Bilirubin in Urine: MedlinePlus Lab Test Information

T What is a Bilirubin in Urine Test?
P A bilirubin in urine test measures the levels of bilirubin in your urine. Bilirubin is a yellowish substance made during the body's normal process of breaking down red blood cells. Bilirubin is found in bile, a fluid in your liver that helps you digest food. If your liver is healthy, it will remove most of the bilirubin from your body. If your liver is damaged, bilirubin can leak into the blood and urine. Bilirubin in urine may be a sign of liver disease.
P Other names: urine test, urine analysis, UA, chemical urinalysis, direct bilirubin

T What is it used for?
P A bilirubin in urine test is often part of a urinalysis, a test that measures different cells, chemicals, and other substances in your urine. Urinalysis is often included as part of a routine exam. This test may also be used to check for liver problems.

T Why do I need a bilirubin in urine test?
P Your health care provider may have ordered a bilirubin in urine test as part of your regular checkup, or if you have symptoms of liver disease. These symptoms include:
- Jaundice, a condition that causes your skin and eyes to turn yellow
- Dark-colored urine
- Abdominal pain
- Nausea and vomiting
- Fatigue
P Because bilirubin in urine can indicate liver damage before other symptoms appear, your health care provider may order a bilirubin in urine test if you are at a higher risk for liver damage. Risk factors for liver disease include:
- Family history of liver disease
- Heavy drinking
- Exposure or possible exposure to hepatitis virus
- Obesity
- Diabetes
- Taking certain medicines that can cause liver damage

T What happens during a bilirubin in urine test?
P Your health care provider will need to collect a sample of your urine. During your office visit, you will receive a container to collect the urine and special instructions to make sure that the sample is sterile. These instructions are often called the "clean catch method." The clean catch method includes the following steps:
- Wash your hands.
- Clean your genital area with a cleansing pad given to you by your provider. Men should wipe the tip of their penis. Women should open their labia and clean from front to back.
- Start to urinate into the toilet.
- Move the collection container under your urine stream.
- Collect at least an ounce or two of urine into the container, which should have markings to indicate the amounts.
- Finish urinating into the toilet.
- Return the sample container to your health care provider.

T Will I need to do anything to prepare for the test?
P You don't need any special preparations to test for bilirubin in urine. If your health care provider has ordered other urine or blood tests, you may need to fast (not eat or drink) for several hours before the test. Your health care provider will let you know if there are any special instructions to follow.

T Are there any risks to the test?
P There is no known risk to having a urinalysis or a bilirubin in urine test.

T What do the results mean?
P If bilirubin is found in your urine, it may indicate:
- A liver disease such as hepatitis
- A blockage in the structures that carry bile from your liver
- A problem with liver function
P A bilirubin in urine test is only one measure of liver function. If your results are abnormal, your health care provider may order additional blood and urine tests, including a liver panel. A liver panel is a series of blood tests that measure various enzymes, proteins, and substances in the liver. It is often used to detect liver disease.

T References
- American Liver Foundation [Internet]. New York: American Liver Foundation; c2017. Liver Function Tests [updated 2016 Jan 25; cited 2017 Mar 23]; [about 3 screens]. Available from: https://www.liverfoundation.org/for-patients/about-the-liver/the-progression-of-liver-disease/diagnosing-liver-disease/
- Hinkle J, Cheever K. Brunner & Suddarth's Handbook of Laboratory and Diagnostic Tests. 2nd Ed, Kindle. Philadelphia: Wolters Kluwer Health, Lippincott Williams & Wilkins; c2014. Bilirubin (Urine); 86–87 p.
- Lab Tests Online [Internet]. American Association for Clinical Chemistry; c2001–2017. Liver Panel: The Test [updated 2016 Mar 10; cited 2017 Mar 23]; [about 4 screens]. Available from: https://labtestsonline.org/understanding/analytes/liver-panel/tab/test
- Lab Tests Online [Internet]. American Association for Clinical Chemistry; c2001–2017. Urinalysis: The Test [updated 2016 May 25; cited 2017 Mar 23]; [about 4 screens]. Available from: https://labtestsonline.org/understanding/analytes/urinalysis/tab/test
- Lab Tests Online [Internet]. American Association for Clinical Chemistry; c2001–2017. Urinalysis: Three Types of Exams [cited 2017 Mar 23]; [about 5 screens]. Available from: https://labtestsonline.org/understanding/analytes/urinalysis/ui-exams?start=1#bili
- Mayo Clinic [Internet]. Mayo Foundation for Medical Education and Research; c1998–2017. Urinalysis: How you prepare; 2016 Oct 19 [cited 2017 Mar 23]; [about 4 screens]. Available from: http://www.mayoclinic.org/tests-procedures/urinalysis/details/how-you-prepare/ppc-20255388
- Mayo Clinic [Internet]. Mayo Foundation for Medical Education and Research; c1998–2017. Urinalysis: What you can expect; 2016 Oct 19 [cited 2017 Mar 23]; [about 5 screens]. Available from: http://www.mayoclinic.org/tests-procedures/urinalysis/details/what-you-can-expect/rec-20255393
- Merck Manual Consumer Version [Internet]. Kenilworth (NJ): Merck & Co., Inc.; c2017. Urinalysis [cited 2017 Mar 23]; [about 2 screens]. Available from: https://www.merckmanuals.com/home/kidney-and-urinary-tract-disorders/diagnosis-of-kidney-and-urinary-tract-disorders/urinalysis
- Saint Francis Health System [Internet]. Tulsa (OK): Saint Francis Health System; c2016. Patient Information: Collecting a Clean Catch Urine Sample; [cited 2017 Jul 14]; [about 3 screens]. Available from: https://www.saintfrancis.com/lab/Documents/Collecting%20a%20Clean%20Catch%20Urine.pdf
- The Johns Hopkins Lupus Center [Internet]. Johns Hopkins Medicine; c2017. Urinalysis [cited 2017 Mar 23]; [about 3 screens]. Available from: https://www.hopkinslupus.org/lupus-tests/screening-laboratory-tests/urinalysis/
- University of Rochester Medical Center [Internet]. Rochester (NY): University of Rochester Medical Center; c2017. Health Encyclopedia: Direct Bilirubin [cited 2017 Mar 23]; [about 2 screens]. Available from: https://www.urmc.rochester.edu/encyclopedia/content.aspx?contenttypeid=167&contentid=bilirubin_direct

