What does it measure?
Bilirubin comes from the breakdown of old red blood cells. The liver processes it into a water-soluble form that normally leaves through bile and the bowel. This processed form can appear in urine when its movement through the liver or bile ducts is disrupted.
Before the test
- Sample
- Collect urine in the laboratory’s container, following its clean-catch instructions.
- Preparation
- This test alone usually needs no special preparation. Instructions for other tests may differ.
What can the result mean?
A positive urine result deserves a closer look at liver and bile-duct health. It does not identify the cause. A negative result does not exclude every liver problem because only certain forms of bilirubin pass into urine. [1]
When is it useful, and how is it read?
When dark urine, jaundice, pale stools, or a liver-test change is being investigated, compare urine bilirubin with blood bilirubin and liver enzymes. The pattern helps separate a pigment finding from the cause behind it. [1]
What can affect it?
The pigment breaks down with light and delayed testing. Some medicines color urine or interfere with strip chemistry. A fresh, correctly handled sample and a complete medicine list help make the result meaningful. [1]
Only one form of bilirubin enters urine
The liver makes bilirubin water-soluble before it can appear in urine. That is why a negative urine test does not rule out every cause of a raised blood bilirubin. [1]
Questions you might have
Is urine bilirubin the same as blood bilirubin?
No. Urine testing looks for bilirubin entering urine; blood tests measure bilirubin in the circulation and add detail. [1]
What usually follows an unexpected positive result?
The clinician may review medicines and request liver blood tests to understand the finding. [1]
What comes next?
Your clinician may confirm the finding with blood bilirubin and liver enzymes. Mention yellow eyes, pale stools, itching, or abdominal pain; fever with significant abdominal pain or jaundice needs prompt assessment. [1]
Do blood bilirubin and liver enzymes confirm the urine finding, and what might explain it?
The reference interval and units on your report are part of understanding your result. Understand units, reference intervals, and treatment targets.
Sources & references
Medical references & original research
Books we consulted
References that informed our explanations of the test and its context.
- Pagana KD, Pagana TJ, Pagana TN. Mosby’s Diagnostic and Laboratory Test Reference. 14th ed. Elsevier; 2019.
Practical-section sources accessed: .
For general health education. Interpreting your result and deciding on tests or treatment requires your health context and a qualified clinician.
