Test Details
Methodology
Electrophoresis on agarose media
Result Turnaround Time
3 - 5 days
Turnaround time is defined as the usual number of days from the date of pickup of a specimen for testing to when the result is released to the ordering provider. In some cases, additional time should be allowed for additional confirmatory or additional reflex tests. Testing schedules may vary.
Test Includes
Graph with quantitation of total urine protein; urine albumin; urine α1; urine α2; urine β; urine γ-globulin fractions if present; quantitation of M-spike if present
Use
Evaluate myeloma, macroglobulinemia of Waldenström, lymphoma, amyloidosis; differentiate between normal renal function, glomerular proteinuria, and tubular proteinuria. Increased glomerular permeability leads to higher concentrations of large proteins in the glomerular filtrate. Diminished tubular reabsorptive capacity results in a marked increase in urinary excretion of low molecular weight problems.
Special Instructions
Record total 24-hour urine volume on the test request form.
Limitations
May not detect pathologic light chains due to insufficient sensitivity. Should be followed with immunoelectrophoretic or immunofixation study performed on concentrated urine. Optimal specimen when looking for a free monoclonal light chain (Bence Jones protein) is a 24-hour collection.
Custom Additional Information
A serum protein electrophoresis should be reviewed concurrently if one has not been recently studied. In nonselective glomerular proteinuria, the urine electrophoretic pattern is often a nonspecific one which may be called “mirror image” to that of the serum. Contamination of the urine with blood can give a similar pattern. With selective glomerular permeability, albumin, α1 proteins, and transferrin are the predominant proteins identified on the urine protein electrophoresis, with a relative absence of heavier molecular weight proteins (ie, α2-macroglobulin and immunoglobulins). With tubular proteinuria, low molecular weight proteins (α2- and β2-microglobulins) are predominant, with trace amounts of albumin. So called “overflow proteinuria” occurs when low molecular weight proteins are filtered through the glomerulus in increased amounts.
Specimen Requirements
Specimen
Urine (24-hour)
Volume
20-mL aliquot
Minimum Volume
6-mL aliquot (Note: This volume does not allow for repeat testing.)
Container
12-mL plastic transport tube (Labcorp No. 23597) without preservative
Collection Instructions
Instruct patient to void at 8 a.m. and discard the specimen. Then collect all urine for the next 24 hours, including the 8 a.m. void the next morning. Label container with the patient's name, date and time the collection started and ended. Measure total volume. Mix well.
Stability Requirements
Temperature | Period |
|---|---|
Room temperature | 14 days |
Refrigerated | 14 days |
Frozen | 14 days |
Freeze/thaw cycles | Stable x1 |
Reference Range
Normal pattern. See table.
Pattern Description | Electrophoretic Zones | |||||
|---|---|---|---|---|---|---|
Total Protein (mg/d) | Albumin | α1 | α2 | β | γ | |
*Looks like serum protein electrophoretogram. | ||||||
+ = mildly elevated. | ||||||
++ = moderately elevated. | ||||||
+++ = markedly elevated. | ||||||
+/– = may or may not be present. | ||||||
Normal | <150 | +/– | +/– | +/– | ||
Selective glomerular proteinuria | ||||||
mild | <1500 | ++ | + | + | ||
severe | >1500 | +++ | ++ | ++ | ||
Nonselective glomerular proteinuria* | >3000 | +++ | ++ | ++ | ++ | ++ |
Tubular proteinuria | <1500 | Trace to + | Trace | ++ | ++ | Trace of light chain |
Mixed glomerular and tubular proteinuria | +++ | + | ++ | + | + | |
Albuminuria | >150 | ++ | ||||
Overflow proteinuria from acute phase response | Trace or present | ++ | ++ | Trace | Trace | |
Overflow proteinuria with monoclonal spike | (spike) or ++ | (spike) or ++ | ||||
Storage Instructions
Refrigerated (preferred) or room temperature
