Evaluation of the asymptomatic athlete with hepatic and urinalysis abnormalities

In general, there is no reason to evaluate either liver function tests or a urinalysis in asymptomatic athletes. However, at times they are ordered inadvertently, and when abnormal, the provider faces a quandary - ignore or evaluate them. Up to 20% of the liver function tests and urinalyses can be abnormal in the asymptomatic healthy athlete. The key concept for the provider is to quickly, accurately, and economically identify results that are normal variants from those that may be a prelude to a pathologic process. This article will discuss the most common etiologies of these abnormal laboratory tests as well as provide a framework to the follow-up evaluation. Our goal is to aid clinicians in keeping their athletes participating in their sports while at the same time not missing any significant illnesses.