Urea Urine 24H

Kidney

Report in 48Hrs

At Home

No Fasting Required

Details

Measures nitrogen excretion.

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Parameters

Why is it done?
- Measures the amount of urea nitrogen excreted in urine over a 24-hour period
- Evaluates kidney function and protein metabolism
- Assesses nutritional status and protein intake
- Diagnoses and monitors renal disease and dysfunction
- Evaluates glomerular filtration rate (GFR) and renal clearance
- Monitors patients with diabetes, hypertension, and other metabolic disorders
- Ordered when patients present with symptoms of kidney disease, proteinuria, or abnormal serum creatinine
Normal Range
- Adults: 12-20 g/24 hours (typically 15-20 g/24 hours for men, 11-20 g/24 hours for women)
- Children: 8-15 g/24 hours (varies with age and body weight)
- Also expressed as: 430-700 mmol/24 hours (SI units)
- Normal urine urea values reflect adequate kidney function, normal protein metabolism, and appropriate dietary protein intake
- Values above 25 g/24 hours: Elevated (indicates increased protein catabolism or high protein diet)
- Values below 12 g/24 hours: Low (suggests reduced protein intake, malnutrition, or liver disease)
- Reference ranges may vary by laboratory; always consult laboratory-specific ranges
Interpretation
- Elevated Urea (>25 g/24 hours):
  - High protein diet or excessive protein intake
  - Increased protein catabolism (fever, infection, trauma, burns)
  - Hyperthyroidism and metabolic disorders
  - Glycogen storage diseases
  - Excessive exercise or physical stress
- Low Urea (<12 g/24 hours):
  - Low protein diet or inadequate protein intake
  - Malnutrition or starvation
  - Severe liver disease (impaired urea synthesis)
  - Pregnancy (physiologic increase in glomerular filtration)
  - Hypothyroidism
  - Syndrome of inappropriate antidiuretic hormone (SIADH)
- Factors Affecting Results:
  - Dietary protein intake is the primary determinant of urinary urea
  - Age, sex, body weight, and muscle mass influence results
  - Physical activity and exercise increase urea excretion
  - Hydration status and fluid intake affect urine concentration
  - Medications (corticosteroids, thyroid hormones) may alter results
  - Kidney disease reduces urea excretion capacity
  - Incomplete 24-hour collection can significantly affect accuracy
Associated Organs
- Primary Organ Systems:
  - Kidneys (primary filtration and excretion of urea)
  - Liver (site of urea synthesis from amino acid catabolism)
  - Urinary system (collection and elimination pathway)
- Diseases and Conditions Associated with Abnormal Results:
  - Chronic kidney disease and acute kidney injury
  - Diabetic nephropathy
  - Hypertensive kidney disease
  - Glomerulonephritis and other autoimmune kidney disorders
  - Polycystic kidney disease
  - Pyelonephritis and urinary tract infections
  - Liver cirrhosis and hepatic failure
  - Malnutrition and protein-energy malnutrition
  - Thyroid disorders (hyper and hypothyroidism)
  - Sepsis and systemic infections
  - Cancer cachexia and wasting syndromes
- Potential Complications and Risks:
  - Progressive renal failure if kidney disease is untreated
  - Uremia from severe kidney dysfunction
  - Hepatic encephalopathy in liver disease
  - Electrolyte imbalances secondary to kidney dysfunction
  - Hypertension from impaired renal function
  - Cardiovascular complications in chronic kidney disease
Follow-up Tests
- Renal Function Assessment:
  - Serum creatinine and blood urea nitrogen (BUN)
  - Glomerular filtration rate (GFR) or estimated GFR (eGFR)
  - Serum electrolytes (sodium, potassium, chloride, bicarbonate)
  - Creatinine clearance (24-hour urine creatinine)
  - Urine protein or albumin (24-hour urine protein)
- Hepatic and Metabolic Assessment:
  - Liver function tests (AST, ALT, bilirubin, albumin, prothrombin time)
  - Serum albumin and total protein (nutritional status assessment)
  - Thyroid-stimulating hormone (TSH) and thyroid function tests if indicated
- Imaging Studies:
  - Renal ultrasound or CT imaging if structural kidney disease suspected
  - Abdominal ultrasound or CT for liver assessment if hepatic disease suspected
- Monitoring Frequency:
  - CKD Stage 1-2: Annual monitoring may be sufficient
  - CKD Stage 3: Every 6-12 months
  - CKD Stage 4-5: Every 3-6 months or as clinically indicated
  - Repeated 24-hour urine urea testing may be ordered to monitor trends in protein metabolism and kidney function progression
Fasting Required?
- No - Fasting is not required for 24-hour urine urea testing
- Patient Preparation Instructions:
  - Collect all urine produced over exactly 24 hours (typically from morning void to morning void the next day)
  - Use the collection container and preservative provided by the laboratory
  - Start collection by discarding the first morning void, then collect all subsequent urine including the first morning void of the following day
  - Keep the urine container refrigerated or on ice during the collection period
  - Record the exact time collection began and ended
  - Do not lose or discard any urine during the collection period
- Medications and Dietary Considerations:
  - No specific medications need to be discontinued; however, inform the laboratory of all current medications
  - Maintain normal diet and hydration during the 24-hour collection period unless otherwise instructed
  - If dietary protein restriction is being assessed, maintain usual diet during collection or follow specific dietary protocol as instructed
  - Avoid strenuous exercise during the collection period if baseline metabolic assessment is desired
  - Do not take diuretics or other urine-altering medications unless specifically directed by the physician
- Collection Container Handling:
  - Transport the completed collection to the laboratory promptly after the 24-hour period
  - Keep the container cool during transport if not already refrigerated
  - Ensure the container is properly labeled with patient identification, collection dates and times

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