Causes for Rejection
Preservative added
LOINC® Map
| Order Code | Order Code Name | Order Loinc | Result Code | Result Code Name | UofM | Result LOINC |
|---|---|---|---|---|---|---|
| 003368 | Protein Electro, 24-Hour Urine | 81231-3 | 013664 | Protein,Total,Urine | mg/dL | 2888-6 |
| 003368 | Protein Electro, 24-Hour Urine | 81231-3 | 013219 | Prot,24hr calculated | mg/24 hr | 2889-4 |
| 003368 | Protein Electro, 24-Hour Urine | 81231-3 | 133686 | Albumin, U | % | 13986-5 |
| 003368 | Protein Electro, 24-Hour Urine | 81231-3 | 133694 | Alpha-1-Globulin, U | % | 13984-0 |
| 003368 | Protein Electro, 24-Hour Urine | 81231-3 | 133702 | Alpha-2-Globulin, U | % | 13987-3 |
| 003368 | Protein Electro, 24-Hour Urine | 81231-3 | 133710 | Beta Globulin, U | % | 13988-1 |
| 003368 | Protein Electro, 24-Hour Urine | 81231-3 | 133728 | Gamma Globulin, U | % | 13989-9 |
| 003368 | Protein Electro, 24-Hour Urine | 81231-3 | 133729 | M-Spike, % | % | 42484-6 |
| 003368 | Protein Electro, 24-Hour Urine | 81231-3 | 133734 | M-Spike, mg/24 hr | mg/24 hr | 42482-0 |
| 003368 | Protein Electro, 24-Hour Urine | 81231-3 | 133800 | Please note: | 77202-0 | |
| 003368 | Protein Electro, 24-Hour Urine | 81231-3 | 003724 | 11502-2 | ||
| Order Code | 003368 | |||||
| Order Code Name | Protein Electro, 24-Hour Urine | |||||
| Order Loinc | 81231-3 | |||||
| Result Code | 013664 | |||||
| Result Code Name | Protein,Total,Urine | |||||
| UofM | mg/dL | |||||
| Result LOINC | 2888-6 | |||||
| Order Code | 003368 | |||||
| Order Code Name | Protein Electro, 24-Hour Urine | |||||
| Order Loinc | 81231-3 | |||||
| Result Code | 013219 | |||||
| Result Code Name | Prot,24hr calculated | |||||
| UofM | mg/24 hr | |||||
| Result LOINC | 2889-4 | |||||
| Order Code | 003368 | |||||
| Order Code Name | Protein Electro, 24-Hour Urine | |||||
| Order Loinc | 81231-3 | |||||
| Result Code | 133686 | |||||
| Result Code Name | Albumin, U | |||||
| UofM | % | |||||
| Result LOINC | 13986-5 | |||||
| Order Code | 003368 | |||||
| Order Code Name | Protein Electro, 24-Hour Urine | |||||
| Order Loinc | 81231-3 | |||||
| Result Code | 133694 | |||||
| Result Code Name | Alpha-1-Globulin, U | |||||
| UofM | % | |||||
| Result LOINC | 13984-0 | |||||
| Order Code | 003368 | |||||
| Order Code Name | Protein Electro, 24-Hour Urine | |||||
| Order Loinc | 81231-3 | |||||
| Result Code | 133702 | |||||
| Result Code Name | Alpha-2-Globulin, U | |||||
| UofM | % | |||||
| Result LOINC | 13987-3 | |||||
| Order Code | 003368 | |||||
| Order Code Name | Protein Electro, 24-Hour Urine | |||||
| Order Loinc | 81231-3 | |||||
| Result Code | 133710 | |||||
| Result Code Name | Beta Globulin, U | |||||
| UofM | % | |||||
| Result LOINC | 13988-1 | |||||
| Order Code | 003368 | |||||
| Order Code Name | Protein Electro, 24-Hour Urine | |||||
| Order Loinc | 81231-3 | |||||
| Result Code | 133728 | |||||
| Result Code Name | Gamma Globulin, U | |||||
| UofM | % | |||||
| Result LOINC | 13989-9 | |||||
| Order Code | 003368 | |||||
| Order Code Name | Protein Electro, 24-Hour Urine | |||||
| Order Loinc | 81231-3 | |||||
| Result Code | 133729 | |||||
| Result Code Name | M-Spike, % | |||||
| UofM | % | |||||
| Result LOINC | 42484-6 | |||||
| Order Code | 003368 | |||||
| Order Code Name | Protein Electro, 24-Hour Urine | |||||
| Order Loinc | 81231-3 | |||||
| Result Code | 133734 | |||||
| Result Code Name | M-Spike, mg/24 hr | |||||
| UofM | mg/24 hr | |||||
| Result LOINC | 42482-0 | |||||
| Order Code | 003368 | |||||
| Order Code Name | Protein Electro, 24-Hour Urine | |||||
| Order Loinc | 81231-3 | |||||
| Result Code | 133800 | |||||
| Result Code Name | Please note: | |||||
| UofM | ||||||
| Result LOINC | 77202-0 | |||||
| Order Code | 003368 | |||||
| Order Code Name | Protein Electro, 24-Hour Urine | |||||
| Order Loinc | 81231-3 | |||||
| Result Code | 003724 | |||||
| Result Code Name | ||||||
| UofM | ||||||
| Result LOINC | 11502-2 |