Defination

24 hour urine collection is performed by collecting a patient’s urine in a special container over a 24-hour period. The container must be kept cool during this time until it is returned to the lab for analysis.

Why Need 24 Hour Urine

A 24 hour urine collection is a simple diagnostic procedure that measures the components of patient’s urine.

Urine consist almost 95% of water and dissolved chemicals such as urea, uric acid, sodium, potassium, calsium, creatinine, phosphorous and etc.

For the normal individual, each chemical component has a normal range dissolved in urine.If the concentration of certain chemical is more or less than a normal range, it can be a very important indicator for the doctor in diagnose and treatment of the patient especially related to renal function disorder.

24 hour urine test can determine the efficiency of renal function in regulation of absorption and excreation. The diseases that related to renal function are diabetic nephropathy, hypertension, lupus, urinary tract infections, urinary tract obstruction or blockage, alport syndrome, nephritic syndrome, polycystic kidney disease, cystinosis dan interstitial nephritis.

24 Hour Urine Testing

The 24 hour urine testing that usually done in laboratory are :

• Urinary excretion rate
• Protein
• Adrenalin
• Amylase
• Bilirubin
• Calcium
• Citric acid
• Cortisol
• Creatinine
• Dopamine
• Electrolytes
• Epinephrine
• Glucose
• HCG (qualitative)
• Homovanillic acid (HVA)
• Ketones
• Leucine aminopeptidase
• Myoglobin
• Norepinephrine
• Normetanephrine
• Osmolality
• Porphyrins
• Potassium
• Sodium
• Urea nitrogen
• Uric acid
• Urine Bence-Jones protein
• Urinary casts
• Amino acids
• Metanephrine
• Vanillylmandelic acid (VMA)

Procedure For Urine 24 Hour Collection

Before The Procedure

Your doctor will explain the procedure to you and offer you the opportunity to ask any questions that you want to know about the procedure.

Generally, no prior preparation, such as fasting or sedation is required.

If possible, choose a 24 hour period when you will be at home for example during holiday, so the procedure can be run more easily.

For the pregnant lady or suspect that you may be pregnant, you should notify your doctor.

Notify your health care provider of all medications (prescription and over the counter) and herbal supplements that you are taking.

Based on your medical condition, your doctor may request other specific preparation.

The patient must decide the time to start the procedure. For example, if he or she wants to start at 7.00 am, he or she must urinate at that time without collecting the urine. The collecting procedure only be started for the next urination during period of 24 hour and the last collection is at 7.00 am of the next day.

Drink less liquid during the collection period than you usually do, unless instructed by your doctor. Do not drink any alcoholic beverages.

Common Instruction For Urine Sample Collection (Men)

1. Retract foreskin (if not circumcised)
2. Using one of the towelettes provided, cleanse the urethral opening with a single stroke directed from the ring of the glans toward the tip. Discard towelette.

• Repeat cleansing procedure using two more towelettes.

1. Void into the toilet and continue to void but interrupt the stream to collect urine into the supplied container.

1. Close the container, complete information on label and attach it to the specimen container.

Common Instruction For Urine Sample Collection (Women)

1. While seated on the toilet spread the outer folds.
2. Using one of the towelettes provided, wipe the inner side of one inner fold by using a single stroke from front to back and discard towelette.

• Using a second towelette, repeat step (ii) on the opposite side.

1. Using a third towelette, cleanse urethral opening with a single front to back stroke.
2. Void into the toilet and continue to void but interrupt the stream to collect urine into the supplied container.

1. Close the container, complete information on label and attach it to the specimen container.

Preservatives In 24 Hour Urine Collection

The preservatives must be added in the urine container to make sure the chemical that we want to measure is stabilise and no significant different occurred. This usually done by lab technician during supplying urine container.

The example of preservatives are:-

Normal Ranges For 24 Hour Urine Tests

The normal ranges for particular chemical depend on the equipment and method that has been used. In general, the normal ranges for selected 24 hour urine test as below:-

Conclusion

The 24 hour urine test is very important in diagnoses and treatment of the patient especially to determine the effectiveness of renal function in absorption and excreation process in our body.

References

1. MedlinePlus Medical Encyclopedia

www.nlm.nih.gov/medlineplus/ency/article/003607.htm

1. Health Encyclopedia – University of Rochester Medical Center

www.urmc.rochester.edu/.

• Introduction to MEDICAL LABORATORY TECHNOLOGY (4^th Edition)