Ever catch a whiff of chicken broth, something fishy, or something sweet — but you’re in the bathroom, not the kitchen? These unusual urine smells are a common topic among MyLupusTeam members.

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Your kidneys work hard to filter out unneeded water and waste from your bloodstream, turning it into urine. Urine usually has a mild odor, but its smell and color can change depending on how much waste, sugar, and other substances are in your blood. If you’re living with a kidney disease such as lupus nephritis, you may notice changes in your urine.

“So about a week ago, I went to the restroom and realized my urine smelled like cat urine,” one member of MyLupusTeam said. “This has never happened before. I thought maybe I was a bit dehydrated. Can anyone shed some light?”

In this article, we’ll discuss different urine smells mentioned by members and some possible causes for them. If you notice any changes to the color or smell of your urine, talk to your doctor.

Lupus and Your Kidneys

According to the National Institute of Diabetes and Digestive and Kidney Diseases, nearly half of all adults with lupus have kidney disease. Lupus nephritis is caused by antibodies (immune system proteins) that attack your kidneys, causing inflammation and damage. When this happens, your kidneys can’t do their normal jobs — filtering waste and regulating your hormone levels and blood pressure — as well as before.

Your kidneys contain millions of tiny blood vessels that act as filtration units. To maintain your blood’s chemical balance, they remove water, waste, and salts that then leave the body as urine. Your urine is made up of:

• Water
• Urea (waste made from breaking down proteins)
• Salts such as potassium, magnesium, and calcium
• Ammonium
• Creatinine (waste made by muscle cells)

Your urine odor may change based on what you eat and drink, how well your kidneys work, and what they excrete. Certain waste products, glucose (blood sugar), and other substances can all affect the smell of your urine.

Here are four urine odors you may notice while living with lupus nephritis. Some may be related to the disease, while others can be due to diet or medications you’re taking.

1. Chicken Broth or Chicken Soup

Many MyLupusTeam members have commented on urine smells that remind them of chicken broth or chicken soup. One member said, “Urine smells like chicken broth: Sorry for the question, but this is new. Anyone else have this happen before?”

The question resonated with many, prompting replies like:

• “I’m so glad you asked this question. As I moved into more lupus symptoms, I noticed my urine smelled like chicken soup, sort of. It’s protein in your urine, which means your kidneys are not working as well as they should.”
• “I dealt with the same thing. My urine always has very high protein levels.”
• “The smell could be high proteins or just even what you’re eating. You can go to the pharmacy and buy a basic urine test to see if anything is off.”

“As I moved into more lupus symptoms, I noticed my urine smelled like chicken soup.”

— A MyLupusTeam member

High protein levels in urine (also called proteinuria) are common in people with kidney disease and lupus nephritis. Normally, glomeruli — tiny blood vessels in your kidneys — filter water and salts out of your blood while preventing larger particles like blood cells and proteins from passing through.

In lupus nephritis, inflammation damages the glomeruli, allowing proteins to leak into your urine. Protein in your urine can sometimes make it look foamy or frothy, but it doesn’t usually cause unusual odors. If your urine smells like chicken or chicken broth, try not to worry. The odor is more likely caused by something you ate or by dehydration, not lupus nephritis.

However, you should watch out for other symptoms of lupus nephritis, such as swelling, blood in your urine, and sudden weight gain. If you notice any combination of these symptoms, make an appointment with your healthcare provider.

2. Ammonia

If your urine smells like cat pee or ammonia, it may be time to talk to your doctor. MyLupusTeam members have discussed this urine smell and the symptoms that come with it.

“Strong ammonia smell in urine,” one member wrote. “Before getting prescribed Plaquenil, I often had sharp pains in my lower back and flank area accompanying flares. I also have had consistently low levels of protein in my urine, and recently, they found red blood cells in my urine.”

One member replied, “I have protein and blood in my urine — had the flank pain also. They did a kidney biopsy and found I had lupus and stage 3B kidney disease. I’d ask your doctor to check your kidneys better.”

“I’m having the same issue — it’s embarrassing in public, it’s that bad. If I go to a public restroom my pee smells horrible,” another member replied.

