Article

Abnormalities of Urine Urobilinogen and Urine Bilirubin Assays and Their Relation to Abnormal Results of Serum Liver Function Tests

Authors: LOUIS BINDER MD, DAVID SMITH MD, THOMAS KUPKA MD, BRIAN NELSON MD, BERT GLASS MD, MICHAEL WAINSCOTT MD, JOHN HAYNES MD

Abstract

ABSTRACTA prospective observational study of 324 cases was conducted in a busy ambulatory care setting to evaluate the sensitivity, specificity, predictive values, and accuracy of spot urine urobilinogen and urine bilirubin assays as screening tests for serum liver function test (LFT) abnormalities. High positive predictive values (88% for at least one abnormal LFT) make the evaluation of positive urine screens detected during routine health care maintenance examinations imperative. Because extraneous factors may influence both urine and serum test results, however, urine assays obtained as a screening parameter in clinical presentations (abdominal pain, jaundice, constitutional symptoms, etc) have only limited clinical utility. The high proportion of false-negative results for both urine assays renders their statistical properties unacceptable as screens in these clinical situations.

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