Test ID: 12PTU
Protein, Total, 12 Hour, Urine
Secondary ID 
A test code used for billing and in test definitions created prior to November 2011
NY State Approved Indicates the status of NY State approval and if the test is orderable for NY State clients.
Useful For Suggests clinical disorders or settings where the test may be helpful
Evaluation of renal disease
Screening for monoclonal gammopathy
Screening for postural (orthostatic) proteinuria
In select clinical situations, collection of a 12-hour specimen may allow more rapid detection of proteinuria states (eg, screening pregnant patients for preeclampsia)
Method Name A short description of the method used to perform the test
Dye Binding (Pyrogallol Red)
Reporting Name A shorter/abbreviated version of the Published Name for a test; an abbreviated test name
Aliases Lists additional common names for a test, as an aid in searching
Specimen Type Describes the specimen type needed for testing
Specimen Required Defines the optimal specimen. This field describes the type of specimen required to perform the test and the preferred volume to complete testing. The volume allows automated processing, fastest throughput and, when indicated, repeat or reflex testing.
Container/Tube: Plastic, 6-mL tube (Supply T465)
Specimen Volume: 5 mL
Collection Instructions:
1. Collect a 12-hour urine specimen.
2. No preservative.
Additional Information: 12-Hour volume is required.
Urine Preservative Collection Options
| Ambient | Preferred |
| Refrigerated | Yes |
| Frozen | Yes |
| 6N HCl | No |
| 50% Acetic Acid | No |
| Na2CO3 | Yes |
| Toluene | Yes |
| 6N HNO3 | No |
| Boric Acid | Yes |
| Thymol | Yes |
Specimen Minimum Volume Defines the amount of specimen required to perform an assay once, including instrument and container dead space. Submitting the minimum specimen volume makes it impossible to repeat the test or perform confirmatory or perform reflex testing. In some situations, a minimum specimen volume may result in a QNS (quantity not sufficient) result, requiring a second specimen to be collected.
Reject Due To Identifies specimen types and conditions that may cause the specimen to be rejected
| Hemolysis | NA |
| Lipemia | NA |
| Icterus | NA |
| Other | NA |
Specimen Stability Information Provides a description of the temperatures required to transport a specimen to the laboratory. Alternate acceptable temperature(s) are also included.
| Specimen Type | Temperature | Time |
|---|---|---|
| Urine | Refrigerated (preferred) | 7 days |
| Ambient | 7 days | |
| Frozen | 7 days |
Clinical Information Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test
Protein in urine normally consists of plasma proteins that have been filtered by glomeruli and not reabsorbed by the proximal tubule, and proteins secreted by renal tubules or other accessory glands. Increased amounts of protein in the urine may be due to:
-Glomerular proteinuria: defects in permselectivity of the glomerular filtration barrier to plasma proteins (eg, glomerulonephritis or nephrotic syndrome)
-Tubular proteinuria: incomplete tubular reabsorption of proteins (eg, interstitial nephritis)
-Overflow proteinuria: increased plasma concentration of proteins that exceeds capacity for proximal tubular reabsorption (eg, multiple myeloma, myoglobinuria)
-Urinary tract inflammation or tumor
-Preeclampsia
-Orthostatic proteinuria
In pregnant women, a urinary protein excretion of >300 mg/24 hours is frequently cited as consistent with preeclampsia, and 12-hour total protein excretion highly correlates with 24-hour values in this patient population.(1,2)
Orthostatic proteinuria is characterized by increased protein excretion in the upright position, but normal levels when supine. This condition can be detected by comparing urine protein levels in a collection split between day and night (see 12PTU/83190 Orthostatic Protein, Urine). Orthostatic proteinuria is common in childhood and adolescence, but rare after age 30.
Reference Values Describes reference intervals and additional information for interpretation of test results. May include intervals based on age and sex when appropriate. Intervals are Mayo-derived, unless otherwise designated. If an interpretive report is provided, the reference value field will state this.
