Protein Electrophoresis, 24-Hour Urine

PROCSFU24H

750

Albumin

Total Protein, Protein Electrophoresis, Creatinine

CPT code 81050 may be added at an additional charge for volume measurement

25 mL of a 24-hour urine collected in a unpreserved, plastic urine container

25 mL

Record total volume on test requisition and specimen container

Room temperature

Room temperature: 4 days
Refrigerated: 5 days
Frozen: 30 days

Acidified urine

Set up: Mon-Sat; Report available: 2-5 days

See Laboratory Report

This test is used to analyze the protein content in urine. The proteins are separated into 5 major components: albumin, alpha-1, alpha-2, beta, and gamma. Interpretation of elevations, decreases, or visual changes in different components and/or associated patterns can provide information on various disease states, including inflammatory diseases, autoimmune diseases, different types of kidney injury, plasma cell disorders, and cancers [1,2].

UPEP is used to evaluate an individual with symptoms associated with potential monoclonal gammopathy, or when an individual has abnormally high total protein, albumin, or immunoglobulin levels. This test can help with initial diagnosis, as well as monitoring disease progression and treatment effectiveness [1,2].

Specifically, the use of 24-hour urine collection (vs random urine) is recommended by the National Comprehensive Cancer Network (NCCN) Panel as one of the tests for diagnosis for multiple myeloma and for monitoring response to treatment. The International Myeloma Working Group (IMWG) recommends ordering this test every 3 to 6 months, or as needed, for example, to establish baseline or if disease worsens [1].

The advantage of analyzing urine that has been collected over a 24-hour period is that it provides insight into compositional changes in urine throughout the day. This allows for a more accurate assessment of urine composition, based on averages, making the test more sensitive than a random UPEP test (test code 8525) [3].

NOTE: The results of this test should not be used in isolation; these results alone are not enough to make a diagnosis or for monitoring. UPEP results should be evaluated along with other laboratory, clinical, and imaging findings as appropriate. Additional testing, such as bone marrow studies, serum protein electrophoresis (SPEP), and immunofixation (IFE), may be required for comprehensive evaluation [1,2].

References
1. National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology. Multiple myeloma. Version 2.2020; October 9, 2019. https://www.nccn.org
2. Rajkumar SV, et al. Lancet Oncol. 2014;15:e538-e548.
3. American Association of Clinical Chemistry. Protein electrophoresis, immunofixation electrophoresis. https://labtestsonline.org/tests/protein-electrophoresis-immunofixation-electrophoresis. Accessed November 13, 2019.