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Bilirubin - urine

Definition

Bilirubin is a yellowish pigment found in bile, a fluid produced by the liver.

This article discusses the laboratory test to measure the amount of bilirubin in the urine. Large amounts of bilirubin in the body can lead to jaundice.

Bilirubin may also be measured with a blood test. For information on that test, see: Bilirubin - blood

Alternative Names

Conjugated bilirubin - urine; Direct bilirubin - urine

How the Test is Performed

A 24-hour urine sample is needed.

• On day 1, urinate into the toilet when you get up in the morning.
• Afterwards, collect all urine in a special container for the next 24 hours.
• On day 2, urinate into the container when you get up in the morning.
• Cap the container. Keep it in the refrigerator or a cool place during the collection period.

Label the container with your name, the date, the time of completion, and return it as instructed.

For an infant, thoroughly wash the area where urine exits the body.

• Open a urine collection bag (a plastic bag with an adhesive paper on one end).
• For males, place the entire penis in the bag and attach the adhesive to the skin.
• For females, place the bag over the labia.
• Diaper as usual over the secured bag.

This procedure may take a couple of attempts -- lively infants can move the bag, causing the urine to be absorbed by the diaper. You may need extra collection bags.

Check the infant frequently and change the bag after the infant has urinated into it. Drain the urine from the bag into the container provided by your health care provider.

Deliver it to the laboratory or your health care provider as soon as possible upon completion.

How to Prepare for the Test

Your health care provider may tell you to stop taking any drugs that may interfere with the test.

Drugs than can increase the level of bilirubin include:

• Allopurinol
• Barbiturates
• Birth control pills
• Certain antibiotics
• Chlorpromazine
• Diuretics
• Phenazopyridine
• Steroids
• Sulfonamides

Drugs that can cause reduce the level of bilirubin include indomethacin and ascorbic acid.

How the Test Will Feel

The test involves only normal urination, and there is no discomfort.

Why the Test is Performed

This test may be done to diagnose liver or gallbladder problems.

Normal Results

Bilirubin is not normally found in the urine.

What Abnormal Results Mean

Increased levels of bilirubin in the urine may be due to:

• Biliary strictures
• Cirrhosis
• Gallstones in the biliary tract
• Hepatitis
• Injury from surgery that affects the biliary tract
• Tumors of the liver or gallbladder

Risks

There are no risks.

Considerations

Bilirubin can breakdown in the presence of light. That's why babies with jaundice are sometimes placed under blue fluorescent lamps. See: Bili lights

References

Berk PD, Korenblat KM. Approach to the patient with jaundice or abnormal liver test results. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 150.

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