The 24-hour urine protein test is an essential test for diagnosing kidney disease. Its advantage is that the test result is accurate and reliable, and relatively less influenced by external factors such as diet and urine volume. The disadvantage is that 24-hour urine retention is required, which is a bit troublesome for patients who visit out of town. Nevertheless, I found that many of my kidney friends have many irregular actions when doing 24-hour urine test, such as not limiting the amount of water drunk during urine retention, and the urine volume reaches 3-4 thousand milliliters, so much urine volume will definitely affect the accuracy of the test. Secondly, the container in which the standard urine is retained is also important, and the presence of preservatives and the degree of cleanliness are very critical. We recommend an article that shows you how to accurately perform a 24-hour urine test. Drain the urine at 7:00 a.m. and “discard” it; add a preservative (such as xylene) to the container. collect all urine after 7:00 a.m. in a large, clean, dry container until 7:00 a.m. the next morning, and drain the last of your urine into the container. Mix all the urine, measure the total urine volume with a measuring device and record it on the lab sheet, or weigh the net weight of all the urine with a scale and record it on the lab sheet, then take a specimen of about 20 ml from the mixed urine and place it in a clean and dry container (given by the hospital) for testing. Important notes: 1. The most likely error for patients is the process of mixing and taking specimens. 2, requirements: use a stick to slowly and gently stir for 3-5 minutes, so that the urine mixes well. Can not stir hard, can not shake, can not produce foam. 3.If it is not mixed well, or foam appears during the mixing process (there will be a lot of protein in the foam), it will lead to inaccurate results. What is 24-hour urine protein quantification? 24-hour urine protein quantification is a urine test that can reflect kidney function by collecting all urine excreted within 24 hours, measuring the 24-hour urine volume, and quantifying the protein in the urine. How to retain it correctly? What are the mistakes that can be made? The “24-hour urine volume” in the 24-hour urine protein quantification means that the first urine in the morning is expelled, and then the second urine is retained. The time of the first urine is recorded for 24 hours until the next day. Put all of the urine from each of these 24 hours into a container, mix it well, and then take 10 to 20 ml from the middle and take it to the hospital for testing. The correct retention of specimens is a key part of ensuring the accuracy of laboratory tests, so what are the common misconceptions? 1, more urine retention The most common problem with 24-hour urine specimens is more urine retention. The main problem is that the doctor who ordered the test did not clearly explain to the patient or family the standard method of urine retention, such as simply saying “urine from 6:00 a.m. today to 6:00 a.m. tomorrow. If the patient urinated at 10:00 p.m. last night and did not urinate again until 6:00 a.m. this morning, then the urine is actually retained for 32 hours. The correct way to do this is to urinate at 6:00 a.m. the first day, when the bladder is empty, and from that time on, the kidneys continue to produce urine and store it in the bladder. And so on, until 6:00 a.m. the next day, regardless of whether there is an urge to urinate, the bladder must be emptied and the urine collected in a clean container, which is the complete 24-hour urine specimen. 2. Leave less urine Some patients forget to catch urine when passing stool or get busy and forget to leave urine when they go out, which can result in some urine not being left. It is recommended that patients who need to keep urine specimens for 24 hours should not go out on the day of urine retention if possible, or bring a container for urine retention if they have to go out. Because the excretion of protein urine is influenced by diet and exercise, it is important to control these factors during urine retention. Some patients may drink more water on the day of 24-hour urine retention, but this is not necessary. Patients only need to eat normally and do not need to drink more water or eat less protein. Do not engage in strenuous exercise such as running, basketball, soccer, etc. on the day of urine retention. Take antihypertensive medication as usual. If you have fever, diarrhea, etc., it is recommended to wait for these conditions to disappear before retaining urine. 4, pollution Suitable containers are very critical, it is recommended to use wide mouth containers with a certain degree of acid resistance, corrosion resistance, easy to clean and have a lid to store urine. The day before the retention of urine specimens flushed with clean water and controlled dry spare. Female patients should avoid menstruation, and if there is more leukorrhea, it is recommended to keep the urine specimen for 24 hours and wash the perineum properly before each urination on the same day, but do not receive only the middle part of the urine. 5.Whether to add preservative If the patient keeps the 24-hour urine specimen only to test the urine protein quantification or urine sodium quantification, there is no need to add preservative. However, it is recommended that the container in which the urine specimen is stored be kept in a cool place. If the indoor and outdoor temperatures are high and you are unsure, you can place the urine specimen in your home refrigerator (where the urine is actually very clean) to keep it cold if your family does not mind. If a patient wants to test a 24-hour urine specimen for tangible components or specific hormones or metabolites, different preservatives should be chosen to prevent the breakdown of these substances depending on the test. What is a normal 24-hour urine protein level? Under normal conditions, the glomerular filtration membrane can only pass substances with a small molecular weight. Normal people generally have 40-80 mg of protein in their urine per day, and this level is usually not detectable by qualitative protein tests. With certain diseases, protein leakage increases and a positive urine protein test can be performed. Therefore, the results reported by the qualitative urine protein test are rough. The quantitative 24-hour urine protein test can accurately measure the amount of protein excreted in the urine. Is exceeding the limit always a kidney disease? (1) 24-hour urine protein quantification is a reliable indicator to determine the presence or absence of nephropathy: Clinically, the occurrence of nephropathy is mostly determined by the qualitative and quantitative urine protein indicators in the routine urine examination. The qualitative urine protein index is often referred to as negative or positive urine protein. If the urine protein test result is positive, the degree of kidney disease depends on how many + it is. The quantitative urine protein test is a more accurate reflection of the kidney function of the patient, and the commonly used diagnostic indicator is the 24-hour urine protein quantification. (2) Occasionally, the 24-hour urine protein quantification exceeds the standard, which cannot confirm the diagnosis of kidney disease: In normal people, the 24-hour urine protein quantification range is less than 150mg/24 hours. If the 24-hour urine protein quantification index of the subject is higher than the reference range of this normal value, it can be considered that there is a kidney function impairment. Although 24-hour urine protein quantification is a reliable indicator of the occurrence of kidney disease, it is inaccurate to conclude that kidney disease has occurred in a patient based on a single abnormal 24-hour urine protein quantification test result. In order to make a clinical diagnosis of kidney disease, it is usually necessary to repeat routine urine tests. By doing regular checkups, the patient’s routine urine test results show that the presence of three or more 24-hour urine protein quantification indexes are higher than the normal reference range before the patient can be judged to have kidney disease. (3) Regular checkups, early detection and early treatment to prevent deterioration: The early onset of kidney disease is insidious, and patients mostly have no obvious symptoms, so it is easy to be ignored. Many people seek medical attention when the kidney disease has developed to the middle or late stage, which brings great difficulty for the treatment of kidney disease in the later stage. Therefore, it is important to develop a good habit of regular health checkups to keep an eye on your body and check for any complications of kidney disease. The difference between urine routine, urine release and 24-hour urine protein quantification Urine release includes urine microalbumin, globulin and β2 microglobulin, etc. Relatively speaking, urine release is more sensitive, and some minor kidney damage can be detected, so many units talk about urine release as an indicator of early kidney damage. The 24-hour urine protein quantification is not as sensitive as the urine immunoassay, but it is more accurate than the urine routine. Urine routine, on the other hand, is easier but relatively crude and is preferred as a clinical screening test for disease. A routine urine test is only a morning or temporary urine test, which of course only reflects the situation of this one urine, but not the rest of the day. The 24-hour urine test can reflect the total protein excretion, creatinine excretion, and calcium excretion for 24 hours, and some children will have their 12-hour or 24-hour total red blood cell excretion checked.
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