24 hrs urine protein

• On day 1, urinate into the toilet upon arising in the morning.
• Collect all subsequent urine (in a special container) for the next 24-hours.
• On day 2, urinate into the container in the morning upon arising.
• Cap the container. Keep it in the refrigerator or a cool place during the collection period. Label the container with your name, the date, the time of completion, and return it as instructed.

Infant:
Thoroughly wash the area around the urethra. Open a urine collection bag (a plastic bag with an adhesive paper on one end), and place it on your infant. For males, the entire penis can be placed in the bag and the adhesive attached to the skin. For females, the bag is placed over the labia. Place a diaper over the infant (bag and all). The infant should be checked frequently and the bag changed after the infant has urinated into the bag. For active infants, this procedure may take a couple of attempts--lively infants can displace the bag, causing an inability to obtain the specimen. The urine is drained into the container for transport to the laboratory.

Deliver it to the laboratory or your health care provider as soon as possible upon completion.

How to Prepare:
No special preparation is necessary for this test, but if the collection is being taken from an infant, a couple of extra collection bags may be necessary.

How it Feels:
The test involves only normal urination, and there is no discomfort.

Risks:
There are no risks.

Why this Test is Performed:
The test determines the amount of protein that is excreted in the urine in 1 day.

Normally, less than 150 milligrams of protein per day (or 10 milligrams per deciliter) is excreted in the urine. The proteins are derived from plasma and the urinary tract. About one-third of the protein is urine albumin , about one-third is small globulins, and about one-third is Tamm-Horsfall protein (a glycoprotein that is secreted by distal tubular cells). Most of the filtered proteins are normally reabsorbed by the proximal tubular cells of the kidney.

Normal Values:
The normal value is less than 150 mg/day, or less than 10 mg/dl.

Note: mg/day = milligrams per day; mg/dl = milligrams per deciliter (of urine)

Abnormal Results:
Increased urinary protein can occur as a result of dehydration and relative renal ischemia (a deficient blood supply), for example, as a result of hemorrhage or salt depletion and in illnesses involving fevers. However, increased urinary protein is usually measured when glomerular disease is suspected. The deterioration in the integrity of the glomerulus allows albumin to permeate in large quantities. Glomerular disease such as nephrotic syndrome may result in urine protein (mostly urine albumin ) of greater than 3.5 gm/day. So-called microalbuminuria with urine albumin levels of 30 to 200 mg/day is considered an early sign of diabetic nephropathy .

Renal tubular diseases usually have urine protein levels in the range of 1 to 2 gm/day. In this case, most of the protein is represented by low-molecular weight globulins that would be reabsorbed by normal tubules. Diseases that fall into this category include pyelonephritis , Fanconi's syndrome , cystinosis, and Wilson's disease .

Overflow proteinuria ( protein in the urine ) results from the presence of greater than normal levels of protein in the plasma, (for example, Bence-Jones proteinuria, which is in multiple myeloma , Waldenstrom's macroglobulinemia , and some lymphomas). The Bence-Jones protein (quantitative) test detects proteins that are light chains of immunoglobulins.

Additional conditions under which the test may be performed:

• complicated UTI (pyelonephritis)

Note: gm/day = grams per day; mg/day = milligrams per day

Cost:
The estimated cost is $24.

Special Considerations:
Healthy people may exceed normal protein excretion levels after strenuous exercise or with dehydration . Some foods may affect protein levels.

Drugs that can cause increased excretion levels include acetaminophen - oral, antibiotics, and non-steroidal anti-inflammatories.

Drugs that can cause test results to appear high can include aspirin, antibiotics, and radiographic contrast media.