Urine
Urine screening
Laboratory screening of ten urine parameters, including protein, glucose, blood cells, nitrite, pH and specific gravity. You collect the sample at home.
€ 35,00
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Urine tests · Urine
Urobilinogen
A breakdown product of bilirubin from the gut; raised with liver problems or rapid breakdown of red blood cells.
At a glance
- Measured in urine
- In 1 test panel
- Check the preparation
Explanation
Urobilinogen: what is measured?
Bilirubin that reaches the gut via the bile is converted by gut bacteria into urobilinogen. Part of it is absorbed into the blood and mostly excreted again by the liver; a small part reaches the urine via the kidneys. A small amount of urobilinogen in the urine is therefore normal. The dipstick is mainly intended to detect a raised amount.
What can it detect?
- Liver problems, such as liver inflammation
- Increased breakdown of red blood cells (hemolysis)
- A complete blockage of bile drainage (then urobilinogen is absent)
Result
What does the result mean?
Urobilinogen too high
A raised urobilinogen can fit a liver that processes it less well, for example with liver inflammation or liver damage from alcohol, or increased breakdown of red blood cells (hemolysis), so that more bilirubin reaches the gut. The value can also be slightly raised with fever and in concentrated urine. Some medicines that color the urine give a falsely raised result.
Urobilinogen too low
A low or undetectable value usually has no meaning, because the dipstick measures small amounts poorly. Urobilinogen is absent when no bile reaches the gut, with a complete blockage of the bile ducts, and can be low during or after a course of antibiotics, which reduces the gut bacteria. Urobilinogen also breaks down in light and in urine that has been standing for a long time.
After an abnormal result
With a raised value, blood tests for liver values and bilirubin follow, and when hemolysis is suspected, a blood count. A single slightly raised value without other abnormalities usually does not lead to further tests.
Reliability
How reliable is the test?
A urine dipstick is a quick screening and not a diagnosis. According to the Dutch GP guideline (NHG) on urinary tract infections, the dipstick is a first step with symptoms that fit a bladder infection; if in doubt, a culture or sediment test follows. For detecting kidney damage, the dipstick is less sensitive than the albumin-creatinine ratio in urine and the eGFR in blood; the NHG guideline on chronic kidney damage is based on those. In people without symptoms, most abnormal dipstick results are temporary or harmless; a single abnormal result therefore says little.
What can affect the result?
- Sample collection: preferably use first morning urine or urine that has been in the bladder for at least 4 hours, and after washing, catch the middle part of the stream (midstream), so that no discharge or skin bacteria get into it.
- Menstruation, and the days before and after it, often gives a positive result for blood and sometimes for leukocytes and protein; it is better to collect at another time.
- Vitamin C (supplements or a lot of fruit juice) can suppress the reaction for blood, glucose, nitrite and bilirubin and give a false negative result.
- Heavy exercise, fever and dehydration in the day before sample collection can temporarily cause protein, blood or ketones. Urine that has been standing for a long time or has become warm gives less reliable results, especially for nitrite, bilirubin, urobilinogen and pH.
Preparation
- Preferably use the first morning urine, or urine that has been in your bladder for at least 4 hours.
- Collect the middle part of the stream.
- Do not collect urine during your period.
Who it is for
Who is the test useful for?
Useful for
Useful with symptoms that may fit a bladder infection, such as frequent and painful urination, or as a simple addition to blood tests for the kidneys, sugar or liver. For detecting kidney damage in diabetes or high blood pressure, the albumin-creatinine ratio in urine says more than the dipstick. In people without symptoms and without risk factors, the chance of a harmless abnormality is greater than the chance of a real condition.
How common is it?
Bladder infection is one of the most common infections in women; in men it is much less common. Chronic kidney damage occurs in about 1 in 10 adults, usually without symptoms. In people without symptoms, an abnormality on the dipstick is found in some, usually without a serious cause.
NHG guideline on urinary tract infections; NHG guideline on chronic kidney damage
Get tested
Urobilinogen: test panels
Urobilinogen is part of these test panels. You order online and have your blood drawn at a collection point or collect the sample at home.
Evidence
Sources
This explanation is based on Dutch guidelines and independent information. It is general information, not a diagnosis. Discuss an abnormal result with your GP.
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