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Mayo Clinic Laboratories

Mayo Test ID PTU Protein, Total, 24 Hour, Urine


Necessary Information


24-Hour volume (in milliliters) is required.



Specimen Required


Supplies: Sarstedt 5 mL Aliquot Tube (T914)

Collection Container/Tube: 24-hour graduated urine container with no metal cap or glued insert

Submission Container/Tube: Plastic, 5 mL tube or a clean, plastic aliquot container with no metal cap or glued insert

Specimen Volume: 4 mL

Collection Instructions:

1. Collect urine for 24 hours. Specimens should be collected before fluorescein is given or not collected until at least 24 hour later.

2. No preservative.

3. Invert well before taking 4-mL aliquot.

4. Do not over fill aliquot tube 4 mL at most.

Additional Information: See Urine Preservatives-Collection and Transportation for 24-Hour Urine Specimens for multiple collections.


Useful For

Evaluation of kidney disease using a 24-hour urine collection

 

Screening for monoclonal gammopathy

Method Name

Turbidimetry

Reporting Name

Protein, Total, 24 HR, U

Specimen Type

Urine

Specimen Minimum Volume

1 mL

Specimen Stability Information

Specimen Type Temperature Time
Urine Refrigerated (preferred) 14 days
  Frozen  30 days
  Ambient  24 hours

Reject Due To

All specimens will be evaluated at Mayo Clinic Laboratories for test suitability.

Clinical Information

Protein in urine is normally composed of a combination of plasma-derived proteins that have been filtered by glomeruli and have not been reabsorbed by the proximal tubules and proteins secreted by renal tubules or other accessory glands.

 

Increased amounts of protein in the urine may be due to:

-Glomerular proteinuria: caused by defects in permselectivity of the glomerular filtration barrier to plasma proteins (eg, glomerulonephritis or nephrotic syndrome)

-Tubular proteinuria: caused by incomplete tubular reabsorption of proteins (eg, interstitial nephritis)

-Overflow proteinuria: caused by increased plasma concentration of proteins (eg, multiple myeloma, myoglobinuria)

-Urinary tract inflammation or tumor

Reference Values

≥18 years: <229 mg/24 hours

Reference values have not been established for patients <18 years of age.

Reference value applies to 24-hour collection.

Interpretation

Total protein greater than 500 mg/24 hours should be evaluated by immunofixation to determine if a monoclonal immunoglobulin light chain is present, and if so, identify it as either kappa or lambda type.

 

Urinary protein levels may rise to 300 mg/24 hours in healthy individuals after vigorous exercise.

 

Low-grade proteinuria may be seen in inflammatory or neoplastic processes involving the urinary tract.

Cautions

False proteinuria may be due to contamination of urine with menstrual blood, prostatic secretions, or semen.

 

After vigorous exercise, the urinary protein concentration may rise to 300 mg/24 hours in healthy individuals.

 

Normal newborn infants may have higher excretion of protein in urine during the first 3 days of life. The presence of hemoglobin elevates protein concentration.

Clinical Reference

1. Delaney MP, Lamb EJ: Kidney disease. In: Rifai N, Horvath AR, Wittwer CT, eds. Textbook of Clinical Chemistry, 6th ed. Elsevier; 2018:1256-1323

2. Rinehart BK, Terrone DA, Larmon JE, et al: A 12-hour urine collection accurately assesses proteinuria in hospitalized hypertensive gravida. J Perinatol. 1999;19:556-558

3. Adelberg AM, Miller J, Doerzbacher M, Lambers DS: Correlation of quantitative protein measurements in 8-, 12-, and 24-hour urine samples for diagnosis of preeclampsia. Am J Obstet Gynecol. 2001 Oct;185(4):804-807

4. Robinson RR: Isolated proteinuria in asymptomatic patients. Kidney Int. 1980;18:395-406

5. Dube J, Girouard J, Leclerc P, et al: Problems with the estimation of urine protein by automated assays. Clin Biochem. 2005;38(5):479-485

6. Koumantakis G, Wyndham, L: Fluorescein Interference with Urinary Creatinine and Protein Measurements. Clin Chem. 1991;37(10):1799

Method Description

The sample is preincubated in an alkaline solution containing EDTA, which denatures the protein and eliminates interference from magnesium ions. Benzethonium chloride is then added, producing turbidity.(Package insert: Total Protein Urine/CSF Gen.3. Roche Diagnostics; V13.0 11/2018)

Specimen Retention Time

7 days

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Test Classification

This test has been cleared, approved, or is exempt by the US Food and Drug Administration and is used per manufacturer's instructions. Performance characteristics were verified by Mayo Clinic in a manner consistent with CLIA requirements.

CPT Code Information

84156

LOINC Code Information

Test ID Test Order Name Order LOINC Value
PTU Protein, Total, 24 HR, U 2889-4

 

Result ID Test Result Name Result LOINC Value
TP2 Total Protein, 24 HR, U 2889-4
TM23 Collection Duration 13362-9
VL21 Urine Volume 19153-6

Day(s) Performed

Monday through Sunday

Report Available

Same day/1 day