24 hour urine normal values

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Twenty-four-hour urine constituents in stone formers: A study from the northeast part of Peninsular Malaysia Hussein N S, Sadiq S M, Kamaliah M D, NorAkmal A W, Gohar M N - Saudi24-hour Urine Protein Test The 24-hour urine protein test checks how much protein is poured into the urine, which can help detect diseases or other problems. The test is simple and not invasive. The urine samples are collected in one or more containers for a period of 24 hours. The containers are kept in a cool environment and then sent to a laboratory for analysis. The specialists review the urine for the protein. When the higher amounts than normal proteins are in the urine, it is called proteinuria. This is often a sign of kidney damage and disease. The test does not show what type of proteins are in the urine. To determine this, your doctor may also order tests like a serum and . The test also does not show the cause of protein loss. Sometimes proteinuria is not a sign of kidney damage. This is especially true for children. Protein levels can be higher during the day than night. Other factors, such as extreme exercise, can also influence the results of the tests. A 24-hour urine protein test is given if you have symptoms of or . Other types of kidney disease or other conditions that affect your kidneys are also sufficient reasons to order the test, including: The 24-hour urine protein test consists of multiple urine samples taken over a 24-hour period. It is different from a protein-a-creatinine relationship test, which uses only one urine sample. The 24-hour urine protein test can be given as a follow-up to a positive protein-to-protein ratio test. The test requires nothing but normal urination. There are no risks involved. The test can be done at home or at the hospital. You will usually be given one or more containers to collect and store your urine for a period of 24 hours. You'll usually start in the morning. You won't keep the urine during that first trip to the bathroom. Instead, flush and start keeping track of time. He'll gather the rest of his urine for the next 24 hours. Keep your urine from the 24-hour period in a cool atmosphere. It can be stored in the refrigerator or ice in a refrigerator. Label the container with its name, date and time of collection. After 24 hours of urine collection, samples should be taken to a laboratory for analysis. If you are home, your healthcare provider will tell you how to transport the urine. Your doctor will tell you how to prepare for the test. You may need to stop taking certain medications that may interfere with test results. Tell your doctor about all the over-the-counter supplements, prescriptions and medications you are taking. Other factors may also interfere with the results of the tests. These may include how much muscle mass a person has. For example, if a person is very ill, they cannot do so much of the creatinine muscle protein. On the other hand, if a person has been bodybuilding and increased muscle mass, it can also affect the results. Sometimes vigorous exercise can only increase the amount of protein a person makes and spills into the urine on a given day. Test results must be available, depending on the lab schedule. A normal test result shows less than 150 milligrams of protein per day. Test results may vary slightly between laboratories. Ask your doctor about the exact meaning of your test results. Protein in the urine can mean kidney damage or disease. Protein levels can also temporarily increase due to factors such as infection, stress, or excess exercise. If the protein is caused by kidney damage, the results of the test will help determine the magnitude of that damage. The amount of protein can also be used to monitor any progression of the disease or measure your response to therapy. Proteinuria is associated with many other conditions. These include: Your doctor may order more tests to make a diagnosis. Last medical review on May 16, 2018

Warning: The NCBI website requires JavaScript to operate. NCBI Bookshelf. Service of the National Library of Medicine, National Institutes of Health. StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan... StatPearls [Internet]. Christopher J. Corder; Banshi M. Rathi; Sairah Sharif; Stephen W. Leslie.AuthorsAfiliations Last Updated: October 27, 2020.Introduction A 24-hour urinalsis is a temporary urine collection used in the metabolic evaluation of urinary stone disease, proteinuria assessment, and estimation of renal function by cleaning creatinine, estimation of residual renal function in the kidney stage Tests are usually performed in an outpatient environment while the patient consumes his or her usual diet. The results are combined with detailed medical and dietary history, serum chemistry and stone composition to guide the prophylactic treatment of stone reduction. A 24-hour urine study can also be used in the pediatric population when inherited conditions such as primary hyperoxaluria and cystinuria are involved. Specimmen requirements and proceduresInstructions to collect a 24-hour urine sample vary according to the laboratory. Typically, the first urine of the patient's morning is discarded. The subsequent urine produced during the next 24 hours, including the first empty specimen of the