24-hour urine protein

How the Test is Performed

A 24-hour urine sample is needed.

• On day 1, urinate into the toilet when you get up in the morning.
• Afterwards, collect all urine in a special container for the next 24 hours.
• On day 2, urinate into the container when you get up in the morning.
• 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.

For an 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 the infant. For males, place the entire penis in the bag and attach the adhesive to the skin. For females, place the bag over the labia. Diaper as usual over the secured bag.

This procedure may take a couple of attempts -- lively infants can move the bag, causing the urine to be absorbed by the diaper. The infant should be checked frequently and the bag changed after the infant has urinated into the bag. Drain the urine from the bag into the container provided by your health care provider.

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

How to Prepare for the Test

Your health care provider will tell you, if needed, to stop taking any drugs that may interfere with the test results.

A number of drugs can change the test results. Make sure your health care provider knows about all medications, herbs, vitamins, and supplements you are taking.

The following may also affect test results:

• A lack of fluid (dehydration)
• Any type of x-ray exam with dye (contrast material) within 3 days before the urine test
• Fluid from the vagina that gets into the urine
• Severe emotional stress
• Strenuous exercise
• Urinary tract infection

How the Test Will Feel

The test involves only normal urination, and there is no discomfort.

Why the Test is Performed

Your doctor may order this test if there are signs of damage to your kidney function on blood, urine, or imaging tests.

Sometimes to avoid a 24-hour urine collection, your doctor may be able to order a test that is done on just one urine sample (protein-to-creatinine ratio).

Normal Results

The normal value is less than 80 milligrams per day, or less than 10 milligrams per deciliter of urine.

The examples above are common measurements for results of these tests. Normal value ranges may vary slightly among different laboratories. Some labs use different measurements or test different samples. Talk to your doctor about the meaning of your specific test results.

What Abnormal Results Mean

Abnormal results may be due to:

• Amyloidosis
• Bladder tumor
• Heart failure
• High blood pressure during pregnancy (preeclampsia)
• Kidney disease caused by diabetes, high blood pressure, autoimmune disorders, a blockage in the kidney system, certain medications, toxins, a blockage of blood vessels, or other causes
• Multiple myeloma

Healthy people may have higher than normal urine protein levels after strenuous exercise or when they are dehydrated. Some foods may affect urine protein levels.

Risks

The test involves normal urination and there are no risks.

Alternative Names

Urine protein - 24 hour

References

Israni AK, Kasiske BL. Laboratory assessment of kidney disease: glomerular filtration rate, urinalysis, and proteinuria. In: Teal MW, Chertow GM, Marsden PA, Skorecki K, Yu ASL, Brenner BM, eds. Brenner & Rector's The Kidney. 9th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 25.

Landry DW, Bazari H. Approach to the patient with renal disease. In: Goldman L, Schafer AI, eds. Cecil Medicine. 24th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 116.

Update Date: 9/3/2012

Updated by: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.