Phosphorus, 24-Hour Urine

CPT: 84105
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Test Details

Synonyms

  • Urine Phos
  • Urine Phosphorus

Test Includes

Phosphorus on random or timed urine specimen

Use

Evaluate calcium/phosphorus balance.

High urinary phosphorus (ie, increased renal losses) occurs in primary hyperparathyroidism, vitamin D deficiency, renal tubular acidosis, diuretic use. Phosphates are among the substances which may be lost in the Fanconi syndrome. Renal loss of phosphate may itself lead to rickets or osteomalacia.

Low in hypoparathyroidism, pseudohypoparathyroidism, vitamin D intoxication

Evaluate nephrolithiasis. Hypophosphatemia with normal serum calcium, high alkaline phosphatase, hypercalciuria, low urinary phosphorus occur with osteomalacia from excessive antacid ingestion. The relationship between serum PO4 and phosphaturia, the phosphate excretion index, is described.1 Largely, however, urine phosphate simply reflects phosphate intake in patients not on phosphate binding medications.

Methodology

Colorimetric

Reference Interval

400−1300 mg/24 hours

Additional Information

Children with thalassemia may have normal phosphorus absorption, but high renal phosphaturia, leading to a deficiency of phosphorus.2 Increasing dietary intake of potassium has been reported to increase serum phosphate concentrations apparently by decreasing renal excretion of phosphate.3 During the last trimester of pregnancy there is a sixfold increase in calcium and phosphorus accumulation as the fetus triples its weight. Plasma phosphorus concentrations and increased urinary phosphate may provide a useful means to assess response to phosphate supplements in the premature infant.4

Specimen Requirements

Specimen

Urine (24-hour)

Volume

10 mL aliquot of entire collection

Minimum Volume

0.5 mL aliquot

Container

Plastic urine container. Collect with 6N HCl.

Collection

Instruct the patient to void at 8 AM and discard the specimen. Then collect all urine including the final specimen voided at the end of the 24-hour collection period (ie, 8 AM the next morning). Screw the lid on securely. Mix well. pH must be 0 to 2.

Storage Instructions

Maintain specimen at room temperature.

Stability Requirements

Temperature

Period

Room temperature

14 days

Refrigerated

14 days

Frozen

14 days

Freeze/thaw cycles

Stable x3

Causes for Rejection

Improper labeling

Clinical Information

Special Instructions

The test request form must state date and time collection started, date and time collection finished, and urine volume. Specimens submitted without preservative should be acidified after receipt to pH <2.0 with 6N HCl.

Footnotes

1. Black DAK, Cameron JS. Renal function. In: Brown SS, Mitchell FL, Young DS, eds. Chemical Diagnosis and Disease. Amsterdam, Holland: Elsevier/North Holland; 1979:453-524.
2. Lapatsanis P, Sbyrakis S, Vertos C, Karaklis BA, Dosiadis S. Phosphaturia in thalassemia. Pediatrics. 1976 Dec; 58(6):885-892. 995519
3. Sebastian A, Hernández RE, Portale AA, Colman J, Tatsuno J, Morris RC Jr. Dietary potassium influences kidney maintenance of serum phosphorus concentration. Kidney Int. 1990 May; 37(5):1341-1349. 2345430
4. Mayne PD, Kovar IZ. Calcium and phosphorus metabolism in the premature infant. Ann Clin Biochem. 1991 Mar; 28(Pt 2):131-142.1859151

LOINC® Map

Order Code Order Code Name Order Loinc Result Code Result Code Name UofM Result LOINC
003251 Phosphorus, 24 hr Urine 013599 Phosphorus, Urine mg/dL 2778-9
003251 Phosphorus, 24 hr Urine 013250 Phosphorus, Urine 24hr mg/24 hr 2779-7

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