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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
This test can be done an any urine sample, although sometimes a 24-hour urine sample is needed. For the 24-hour urine sample:
- 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, and the time when you finish it, 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 often 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 the sample to the laboratory or to your health care provider as soon as possible.
How to Prepare for the Test
Your health care provider may tell you to stop taking any drugs that may affect the test.
Drugs that can increase the level of bilirubin include:
- Allopurinol
- Barbiturates
- Birth control pills
- Chlorpromazine
- Diuretics
- Isoniazid
- Phenazopyridine
- Steroids
- Sulfonamides
Drugs that can 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 tract disease
- Cirrhosis
- Gallstones in the biliary tract
- Hepatitis
- Liver disease
- Tumors of the liver or gallbladder
Risks
There are no risks.
Considerations
Bilirubin can break down in light. That is 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.
Lidofsky SD. Jaundice. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease. 9th ed. Philadelphia, Pa: Saunders Elsevier;2010:chap 20.
Reviewed By: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