next morning, is collected in containers that are provided by the laboratory. A condom solution is added to urine collection to stabilize the sample for later analysis. Once 24 hours of urine are collected, the total volume is recorded. A representative sample of the total collection for analysis is presented to the laboratory below. Serum samples, usually calcium, potassium, uric acid and phosphorus, are sometimes also included in the study. It is important for patients to adhere to their normal diet and activities during the collection. Once the test is complete, a detailed report of the results is provided to the order doctor. These results are used to direct prophylactic medical management. Collecting a sample for 24 hours can be difficult for some patients and is certainly inconvenient. However, it is necessary to identify with accuracy and reliability the risk factors of urinary chemistry for the formation of calculations, as urine chemistry is inadequate. A chemical composition analysis of any stone material is very useful if available. Diagnosis Tests Several laboratories offer 24-hour urine tests that provide doctors with a detailed laboratory report stratifying the risk of stone based on the laboratory data points. Typically, 24-hour urine tests for nepholithiasis prophylaxis will include urinary volume, pH, calcium, citrate, magnesium, phosphate, sulfate, oxalate and uric acid. Supersaturation ratios for various types of stone can be calculated. In patients with a history of cystic stones or positive cysteine cyanide test, 24 hour cystine levels can also be measured. Finding or selecting a laboratory for processing 24-hour urine pharmacies can sometimes be difficult. Optimally, all tests are done in a single lab, and the results are presented clearly in only 1 or 2 pages. The totals of 24 hours and relative concentrations should be given. Note that "normal" values are not necessarily "optimal" values for urinary chemical components. Optimal urinary chemistry reference values are not reported to make interpretation a little more complicated. Try to use a lab that performs a lot of 24-hour urine tests and reports all results together. When you have to combine multiple reports from several laboratories to recover all data, it is much more difficult to correlate and analyze. Results, Reporting, Critical FindingsThe 24-hour urine test components vary according to the laboratory. The components included in most of the 24 hour standard analysis include urine volume, urine calcium concentration, oxalate, citric and uric acid, urine pH level and supersaturation values. The supersaturation of calcium oxalate, calcium phosphate and uric acid are commonly reported. Other analytes include urine potassium, magnesium, phosphorus, ammonia, chloride, sulfate and nitrogen in urea form. Reports often include reference range values that help stratify the risk of stone formation. Specialized tests are also available for pediatric patients and patients with cistinuria. These tests include excretion of cysteine, supersaturation and urine pH. The interpretation of urine chemistry requires reference ranges. Urinary chemistry is a continuous variable that makes strict cut points and abnormal values somewhat arbitrary. As the urinary components reach out of normal or optimal ranges, the litogenic risk increases. Below is a summary of the key components of the 24-hour urine and its importance. Urine Volume and Ziptinin Volume and ZipThe reduced urine volume is an important risk factor for stone disease as concentrated urine raises supersaturation of all stone formation salts. A prospective trial of Borghi et al. in 1999 helped define an objective urinary volume level of 2500 mL a day to reduce the risk of stone. In addition, urine volumes on this amount can further reduce the risk of stone. The urinary creatinine excretion is used to determine the accuracy of a tempered urine collection. As a byproduct of muscle metabolism, the excretion of creatinine is relatively stable based on muscle mass. The average daily excretion of creatinine for men is 18 to 24 mg/kg and 15 to 20 mg/kg for women. Thus, a creatinine excretion less than expected suggests an incomplete collection. p The urine HpHHuman has a pH typically between 4.5 and 8.0. The urine pH is a critical data point as changes in the urine pH can lead to crystallization of certain salts. The crystallization of calcium phosphate, calcium oxalate, uric acid, cistino and struvite are all dependent on pH. Precipitation of calcium oxalate is usually not as dependent on pH as others. The risk of uric acid stone is higher in the acid range below 5.5. Calcium phosphate crystals are formed in an alkaline environment of 6.5 and above. The average urine pH for a period of 24 hours should fall between 5.7 to 6.3, which limits the formation of stone dependent on pH. Sodium and PotassiumSodium and PotassiumThe excretion of urinary sodium is approximately the intake of dietary sodium. As urinary sodium increases, urinary calcium excretion increases. Because of this relationship, dietary sodium control is key to controlling hypercalciuria. Low sodium diets usually allow up to 1500 mg of dietary sodium per day. The concentration of urinary potassium is very useful to monitor the compliance of treatments such as potassium citrate. Potassium citrate