<54 mg/12 hours (day or night collection)
Interpretation Provides information to assist in interpretation of the test results
Total urine protein determined to be >500 mg/24 hours should be evaluated by immunofixation to assess if there is a monoclonal immunoglobulin light chain and, if present, identify it as either kappa or lambda type.
Urinary protein levels may rise to 300 mg/24 hours in healthy individuals after vigorous exercise.
Low-grade proteinuria may be seen in inflammatory or neoplastic processes involving the urinary tract.
Cautions Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances
False-proteinuria may be due to contamination of urine with menstrual blood, prostatic secretions, or semen.
Protein electrophoresis and immunofixation may be required to characterize and interpret the proteinuria.
Clinical Reference Provides recommendations for further in-depth reading of a clinical nature
1. Rinehart BK, Terrone DA, Larmon JE, et al: A 12-hour urine collection accurately assesses proteinuria in hospitalized hypertensive gravida. J Perinatol 1999;19:556-558
2. 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;185:80-807
3. Keren DF: Clinical indications for electrophoresis and immunofixation. In Manual of Clinical Laboratory Immunology. Fifth edition. Edited by NR Rose, E Conway de Macario, JD Folds, et al. Washington, DC, Am Soc Microbiol, 1997, pp 65-74
4. Robinson RR: Isolated proteinuria in asymptomatic patients. Kidney Int 1980;18:395-406
Method Description Describes how the test is performed and provides a method-specific reference
The pyrogallol red dye is combined with molybdenum acid, forming a red complex with maximum absorption at 470 nm. When this complex is combined with protein under acidic conditions, its maximum absorption is shifted to a longer wavelength and develops a blue-purple color with a maximum at 604 nm. The concentration of protein in the specimen is equivalent to the absorbance of the dye urine mixture measured at 600 nm.(Package insert: Wako)
Day(s) and Time(s) Test Performed Outlines the days and times the test is performed. This field reflects the day and time the sample must be in the testing laboratory to begin the testing process and includes any specimen preparation and processing time required before the test is performed. Some tests are listed as continuously performed, which means assays are performed several times during the day.
Monday through Sunday; Continuously
Analytic Time Defines the amount of time it takes the laboratory to setup and perform the test. This is defined in number of days. The shortest interval of time expressed is "same day/1 day," which means the results may be available the same day that the sample is received in the testing laboratory. One day means results are available 1 day after the sample is received in the laboratory.
Maximum Laboratory Time Defines the maximum time from specimen receipt at Mayo Medical Laboratories until the release of the test result
Specimen Retention Time Outlines the length of time after testing that a specimen is kept in the laboratory before it is discarded
Performing Laboratory Location The location of the laboratory that performs the test
Test Classification Provides information regarding the medical device classification for laboratory test kits and reagents. Tests may be classified as cleared or approved by the US Food and Drug Administration (FDA) and used per manufacturer's instructions, or as products that do not undergo full FDA review and approval, and are then labeled as an Analyte Specific Reagent (ASR), Investigation Use Only (IUO) product, or a Research Use Only (RUO) product.
CPT Code Information Provides guidance in determining the appropriate Current Procedural Terminology (CPT) code(s) information for each test or profile. The listed CPT codes reflect Mayo Medical Laboratories interpretation of CPT coding requirements. It is the responsibility of each laboratory to determine correct CPT codes to use for billing.
84156
LOINC® Code Information Provides guidance in determining the Logical Observation Identifiers Names and Codes (LOINC) values for the result codes returned for this test or profile.
| Result ID | Reporting Name | LOINC Code |
|---|---|---|
| TPU12 | Protein, Total, 12 Hour, U | 26801-1 |
| TM23 | Collection Duration | 13362-9 |
| VL21 | Urine Volume | 19153-6 |
| CONC1 | Concentration | 35663-4 |
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