The most common reason behind strong urine odors is dehydration. Not drinking enough water can cause the contents of your urine, such as ammonia, to become more concentrated and give off an odor. If your urine also looks darker than usual, dehydration is likely the cause. Urine that’s high in urea can also create an ammonia-like scent.

Not drinking enough water can cause the contents of your urine, such as ammonia, to become more concentrated and give off an odor.

Other reasons your urine may smell like ammonia include:

• Lupus nephritis — Damaged kidneys can’t filter your blood properly. When this happens, they may make less urine, and the urine can have more ammonia in it.
• Urinary tract infection (UTI) — A bacterial infection in your bladder, kidneys, or urethra can make your urine smell like ammonia.
• Kidney stones — These solid masses are made of ammonium and other excreted salts that can make your urine smell different.

If your urine smells like ammonia and you also have abdominal pain or flank pain or are peeing less than normal, make an appointment with your doctor.

3. Fruity or Sweet-Smelling Odor

Does your urine smell fruity or sweet? If so, it may be a sign of uncontrolled type 2 diabetes. Studies show that between 5 percent and 15 percent of people with systemic lupus erythematosus (SLE) have diabetes.

SLE interferes with your cells’ ability to use glucose for energy. As a result, your blood sugar levels increase, and your kidneys get rid of the excess sugar through your urine. If you’re living with SLE and notice that your urine smells sweet, it may be a sign that your blood sugar levels are too high. Your doctor can order bloodwork to check your blood sugar and diagnose diabetes.

If you’re also peeing more often than usual and your breath smells fruity, having urine that smells sweet may be a symptom of diabetic ketoacidosis. This condition can be life-threatening and requires immediate treatment. In diabetic ketoacidosis, your body can’t use glucose for energy, so it breaks down fat in your liver for fuel. This process creates ketones that are excreted in your urine, making it smell fruity.

Get medical attention right away if your urine smells sweet and you’re experiencing any of the following symptoms:

• Extreme thirst
• Urinating much more often than usual
• Fatigue (extreme tiredness that doesn’t improve with rest)
• Abdominal pain
• Vomiting
• Fruity-smelling breath
• Confusion
• Breathing difficulty

4. Fishy or Foul-Smelling Odor

Certain foods and medications can also affect how your urine smells. For example, asparagus, onions, and garlic contain asparagusic acid, which is broken down into sulfur compounds. You may notice that your urine smells like sulfur or rotten eggs after eating those foods. A recent seafood meal can also lead to a fishy or foul-smelling odor.

Some medications and vitamins that contain sulfur-related compounds can also give urine a particular scent. Certain antibiotics, immunosuppressants (medications that calm an overactive immune system), diabetes drugs, and vitamins can make your urine smell different. Some supplements and drugs that can cause foul-smelling urine, include:

• Vitamins B and D
• Sulfa antibiotics, such as sulfamethoxazole/trimethoprim, that treat UTIs
• Immunosuppressants, such as sulfasalazine, that treat rheumatoid arthritis
• Sulfonylureas, such as glimepiride and glipizide, that treat diabetes

Talk to Your Doctor About Urine Smells

Your urine says a lot about your health — if your urine smells unusual or if you have new lupus or lupus nephritis symptoms, your doctor can help. Your healthcare provider can determine what tests you need. These may include checking your kidney function and looking for any abnormalities.

Your urine says a lot about your health — if your urine smells unusual or if you have new lupus or lupus nephritis symptoms, your doctor can help.

Tests your doctor may perform include:

• Urinalysis — Identifies pathogens causing UTIs, blood cells, and waste and salt concentration
• Kidney biopsy — Involves studying a small piece of your kidney tissue under a microscope to look for inflammation and damage in lupus nephritis
• Dipstick test — Checks for proteinuria

Once you receive your test results, your doctor will discuss the next steps with you. When living with lupus, it’s important to take care of your kidney health to prevent other health problems.

Join the Conversation

On MyLupusTeam, people share their experiences with lupus, get advice, and find support from others who understand.

Have you noticed any changes in your urine’s smell? Let others know in the comments below.