Anesth Pain Med.  2017 Jul;12(3):230-232. 10.17085/apm.2017.12.3.230.

Cloudy urine developed during total intravenous anesthesia with 2% propofol in the patient taking hydroxyurea: A case report

• Hwang BY
• Kwon JY
• Kim HK
• Kim E
• Hong S
• Hong JM

• KMID: 2388837
• DOI: http://doi.org/10.17085/apm.2017.12.3.230

Abstract

We report a case that a 68-year-old man taking hydroxyurea for essential thrombocythemia produced milky urine during propofol infusion. Under microscopic analysis, the cloudy urine sample was revealed to comprise uric acid crystals. Postoperatively, kidney function such as urine output and blood urea nitrogen to creatinine ratio showed no abnormality. We suggest that the cloudy urine may be due to the increased excretion of uric acid after administration of propofol. Although this rare case of cloudy milky urine is resolved on its own, we need to consider the possibility of such urine color changes. It is particularly important to understand that medication, preoperative serum uric acid level, urine pH, and the hypothermal operating room can change the color of urine through the presence of uric acid crystals.

Keyword

Cloudy urine; Hydroxyurea; Propofol; Uric acid

MeSH Terms

Aged
Anesthesia, Intravenous*
Blood Urea Nitrogen
Creatinine
Humans
Hydrogen-Ion Concentration
Hydroxyurea*
Kidney
Operating Rooms
Propofol*
Thrombocythemia, Essential
Uric Acid
Creatinine
Hydroxyurea
Propofol
Uric Acid

Figure

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  Fig. 1 Cloudy urine after propofol. Clear urine dropped out into lower bag before the start of the operation and cloudy urine was observed in upper chamber 2 h after the initiation of propofol.

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  Fig. 2 Uric acid crystals seen under the microscope. The observed crystals in urine sample collected during anesthesia were consistent with uric acid.

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