supplements should result in marked increases in potassium urinary secretion. MagnesiumMagnesiumMagnesium is a urinary crystallization inhibitor, which decreases the risk of stone. Almost half of the dietary magnesium is excreted in the urine. Low urine magnesium is typically dietary in origin. CalcioCalcium The high urinary concentration of calcium can be found in almost half of the patients forming calcium stones. The concentration of urine calcium depends on dietary calcium, sodium intake and protein intake. Moderate calcium intake is generally recommended to limit urinary excretion by maintaining bone health. Low calcium diets can be litogenic, due to increased oxalate absorption in a low calcium diet. The modification of urine calcium is often done with diet changes or medications depending on etiology. CitrateCitrateCitrate is a powerful inhibitor of calcium salt crystallization. Hypocitraturia is a common risk factor for stone disease and can be found in up to one third of the ancients of calcium stone. Low urinary citrates can be from a variety of factors including diet, metabolic acidosis, or hypokalemia. Hypocitraturia can also be idiopathic. Citrate can be found in foods such as citrus juice. Most patients with low urinary citrate require supplements as only dietary means are insufficient. Concentrated citrate supplements such as potassium citrate are commonly available. Optimal levels of urinary citrate are approximately 300 mg per 1000 ml of urine. The low levels of urinary citrus in the establishment of tiazide therapy can be correlated with hypokalemia. A 24-hour urine study is used to monitor urinary citrate concentration and the resulting urinary pH level. On alkalinization, urine can predispose to calcium phosphate stones if pH systematically exceeds 7.0. Oxalato High urine oxalate is another common anomaly in the urine of ancient calcium stone. Approximately one third of the ancient calcium stone will have high urine oxalate. Oxalate is both endogenous and dietary. Dietary oxalate is absorbed in the parts of the colon and distal of the illiterate. Normal oxalate excretion varies from approximately 40 to 50 mg per day. Reductions in excretion can have targets as low as 25 mg a day. Oxalate dietary sources include black tea, nuts, chocolate and green leaf vegetables such as spinach. Excessive vitamin C supplements are also metabolized for oxalate in the urine. For this reason, vitamin C supplements should be limited to 1000 mg or less daily. Ventricular hyperoxaluria may be a significant risk factor for patients with inflammatory bowel disease, cystic fibrosis, pancreatic insufficiency or previous intestinal surgery. A more detailed review of the 24-hour guides for the interpretation and treatment of urine chemistry for the prevention of kidney stone can be found in our review article of the 24-Hour urine survey for neophystiasis: Guide to the interpretation of Leslie and Bashir. Clinical Significance The 24-hour urine analysis is a key component of metabolic work for ancients of recurrent stone. Accurate collections can detect treatable abnormalities predisposed to nephrolitissis and monitor progress of treatment. Urinary components are highly variable based on diet factors and lifestyle. Interpretation is complex and often subjective due to this variability. Commercially available tests make the analysis easily accessible. A metabolic evaluation is recommended using 24-hour analysis for old recurring stone based on current guidelines. More than 90% of tested kidney stone patients will demonstrate at least a chemical disorder that is sub-optimal. The fact that patients usually don't feel better in treatment makes it much harder to keep patients in long-term therapy. Therefore, those patients who are the most strongly motivated to minimize their risk of long-term kidney stones and are likely to continue long-term treatment will receive the greatest benefit of this test. 24-hour urine tests are not curative, but a direct prophylactic treatment for those who are willing to follow long-term therapeutic guidelines. Improvement of Health Team Results 24-hour urine is a temperate urine collection used in metabolic evaluation of various types of kidney disorders. The urine collection is done more often by the nurse for internal patients. The nurse should be familiar with urine collection and the need to keep her free from contaminants. When the test is done in an outpatient setting, the patient needs to be educated about how to collect the urine. Precise collections can detect treatable abnormalities predisposed to nephrolitis, glomerulonephritis or nephrotic syndrome and help monitor the progress of treatment. Continuous Education / Review QuestionsReferences This book is distributed under the terms of the Creative Commons 4.0 International License (), which allows the use, duplication, adaptation, distribution and reproduction in any medium or format, provided that you give appropriate credit to the original author(s) and source, a link to the Creative Commons license is provided, and the changes made are indicated. ViewsIn this PageRelated information Similar products in PubMed Recent activityYour navigation activity is empty. The activity recording is off. , 8600 Rockville Pike, Bethesda MD, 20894 USA

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