What is a urinary bilirubin test?

What is a urinary bilirubin test?

Bilirubin in urine is a common condition; if your doctor finds it, you may have some complications. To find out about this test, we explain in detail what a urinary bilirubin test is, how it is done and why you should do it.

Bilirubin is a yellow substance that your body makes during the normal process of breaking down red blood cells and can also be formed when there are problems with your liver.

A bilirubin test is a laboratory test that measures the levels of bilirubin in your urine, which may be an early sign of a liver condition.

Urinary Bilirubin TestA bilirubin in urine test is used to diagnose the presence of bilirubin in the blood (hepatic) or the blood-forming tissues (liver). The bilirubin level in a patient's urine depends on how the liver breaks down many red blood cells. The presence of high levels of this substance indicates that there is not enough RBCs being produced, which could mean that a liver problem is present.

What is a Urinary Bilirubin test?

A urine bilirubin test measures the level of bilirubin in your urine. Bilirubin is a breakdown product of haemoglobin, a protein found in RBC. It can be released into your urine when your liver breaks down RBC. Bilirubin is a yellow pigment that is produced by the body as a normal part of metabolism. Bilirubin is found in many body fluids, including blood, sweat, urine, and saliva.

Bilirubin is a yellow substance produced by the breakdown of RBC, a process called haemolysis. Bilirubin is normally excreted from the body in bile and then reabsorbed into the bloodstream. When RBCs die, they can't be digested, so the body releases bilirubin into the bloodstream.

This is a metabolic breakdown product of haemoglobin, which is an iron-containing protein that transports oxygen from the lungs to the rest of the body.

Types of Bilirubin

There are two types of bilirubin: conjugated or total bilirubin and unconjugated or direct bilirubin. Conjugated bilirubin and unconjugated bilirubin are both measured in blood tests, but they have different functions and effects on your body.

Total or Conjugated Bilirubin:

This is the most common type of bilirubin and is measured by a blood test. This test measures the amount of total bilirubin in your blood. Conjugated bilirubin makes up 90% of total bilirubin levels in blood serum. It contains 2 pigments: glucuronic acid and glucuronic acid conjugates (also called GBCs). When you have elevated levels of conjugated bilirubin, it means that there is too much damage to your RBCs. Conjugated bilirubin can be either temporary or permanent, depending on the damage to your RBC.

Direct Bilirubin or Unconjugated

Unconjugated bilirubin is found in your urine and can be measured by a urine or blood test. Direct bilirubin is produced when your body breaks down old red cells and haemoglobin. It can also result from an infection or exposure to certain medications or toxins, like alcohol or street drugs, that affect RBC production of haemoglobin or cause other problems with your liver function, such as cirrhosis (liver scarring) or hepatitis (inflammation).

Why is a bilirubin in urine test done?

A urinary bilirubin test can be done if you have an unusual amount of blood in your urine and your doctor suspects that the cause may be a urinary tract infection, kidney disease, liver disease or other medical problem.

A urinary bilirubin blood test works by looking for bilirubin in the urine. Bilirubin is a chemical found in the blood that gets broken down by haemolysis (splitting) into its component parts: urobilinogen, urobilin and biliverdin. The breakdown products are then eliminated from the body in urine.

What are the risks of bilirubin in urine tests?

There is a small risk that the test results will be falsely positive. The following factors can increase your risk of having a false-positive test:

High bilirubin levels (above 1,000 mcg/dL). A high bilirubin level in your urine can lead to an overreaction by the lab testing equipment, which may cause a false-positive result.


A pregnant woman's blood may contain higher levels of bilirubin as her body tries to rid itself of excess RBC so she can give birth safely and quickly. But it's very rare for pregnancy to cause a false-positive result from a urinalysis.

Kidney disease

Kidney disease can affect how well you process toxins, which could lead to false-positive results on some tests.

What happens during a bilirubin urine test?

The test is performed by collecting a urine sample and analyzing it for the presence of bilirubin.

What happens during a bilirubin in Urine test

The presence of excessive amounts of urine bilirubin can be an indication that you have a problem with your liver or have become infected with the hepatitis B virus (HBV). In both cases, you may need treatment.

How long does a urine bilirubin test take?

A urine bilirubin test is typically performed during an office visit and takes about 15 minutes to complete, although it can take longer.

The results of your urine bilirubin test will show how much bilirubin is present in your urine and what its concentration is. If your levels are abnormal, your doctor will likely recommend other tests to help determine the cause of your liver damage and treatment options for you.

What disease causes bilirubin in urine?

Urine bilirubin levels can increase as a result of haemolysis (a condition where RBC break down) or hepatobiliary disease (abnormalities in the liver). Haemolysis can also occur when someone has had a blood transfusion or an accident, such as an injury to the spleen or liver.

Haematological diseases include leukaemia, lymphoma and myeloproliferative disorders. A haemolytic disease may also cause increased levels of non-haemoglobin-related substances such as uric acid, urea, creatine and lactate sulphate (lactate dehydrogenase).

How is your level compared to the average?

The average level of bilirubin in your blood is between 1.5 and 2.5 milligrams per decilitre (mg/dL). A person with a normal bilirubin level has a reading between 0 and 2.5 mg/dL. If your reading is low (below 0), you may have an illness or injury causing it to be high; otherwise, it could be caused by an underlying condition like liver disease or kidney problems.


A healthy liver is vital to the overall health of the human body. Any organism with a liver, including most mammals and many reptiles, amphibians, fish and birds, has a far greater chance of living longer and attaining reproductive success than those without.

A bilirubin urine test is safe and does not use radioactive or x-ray materials. The results of the bilirubin test often indicate what might be wrong with the patient, whether it be an infection, cirrhosis or other liver problems. A bilirubin test is a very useful procedure for diagnosing some of these conditions.


If you're interested in getting your Bilirubin levels checked, order an at-home test from Welzo! Click here to order today!

Want to learn more? Read about how to check your liver function or signs that your liver is not functioning correctly.  

Or, learn more about blood tests here!



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