Bilirubin is a yellow pigment formed during the decay of erythrocytes, more precisely - when a non-protein part of hemoglobin - heme is destroyed. His metabolism in the body affects a large number of organs and systems, therefore it is of great interest for doctors of all specialties.
In the blood, the level of bilirubin is examined in the biochemical analysis, in urine its presence and quantity is determined by a general analysis of this biological fluid.
If the concentration of bilirubin in the blood is increased or the liver function is impaired, then a significant amount of urine enters the urine. Consequently, the presence of this substance in the blood speaks about liver diseases( cirrhosis, liver failure) or about blood diseases( malaria, anemia, hemolysis).
Bilirubin detected in urine - what does it mean?
In the urine of an adult, the bilirubin content is extremely low and is not determined by standard methods of research( biochemical analysis of urine, general urine analysis).Therefore, it is believed that normal bilirubin in the urine is absent.
Therefore, the presence of bilirubin in the urine is characteristic of the appearance of diseases that are accompanied by damage to the liver cells, which leads to the ingress of a large number of already bound bilirubin.
The determination of bilirubin in urine is of great informative value in the diagnosis of the diseases listed above. Application of the technique allows:
- to conduct early diagnosis of hepatitis;
- to carry out differential diagnostics of mechanical and hepatic jaundice( with bile flow disorders bilirubin in urine is absent);
- is authentically judged on the functional state of the liver( bilirubin in urine 17 mmol / l indicates severe liver damage).
In addition to diseases that cause the death of liver cells, the appearance of bilirubin in the urine is caused by conditions in which increased formation of bilirubin occurs.
Causes of increased bilirubin in urine
Why is bilirubin in the urine elevated, and what does it mean? Bilirubinuria is a symptom of impaired liver function. The causes of for detecting bilirubin in the urine are diverse :
- acute viral hepatitis( in 90% of cases A or B);
- medicinal hepatitis( overdose of antibiotics, steroids, etc.);
- chronic hepatitis( most often viral etiology);
- of the liver;
- biliary cirrhosis;
- in pregnancy in later terms, some women may develop cholestatic hepatitis;
- toxic hepatitis( poisoning with hepatotoxic poisons);
- alcoholic hepatitis( chronic alcoholism);
- infectious diseases accompanied by hepatocyte damage: leptospirosis, mononucleosis, brucellosis, etc.
In all of these cases, urinalysis shows only direct bilirubin, which the liver failed to excrete with bile into the intestine, becauseis sick, and the enzyme has got into the blood and kidneys. The blood test for direct bilirubin is also above normal.
At the same time, there are disorders in which there is an overabundance of indirect bilirubin( for hemolytic anemia, for example), and then a blood test shows it, and a urinalysis does not.
We found out that the main cause of bilirubin in urine is liver disease and the transfer of enzymes into the blood. Therefore, the main symptom of bilirubinuria is jaundice, in which the skin, eyes and mucous membranes of the patient become yellow.
In addition, any hepatic diseases are characterized by severity in the right upper quadrant, bitter eructations. Those who are ill complain of frequent nausea. The color of the stool masses also changes, they become practically white. But urine - it's getting dark. Sometimes patients complain of hepatic colic or itchy skin. If you find the above symptoms, immediately go to an additional examination with a specialist.
Depending on the disease( the initial causes of bilirubin in the urine), appropriate treatment is prescribed. In addition to drug therapy, it is appropriate, and even necessary, a diet.