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Bilirubin-to-Creatinine Ratio, Urine

Published: August 9, 2026Updated: August 16, 2026

A urine test that compares bilirubin with creatinine to help assess bilirubin excretion, often when evaluating jaundice, particularly in newborns.

Quick summary

["This ratio can help clinicians evaluate whether bilirubin is being excreted in the urine, especially during assessment of infant jaundice."]

Medically reviewed by WellAlly Editorial TeamLast reviewed August 16, 2026Editorial policy

Key facts at a glance

LOINC
25146-2
Short code
Bilirub Cry #/area UrnS HPF
Synonyms
Bilirub Cry #/area UrnS HPF
Category
liver
Sample
urine
Container
Sterile urine container
Units
N/A
Fasting
false
Population
adult
Sex
all
Age range
18–65 years
Method
microscopy-light-hpf
Specimen volume
10 mL
Stability
Room temperature: 2h, Refrigerated: 24h, Frozen: 7d
Hemolysis max
0
Lipemia max
0
Icterus max
0
TAT
4–24 hours
Order
routine

What is this test?

The urine bilirubin-to-creatinine ratio compares the amount of bilirubin in urine with the amount of creatinine. Creatinine is used as a reference because its amount in urine varies with urine concentration.

Why might I need this test?

This test may be used to help evaluate jaundice, particularly in newborns when other bilirubin measurements are uncertain or borderline. It may also be used in adults when a clinician needs to assess urinary bilirubin excretion.

How is the test performed?

A urine sample is collected and tested for bilirubin and creatinine. The laboratory then calculates the bilirubin-to-creatinine ratio.

How do I prepare for the test?

No fasting is usually required. Follow the laboratory's instructions for collecting a clean-catch or timed urine sample, and tell the laboratory if the test is for an infant or child.

Clinical interpretation

How abnormal results are interpreted and what conditions they suggest.

An increased ratio may occur when more bilirubin is being excreted, including with jaundice caused by increased red blood cell breakdown or impaired bile flow. In newborns, the result may help guide further evaluation of suspected hyperbilirubinemia. Interpretation depends on age, urine concentration, kidney function, medications, and other liver and blood tests; an abnormal ratio alone does not establish a diagnosis.

Short name

Urine bilirubin/creatinine ratio

Frequently asked questions

Is this the same as a blood bilirubin test?
No. A blood bilirubin test measures bilirubin in the bloodstream, while this test measures bilirubin relative to creatinine in urine. The results answer different clinical questions and may be used together.
Does the urine bilirubin/creatinine ratio replace a serum bilirubin test?
Not necessarily. It is an additional tool that can support evaluation of jaundice, especially in newborns, but clinicians interpret it alongside blood tests and the patient's clinical condition.
What can affect the result?
Urine concentration, hydration, kidney function, age, medications, and conditions that increase red blood cell breakdown or affect bile flow can influence the result.
  1. 1
    MedlinePlus — Laboratory TestsSource
  2. 2
    Lab Tests OnlineSource
  3. 3
    Mayo Clinic — Tests & ProceduresSource

Click any link to access the full source. PubMed Central (PMC) links provide free full-text access.

This information is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment.

Medical Disclaimer

This content is for general informational and educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the guidance of a qualified healthcare provider with any questions you have about a medical condition, and never disregard professional medical advice or delay seeking it because of something you read here.

If you think you may have a medical emergency, call your local emergency number or go to the nearest emergency department immediately.

Medically reviewed by WellAlly Editorial Team Last reviewed August 16, 2026. · Read our editorial policy