What does a urine test result of bilirubin +1 mean?

Under normal circumstances, a urine test showing bilirubin +1 indicates a weakly positive level of bilirubin in the urine, which may be caused by liver disease, biliary obstruction, hemolytic disorders, and other conditions.

1. Liver Disease

Liver diseases such as viral hepatitis, cirrhosis, and liver abscess can damage hepatocytes, impairing the liver's ability to uptake, conjugate, and excrete bilirubin. This leads to elevated bilirubin levels in the blood. Excess bilirubin is then filtered through the kidneys into the urine, resulting in a positive bilirubin test.

2. Biliary Obstruction

Conditions such as cholelithiasis (gallstones), cholangitis, and biliary tract tumors can cause biliary obstruction, hindering bile drainage. This increases pressure within the bile ducts, forcing bilirubin to reflux into the bloodstream and subsequently increasing bilirubin levels in the urine.

3. Hemolytic Disorders

Various conditions causing extensive red blood cell destruction—such as hereditary spherocytosis or autoimmune hemolytic anemia—lead to overproduction of unconjugated bilirubin, exceeding the liver’s metabolic capacity. The excess bilirubin that remains unprocessed by the liver is excreted through the kidneys, resulting in a positive urinary bilirubin test.

A bilirubin reading of 1+ in routine urinalysis may stem from multiple causes. It is recommended to promptly visit a qualified medical institution for relevant examinations, such as urinalysis, complete blood count, ultrasound, CT scans, etc., to determine the underlying cause and initiate timely treatment.