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Protein Quant, Urine (TPQT)

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EPIC Test Name

PROTEIN, URINE, 24 HOUR

EPIC Code

LAB441

Specimen Requirements

Urine
Minimum Volume:24 Hr sample
Collection:Empty your bladder by voiding completely at a specified early morning time and discard this urine. Collect and save all future specimens over the next 24 hours, until the next morning at the specified early morning time, at which time you empty your bladder by voiding for the final time and save this specimen with the rest of the collection. Urine upon collection should be emptied into the 2 quart plastic container provided and refrigerated. Patient's name, address, date and starting and ending time of the collection should be printed on the container.
Transport:Room Temperature ASAP
Stability:Room Temperature: 1 day at 15-25 degrees C Refrigerated: 7 days at 2-8 degrees C
Frozen: 1 month at -20 degrees C
Container:2 quart plastic container
Notes:Store 24-hour sample in Refrigerator during collection. Also order a Epic code LAB2808 -Sunquest COLL

Methods

Turbidimetric

Turnaround Time

SpecimenTurnaround TimeFrequency
Urine2 daysDaily

Reference Ranges

Turbidimetric
All RangeUnit
<0.15 g/24 hrg/(24.h)

Clinical Indications

Physiologically, proteins with higher molecular weight in the circulation are retained or do not pass through the glomerular filter, and lower molecular weight proteins can be freely filtered, but reabsorbed by the tubular cells. The presence of notable amounts of protein in the urine indicates renal disease. Proteinuria can be caused by either tubular, glomerular impairment or overflow proteinuria, where filtration of excessive amounts of low molecular weight protein exceeds the tubular reabsorption, e.g., Bence Jones proteinuria and myoglobinuria. Proteinuria is used as a biomarker for assessing progressiveness of kidney disease, and is monitored for therapeutic purposes.

Additional Information

• For patients whose urine total protein > 500 mg/24 hours, immunofixation analysis to the urine sample should be performed for detecting monoclonal immunoglobulin kappa or lambda light-chain.
• Urinary protein can increase to 300 mg/24 hours after vigorous exercise for healthy subjects.
• Urine contaminated by menstrual blood, prostatic secretions, or semen can cause false proteinuria. Urine sample should be recollected and test repeated.

Common Synonyms

TP, Quant, Urine

Performed

Lab
Chemistry - Downtown

Interpretative Information

Interpretations: Increased amounts of protein in the urine may be due, though not limited, to:

1. Primary, secondary or drug-induced glomerulonephropathy
1.1 Primary glomerulonephropathy
• Minimal change disease
• Idiopathic membranous glomerulonephritis
• Focal segmental glomerulonephritis
• Membranoproliferative glomerulonephritis
• IgA nephropathy
• Nephrotic syndrome and Nephritic syndrome
1.2 Secondary glomerulonephropathy
• Diabetes mellitus
• Collagen vascular disorders (e.g., lupus nephritis)
• Amyloidosis
• Preeclampsia
• Infection (e.g., HIV, hepatitis B and C, poststreptococcal illness, syphilis, malaria and endocarditis)
• Gastrointestinal and lung cancers
• Lymphoma, chronic renal transplant rejection
• Nephrotic syndrome and Nephritic syndrome
1.3 Glomerulonephropathy associated with the following drugs:
• Heroin
• NSAIDs
• Gold components
• Penicillamine
• Lithium
• Heavy metals

2. Tubular
2.1 Hypertensive nephrosclerosis
2.2 Tubulointerstitial disease due to:
• Uric acid nephropathy
• Acute hypersensitivity interstitial nephritis
• Fanconi syndrome
• Heavy metals
• Sickle cell disease
• NSAIDs, antibiotics

3. Overflow
• Hemoglobinuria
• Myoglobinuria
• Multiple myeloma
• Amyloidosis

4. Urinary tract inflammation or tumor

CPT

84156

LOINC

2889-4

References

1. CARROLL MF, TEMTE JL. Proteinuria in Adults: A Diagnostic Approach. Am Fam Physician. 2000;62:1333-40.
2. Glassrock RJ. Proteinuria. In: Massry SJ, Glassrock RJ, eds. Textbook of nephrology. 3d ed. Baltimore: William & Wilkins, 1995:602.
3. Williams DL. Case Presentation - IgA Nephropathy. EJIFCC. 2005;16:1-2.
4. Delaney MP, Lamb EJ: Kidney disease. In: Rifai N, Horvath AR, Wittwer CT, eds. Textbook of Clinical Chemistry, 6th ed. Elsevier; 2018:1256-323.
5. Rinehart BK, Terrone DA, Larmon JE, et al: A 12-hour urine collection accurately assesses proteinuria in hospitalized hypertensive gravida. J Perinatol. 1999;19:556-8.
6. 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;185:804-7.
7. Robinson RR: Isolated proteinuria in asymptomatic patients. Kidney Int. 1980;18:395-406.

Contact Information

Chemistry - Downtown: (315)464-4460
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