammation and decreased functioning, in which bilirubin is not properly broken down. Bilirubin is a pigment that is the result of hemoglobin breakdown, which is eliminated through the urine in high concentrations. 

It is also common to additionally notice white or pale stools, which happens with bilirubin changes as well as problems with fat digestion. Read more about what can cause white stool

What to do: If you notice any signs or symptoms of liver problems, you should se ea doctor for assessment. The doctor will likely order testing to identify the cause of the dark urine, and start treatment as necessary. Treatment may involve the use of medications or diet changes. Complete our online quiz to assess your risk for liver disease

6. Kidney disease

Some health conditions can interfere with adequate kidney functioning and can compromise the way the kidney filter and absorb substances in the blood. This can lead to more concentrated urine, making it appear darker. 

The kidneys can be overladed due to diets that are rich in protein and calcium, supplement use, chronic UTI, kidney stones and high blood pressure. Check-out our online quiz to assess your kidney symptoms and determine your risk for kidney disease. 

What to do: The underlying cuase of the kidney problem should be identified by a doctor to prevent further and more permanent kidney damage that can lead to kidney failure. 

Depending on the cause of the dark urine, the doctor may prescribe anti-ifnlammatories, antibiotics, or diuretics. Surgery or dietary changes may also be recommended. 

7. Blood in urine

The presence of blood in the urine can also make urine darker. This can occur with many conditions, like a UTI in the bladder or kidneys, medications like warfarin or aspirin, or cancer in the kidneys, bladder or prostate. 

Some women may notice blood in their urine in the first days of menstruation. This occurs due to menstrual blood mixing with urine in the toilet, which may give urine a darker color. Learn more about the most common causes of blood in the urine and what to do. 

What to do: Bloody urine should always be assessed by a doctor. The doctor will likely perform a physical exam and order testing to confirm a diagnosis and start treatment as necessary. 

During menstruation, you should monitor for symptoms like fever and burning with urination, as these may be a sign of a UTI. Read more about UTI treatment that the doctor may recommend. 

Was this information helpful?

Edited by Tua Saude editing team in August 2022. Medical review completed by Dr. Gonzalo Ramirez - General Practitioner and Psychologist in August 2022.
Medical review:
Dr. Gonzalo Ramirez
General Practitioner and Psychologist
Dr. Ramirez possesses a medical degree from the Universidad Popular Autónoma del Estado de Puebla (UPAEP). He also specializes in clinical psychology.