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Bilirubin/Creatinine Ratio, Urine

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

This urine test measures bilirubin relative to creatinine, helping account for variations in urine concentration when evaluating bilirubin excretion.

Quick summary

["An elevated urine bilirubin/creatinine ratio may indicate increased bilirubin excretion, such as with liver disease or bile duct obstruction."]

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

Key facts at a glance

LOINC
38442-0
Short code
Bilirub Cry #/area UrnS LPF
Synonyms
Bilirub Cry #/area UrnS LPF
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-lpf
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?

This test measures the amount of bilirubin in urine relative to the amount of creatinine. Creatinine is included because it can help adjust the bilirubin result for how concentrated the urine is.

Why might I need this test?

A clinician may use this test to evaluate jaundice, suspected liver disease, or blockage of bile ducts. It may also be used in some newborn screening evaluations for conditions that affect bile flow.

How is the test performed?

A urine sample is collected and tested in the laboratory. The laboratory may measure bilirubin with a urine reagent strip and determine creatinine so that a bilirubin-to-creatinine ratio can be calculated.

How do I prepare for the test?

No special preparation is usually needed unless your clinician gives you different instructions. Collect the urine as directed, using a clean container and avoiding contamination from toilet paper or other fluids.

Clinical interpretation

How abnormal results are interpreted and what conditions they suggest.

◆Associated findings1

Short name

Urine bilirubin/creatinine ratio

Frequently asked questions

What does urine bilirubin measure?
It measures bilirubin, a yellow pigment produced during the breakdown of heme, the oxygen-carrying part of red blood cells. Small amounts normally enter urine, but increased amounts can occur with liver or bile duct conditions.
Why is creatinine included?
Urine can vary greatly in concentration. Creatinine provides a way to compare bilirubin with another urine component that also varies with concentration, making the ratio more useful for interpretation.
Does this test require fasting?
Fasting is generally not required for a routine urine bilirubin/creatinine ratio. Follow any specific collection or timing instructions provided by the ordering clinician or laboratory.
  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