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Protein Electrophoresis, Urine 24 Hrs
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Report in 120Hrs
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No Fasting Required
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Detects protein types in urine.
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Protein Electrophoresis Urine 24 Hrs - Comprehensive Medical Test Guide
- Why is it done?
- Test Overview: This test measures the specific types and amounts of proteins in a 24-hour urine collection. It separates proteins by their electrical charge using electrophoresis, identifying abnormal protein patterns that may indicate kidney disease, plasma cell disorders, or other systemic conditions.
- Primary Indications: Detection of monoclonal or polyclonal proteinuria, investigation of kidney dysfunction, evaluation of proteinuria when dipstick results are abnormal, diagnosis of multiple myeloma or light chain disease, monitoring patients with known kidney or plasma cell disorders
- When Test is Performed: When proteinuria is detected on routine screening, during evaluation of kidney disease, when multiple myeloma is suspected, for follow-up of known kidney or hematologic disorders, and during monitoring of immunosuppressive therapy response
- Normal Range
- Total 24-Hour Urinary Protein: Less than 150 mg/24 hours (normal range may vary slightly by laboratory)
- Albumin: Normally absent or trace amounts in urine; presence suggests glomerular disease
- Immunoglobulin Light Chains (Bence Jones Protein): Negative or absent (< 60 mg/24 hours by immunofixation)
- Normal Pattern Interpretation: Normal results show predominantly small amounts of physiologic proteins (mainly albumin and other serum proteins) with no discrete bands representing monoclonal protein
- Units of Measurement: mg/24 hours, g/24 hours, or percentage of total protein; results reported as qualitative pattern and quantitative values
- Interpretation
- Monoclonal Protein Pattern: Discrete single band indicates production by single clone of plasma cells; associated with multiple myeloma, Waldenström macroglobulinemia, light chain disease, or monoclonal gammopathy of undetermined significance (MGUS)
- Polyclonal Protein Pattern: Increased but diffuse protein pattern suggests glomerular disease, systemic lupus erythematosus, rheumatoid arthritis, or chronic infections
- Selective Proteinuria: Predominantly albumin excretion indicates glomerular disease; typically nephrotic syndrome or minimal change disease
- Non-Selective Proteinuria: Both large and small molecular weight proteins in urine suggests membranoproliferative glomerulonephritis or advanced kidney disease
- Bence Jones Proteinuria: Light chain proteins detected; associated with multiple myeloma, light chain disease, or AL amyloidosis; may cause kidney damage
- Factors Affecting Results: Incomplete 24-hour collection (most common error), fever or strenuous exercise (increases protein), dehydration, contamination of specimen, medications affecting protein metabolism, pregnancy (physiologic proteinuria), and standing position (orthostatic proteinuria)
- Borderline Values: Protein excretion 150-500 mg/24 hours warrants investigation for underlying cause; may indicate early kidney disease or require repeat testing
- Associated Organs
- Primary Organ Systems: Kidneys (glomerular filtration dysfunction), immune system (plasma cell disorders and abnormal immunoglobulin production), hematologic system (multiple myeloma and related disorders)
- Diseases Detected or Diagnosed: Multiple myeloma, light chain disease, Waldenström macroglobulinemia, monoclonal gammopathy of undetermined significance (MGUS), AL amyloidosis, membranoproliferative glomerulonephritis, lupus nephritis, diabetic nephropathy, immunoglobulin A nephropathy, focal segmental glomerulosclerosis, post-infectious glomerulonephritis, nephrotic syndrome
- Associated Conditions: Chronic kidney disease, end-stage renal disease, systemic lupus erythematosus, rheumatoid arthritis, HIV infection, hepatitis C, amyloidosis, plasma cell dyscrasias, bone marrow disorders
- Potential Complications: Untreated proteinuria may lead to progressive kidney damage and renal failure, light chain nephropathy can cause acute kidney injury, high protein excretion may indicate severe glomerular damage requiring urgent intervention, myeloma-associated cast nephropathy ("myeloma kidney") may cause irreversible kidney dysfunction
- Follow-up Tests
- Recommended Follow-up Tests: Serum protein electrophoresis and immunofixation, serum free light chain assay, complete metabolic panel (creatinine, BUN, electrolytes), complete blood count, kidney ultrasound or biopsy when indicated, urine microscopy for cell casts, 24-hour creatinine clearance for GFR estimation
- If Monoclonal Protein Detected: Serum and urine immunofixation electrophoresis, serum free light chain measurement, bone marrow biopsy, skeletal survey or PET-CT for multiple myeloma staging, flow cytometry, LDH and calcium levels
- If Proteinuria Confirmed: Antinuclear antibody (ANA) testing, anti-GBM and ANCA serologies, renal function panel, blood glucose and HbA1c (diabetes screening), blood pressure monitoring, kidney biopsy if etiology unclear
- Monitoring Frequency: Baseline test followed by repeat urinary protein electrophoresis every 6-12 months for known myeloma or light chain disease, every 3-6 months for monoclonal gammopathy of undetermined significance (MGUS), annual testing for stable proteinuria, more frequent monitoring if proteinuria is increasing or patient has declining renal function
- Complementary Tests: Serum albumin and total protein, urine myoglobin (if myositis suspected), beta-2 microglobulin for prognosis, cardiac biomarkers if amyloidosis suspected, kidney function tests and urinalysis, repeat 24-hour urine collection to confirm initial abnormality
- Fasting Required?
- Fasting Status: No - Fasting is NOT required for this test
- Patient Preparation - Collection Instructions: Collect all urine for exactly 24 hours. Start collection by discarding first morning void, then collect every void until same time next morning (include final morning void). Use sterile container provided by laboratory. Keep collection at room temperature or refrigerated if not delivered same day.
- Medications to Continue: All regular medications should be continued as prescribed. No special medication adjustments needed for this test.
- Medications to Avoid: Avoid strenuous exercise and heavy exertion during collection period (can increase protein excretion). Do not use diuretics unless medically necessary. Avoid alcohol consumption during collection. If possible, avoid NSAIDs or ACE inhibitors during test period, but only if approved by physician.
- Special Instructions: Maintain normal hydration and activity. Avoid fever or acute illness during collection. Women should not collect during menstrual period (may contaminate sample). Label container clearly with exact start and end times and dates. Transport specimen to laboratory within 2 hours or refrigerate. Incomplete collections invalidate results.
How our test process works!
