Protein Electrophoresis, 24-Hour Urine

CPT: 84156; 84166
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Test Details


  • Electrophoresis, Protein, 24-Hour Urine
  • Globulins, 24-Hour Urine

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


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.


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.


Electrophoresis on agarose media

Reference Interval

Normal pattern. See table.

24-Hour Urine Protein Electrophoresis Interpretation

Pattern Description

Electrophoretic Zones

Total Protein







*Looks like serum protein electrophoretogram.

+ = mildly elevated.

++ = moderately elevated.

+++ = markedly elevated.

+/– = may or may not be present.






Selective glomerular proteinuria











Nonselective glomerular proteinuria*







Tubular proteinuria


Trace to +




Trace of light chain

Mixed glomerular and tubular proteinuria









Overflow proteinuria from acute phase response

Trace or present





Overflow proteinuria with monoclonal spike

(spike) or ++

(spike) or ++

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


Urine (24-hour)


20-mL aliquot

Minimum Volume

6-mL aliquot


12-mL plastic transport tube (LabCorp N° 23597) without preservative


Instruct patient to void at 8 AM and discard the specimen. Then collect all urine for the next 24 hours, including the 8 AM void the next morning. Label container with the patient's name, date and time the collection started and ended. Measure total volume. Mix well.

Storage Instructions

Refrigerate at 2°C to 8°C.

Causes for Rejection

Preservative added

Clinical Information

Special Instructions

Record total 24-hour urine volume on the test request form.


Order Code Order Code Name Order Loinc Result Code Result Code Name UofM Result LOINC
003368 Protein Electro, 24-Hour Urine 013664 Protein,Total,Urine mg/dL 2888-6
003368 Protein Electro, 24-Hour Urine 013219 Prot,24hr calculated mg/24 hr 2889-4
003368 Protein Electro, 24-Hour Urine 133686 Albumin, U % 13986-5
003368 Protein Electro, 24-Hour Urine 133694 Alpha-1-Globulin, U % 13984-0
003368 Protein Electro, 24-Hour Urine 133702 Alpha-2-Globulin, U % 13987-3
003368 Protein Electro, 24-Hour Urine 133710 Beta Globulin, U % 13988-1
003368 Protein Electro, 24-Hour Urine 133728 Gamma Globulin, U % 13989-9
003368 Protein Electro, 24-Hour Urine 133729 M-Spike, % % 42484-6
003368 Protein Electro, 24-Hour Urine 133734 M-Spike, mg/24 hr mg/24 hr 42482-0
003368 Protein Electro, 24-Hour Urine 133800 Please note: 77202-0
003368 Protein Electro, 24-Hour Urine 003724 PDF 11502-2

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