How Urinalysis Can Help with Liver Health

Chris A. Stoll
Chris A. Stoll
November 4, 2022
min read
Technically reviewed by: 
H. Ali, Ph.D.
How Urinalysis Can Help with Liver Health

What is urinalysis, and how is it related to Liver Health?

Urinalysis is a combination of two words, 'urine' and 'analysis’. It refers to one of the many types of urine tests performed to detect or monitor various medical conditions such as liver disease, kidney disorder, urinary tract infection, diabetes, metabolic disorders, bacterial infections, and many more. It is thus a powerful diagnostic tool used universally by healthcare providers to get insights about a person's health and well-being. When it comes to liver health, urinalysis is one of the first tests a healthcare provider prescribes, as it is a simple, quick, and non-invasive way to learn about liver function. An at home liver test checks the levels of liver-related metabolites (chemicals) in urine.

Urine test can be performed using a urine dipstick. The colors of the reagent pads on the dipstick change color according to the chemical composition of urine. A dipstick test can be performed in a clinic or at home.
Urine test can be performed using a urine dipstick. The colors of the reagent pads on the dipstick change color according to the chemical composition of urine. A dipstick test can be performed in a clinic or at home.

Which liver health parameters does urinalysis address?

Urobilinogen and bilirubin are two metabolites that are formed in the liver. Scientific research and clinical evidence indicate that abnormal (below or above normal) levels of these chemicals in urine hint at potential risks to liver health, such as cirrhosis, hepatitis, gallstone, biliary tract disease, jaundice, hemolytic anemia or liver damage due to drugs, etc. Therefore, urine testing for urobilinogen and bilirubin is considered a gold-standard test for diagnosing liver-related health conditions.

Urinalysis for bilirubin and urobilinogen levels is a highly recommended practice because of its significance for your liver health.

What do urobilinogen and bilirubin have to do with my liver health?

The liver, in simplest terms, regulates the quantities of urobilinogen and bilirubin in your blood and urine, and any deviation from normal levels should be seen as a matter of concern.

Bilirubin, a yellowish pigment, is formed during the process of red blood cell breakdown. From the bloodstream, bilirubin reaches your liver where it is used to make bile, a fluid that helps in digestion. Bile carries bilirubin to intestine from where it is flushed out with stool. Higher than normal bilirubin levels in blood or urine indicate excessive breakdown of red blood cells, or liver dysfunction. It could also be a sign of some obstruction preventing the passage of bilirubin from your liver to the intestine.

Urobilinogen is a product of bilirubin. Bilirubin in the intestine is broken down into urobilinogen and other compounds. Most of the urobilinogen is removed with stool, but small quantities of it enter your urine which is normal. High levels of urobilinogen in urine are worrisome as they indicate liver ailments such as cirrhosis, hepatitis or hemolytic anemia. Lower than the normal quantity shows biliary obstruction.

When should I go for urobilinogen and bilirubin urinalysis?

A urine test for urobilinogen and bilirubin is usually the first choice if you experience liver disease symptoms. Some physical symptoms of liver disease include:

  • Yellowing of skin and eyes
  • Abdominal pain/swelling
  • Dark urine color
  • Pale stool color
  • Swelling in the legs and ankles
  • Heart palpitations
  • Chronic fatigue
  • Loss of appetite
  • Nausea and vomiting
  • A tendency to bruise easily

At times, the symptoms of liver disease are not striking. In such situations, it becomes difficult to notice these signs. However, liver diseases are generally easy to perceive. For example, yellowing of skin and eyes, and darker urine color are commonplace signs of liver disease. Occurrence of these physical symptoms requires further investigation. So the moment you experience any of these, you should at once go for a urine test for urobilinogen and bilirubin.

Monitoring of urobilinogen and bilirubin in urine is also crucial for the at-risk group as well as individuals with a weakened immune system. Here are some of the factors that put your liver at a greater risk:

  • Heavy alcohol use
  • Obesity
  • Type-2 diabetes
  • Tattoos or body piercings
  • Use of shared needles for addictive drugs
  • Unprotected sex
  • Exposure to certain chemicals or toxins, etc.

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A urine test strip with urobilinogen and bilirubin parameters
A urine test strip with urobilinogen and bilirubin parameters.

