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Bilirubin - urine

Conjugated bilirubin - urine; Direct bilirubin - urine

Bilirubin is a yellowish pigment found in bile, which is a fluid produced by the liver and stored in the gallbladder.

This article is about a lab test to measure the amount of bilirubin in the urine. Large amounts of bilirubin in the body can lead to jaundice or yellowing of the skin.

Bilirubin may also be measured with a blood test.

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How the Test is Performed

This test can be done on any urine sample.

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 few tries. An active baby can move the bag, causing urine to go into the diaper.

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 provider as soon as possible.

How to Prepare for the Test

Many medicines can interfere with blood test results.

• Your provider will tell you if you need to stop taking any medicines before you have this test.
• Do not stop or change your medicines without first talking to your provider.

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, including gallstones in the biliary tract
• Cirrhosis, hepatitis, or other forms of liver disease
• Tumors of the liver or gallbladder

Considerations

Bilirubin can break down in light. That is why babies with jaundice are sometimes placed under blue fluorescent lamps.

Related Information

References

Dean AJ, Lee DC. Bedside laboratory and microbiologic procedures. In: Roberts JR, Custalow CB, Thomsen TW, eds. Roberts and Hedges' Clinical Procedures in Emergency Medicine and Acute Care. 7th ed. Philadelphia, PA: Elsevier; 2019:chap 67.

Korenblat KM. Approach to the patient with jaundice or abnormal liver test results. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 133.

Riley RS, McPherson RA. Basic examination of urine. In: McPherson RA, Pincus MR, eds. Henry's Clinical Diagnosis and Management by Laboratory Methods. 24th ed. Philadelphia, PA: Elsevier; 2022:chap 29.

Review Date: 8/20/2023  

Reviewed By: Jacob Berman, MD, MPH, Clinical Assistant Professor of Medicine, Division of General Internal Medicine, University of Washington School of Medicine, Seattle, WA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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