Bilirubin is primarily derived from metabolism of hemoglobin. Only conjugated bilirubin (=water soluble) is excreted into the urine and normally only trace amounts can be detected in urine. Elevated urinary bilirubin occurs in patients with obstructive jaundice or jaundice due to hepatocellular disease or injury. However, urine bilirubin is relatively insensitive for detection of liver disease. Hyperbilirubinemia due to hemolysis is principally due to unconjugated bilirubin, and therefore does not result in increased urinary bilirubin.
Bilirubin, Urine
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