How to check liver function at home?

Yes, you can! A urine dipstick test, also called a rapid urine test, is the fastest way to monitor signs of liver-related conditions. The results of a standard dipstick urinalysis become instantly available, and what's more, anyone can conduct this liver health assessment at home or in clinical/lab settings very quickly. The at home liver test kits usually come with urine test strips (dipsticks) and a color-code chart corresponding to different health parameters, including bilirubin and urobilinogen. To get a holistic health view, you should choose a multiparameter urine dipstick kit like Urinox-10 that checks as many as ten health indicators, including those related to liver health.

How do I perform and interpret a liver dipstick test?

To perform a liver dipstick test, all you need to do is dip one of the urine strips into the urine sample and, after the stipulated time, match the shade/color of the reagent pads with the accompanying color code chart.

For the bilirubin in urine test, any shade of white or cream on the reagent pad indicates a negative result. However, if the pad changes to peach, brown, or reddish-brown, it indicates a positive result for bilirubin. The intensity of the color usually correlates with the levels of bilirubin in the test sample (the darker the color, the higher the concentration). For a healthy liver, the bilirubin test should yield a negative result.

A small level of urobilinogen in urine is typically present in healthy individuals. However, an abnormal concentration of urobilinogen yields a positive test result, indicated by the change of reagent pad color to pink.

If both tests yield a positive result, the risks to liver health are further amplified. This means, you should immediately consult a healthcare professional to further investigate your liver health.

Urinox-10 urine test strips are FDA-cleared for professional use and are CLIA-waived test strips that deliver clinical-grade accuracy within two minutes. The Urinox mobile app helps you monitor urinalysis results and to share them digitally with your healthcare provider.

How important is an at-home urine test for liver health?

An at-home liver test is an efficient tool for you to monitor and manage your health. While a clinical diagnosis should always come from a medical expert, urinalysis using Urinox-10 kit allows you to counter any potential risk to your liver health. It is an educated choice; an affordable and convenient way to diagnose, monitor, and manage the health of your liver.

  1. Mundt, A. Lillian, Shanahan, Kristy. Graff's Textbook of Urinalysis and Body Fluids, Third Edition, China, 2016, 100.
  2. Rai, Alex J. (2010). [Methods in Molecular Biology] The Urinary Proteome Volume 641 || Introduction to Urinalysis: Historical Perspectives and Clinical Application, 10.1007/978-1-60761-711-2(Chapter 1), 1–12.
  3. James R. Roberts in Roberts and Hedges' Clinical Procedures in Emergency Medicine and Acute Care, 2019.
  4. Fan, Shu-Ling (2020). Contemporary Practice in Clinical Chemistry || Urinalysis. 665–680.
About the Author
Chris A. Stoll

Chris Stoll is a medical content writer with a passion for science and understanding how the human body functions. He has spent the last several months working with Diagnox, a leading provider of health and wellness products, to educate consumers about a variety of topics related to health and wellness. In addition to his work in the medical field, Chris is also a dedicated Star Wars fan and enjoys spending his free time exploring the vast universe created by George Lucas. With a strong understanding of science and a desire to share that knowledge with others, Chris is dedicated to helping people understand the intricacies of the human body and how to maintain optimal health and wellness.

About the Reviewer
This blog was
Technically reviewed by: 
H. Ali, Ph.D.

Hussnain Ali received his Ph.D. degree in EE in 2015 from the University of Texas at Dallas, USA. He is the co-founder and the Chief Executive Officer (CEO) at Diagnox Health, Plano, TX 75024, USA, and a visiting research scientist at the University of Texas at Dallas. His academic and industry experience spans over 15 years in organizations like the Center for Advanced Research in Engineering, The University of Texas at Dallas, and Harman/Samsung. He has served as a co-PI on an RO1 grant from the National Institutes of Health (NIH). His research interests include biomedical devices, auditory rehabilitation, and cochlear implants. He has authored and co-authored over 70 international publications and has been awarded multiple US patents. His latest work at Diagnox encompasses the development of innovative healthcare and wellness products/solutions that provide convenient and affordable at-home screening/diagnosis. He aims to bridge conventional clinical diagnostic products with Artificial Intelligence (AI) and contemporary data-centric technologies to modernize the healthcare and wellness industry.

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