Protein Electrophoresis With Interpretation, 24-Hour Urine

CPT: 84156; 84166
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Test Details

Synonyms

  • Interpretation, Protein Electrophoresis, Urine

Test Includes

Evaluation of protein electrophoretic bands; protein electrophoresis, urine; quantitation of M-spike if present

Use

Work up 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.

Methodology

Electrophoresis on agarose media

Reference Interval

Normal pattern. See table.

24-Hour Urine Protein Electrophoresis Interpretation

Pattern Description

Electrophoretic Zones

Total Protein

(mg/d)

Albumin

α1

α2

β

γ

*Looks like serum protein electrophoretogram.

+ = mildly elevated.

++ = moderately elevated.

+++ = markedly elevated.

+/– = may or may not be present.

Normal

<150

+/–

+/–

+/–

Selective glomerular proteinuria

mild

<1500

++

+

+

severe

>1500

+++

++

++

Nonselective glomerular proteinuria*

>3000

+++

++

++

++

++

Tubular proteinuria

<1500

Trace to +

Trace

++

++

Trace of light chain

Mixed glomerular and tubular proteinuria

+++

+

++

+

+

Albuminuria

>150

++

Overflow proteinuria from acute phase response

Trace or present

++

++

Trace

Trace

Overflow proteinuria with monoclonal spike

(spike) or ++

(spike) or ++

Specimen Requirements

Specimen

Urine (24-hour)

Volume

20-mL aliquot

Minimum Volume

6-mL aliquot

Container

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

Collection

Mix well.

Storage Instructions

Refrigerate at 2°C to 8°C.

Causes for Rejection

Preservative added

Clinical Information

Special Instructions

State 24-hour volume on the request form.

LOINC® Map

Order Code Order Code Name Order Loinc Result Code Result Code Name UofM Result LOINC
261511 Prot Electro+Interp, 24-Hr Ur 013664 Protein,Total,Urine mg/dL 2888-6
261511 Prot Electro+Interp, 24-Hr Ur 013219 Prot,24hr calculated mg/24 hr 2889-4
261511 Prot Electro+Interp, 24-Hr Ur 133686 Albumin, U % 13986-5
261511 Prot Electro+Interp, 24-Hr Ur 133694 Alpha-1-Globulin, U % 13984-0
261511 Prot Electro+Interp, 24-Hr Ur 133702 Alpha-2-Globulin, U % 13987-3
261511 Prot Electro+Interp, 24-Hr Ur 133710 Beta Globulin, U % 13988-1
261511 Prot Electro+Interp, 24-Hr Ur 133728 Gamma Globulin, U % 13989-9
261511 Prot Electro+Interp, 24-Hr Ur 133729 M-Spike, % % 42484-6
261511 Prot Electro+Interp, 24-Hr Ur 133734 M-Spike, mg/24 hr mg/24 hr 42482-0
261511 Prot Electro+Interp, 24-Hr Ur 133800 Please note: 77202-0
261511 Prot Electro+Interp, 24-Hr Ur 003724 PDF 11502-2
261511 Prot Electro+Interp, 24-Hr Ur 120030 P E Interpretation, U 49301-5

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