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What to Know About 24-Hour Urine Protein Tests

Medically Reviewed by Dan Brennan, MD on May 20, 2021

Some people are more likely to have protein in their urine. If your doctor does a routine dipstick protein urine test, you might need to do a 24-hour urine protein test. 

What Is a 24-Hour Urine Protein Test?

A 24-hour urine protein test measures the amount of albumin in your urine over 24 hours.

Your kidneys filter protein from your body and then absorb it. When it's sent back into your blood, waste products are removed from your body as urine. Urine is made of water and other chemicals, including:

  • Potassium
  • Sodium
  • Urea
  • Creatinine

Some amounts of these chemicals are normal. If your kidneys aren’t working properly, you might have too much protein in your urine. Protein is also called albumin. Too much albumin in your urine is called proteinuria. It is also called microalbuminuria albuminuria.‌

Some conditions can cause high amounts of protein in your urine. These include:

  • Diabetes
  • Kidney disease
  • Preeclampsia during pregnancy
  • High blood pressure

24-Hour Urine Protein Test During Pregnancy

Preeclampsia is a serious and potentially life-threatening condition that causes very high blood pressure. Your maternity doctor will take urine samples at your regular appointments to test for protein. This is a simple dipstick test that quickly measures the amount of protein in a sample.

If this test comes back high, you might need to do a 24-hour urine protein test to verify the results.

If you have other symptoms of preeclampsia, your doctor might also order a test. These symptoms can include:

  • Swollen face
  • Swollen hands and feet
  • Headache
  • Pain below your ribs
  • Vision problems
  • Trouble breathing
  • Nausea
  • Sudden weight gain

Other Reasons for 24-Hour Urine Protein Test

This test checks how well your kidneys are working. You might have this test if you have symptoms of chronic kidney disease or other kidney problems. These symptoms include:

  • Shortness of breath
  • Swollen hands and face
  • Swollen ankles and feet
  • Blood in your urine
  • Weight loss
  • Poor appetite
  • Tiredness
  • Peeing more than usual, especially at night

You can’t always tell that you have kidney disease or problems, so your doctor might order the 24-hour urine protein test regularly. They might do this to monitor your health, especially if you have a high risk of having problems.

These risks can include:

  • Heart disease
  • Heart failure
  • Kidney stones
  • Lupus
  • Enlarged prostate
  • High blood pressure
  • Family history of chronic kidney disease
  • Family history of a genetic kidney disease
  • Blood in your urine for no known reason
  • Diabetes

How to Do a 24-Hour Urine Protein Test

A 24-hour urine test is safe and easy and you can do it on your own. If you are very unwell, it might be done in the hospital.

Generally, your doctor will send you home with several containers and a special pan to pee into that sits on the toilet seat.

To collect your samples:

  • Start with the first time you pee during the day, but don’t collect this sample. Instead, urinate as normal and note the time.
  • For each other time throughout the day, pee in the pan and transfer it to one of your containers. Label it with your name and the time and store it in a bag in the fridge. Collect all urine throughout the day.
  • Try to take your last sample at the same time you started 24 hours later.
  • Take your samples to the lab right away. Follow the instructions.

You may need to repeat the test over the next few days. You might need to stop exercising for a few days before your test.

What Happens After a 24-Hour Urine Protein Test?

There are no special care instructions after a 24-hour urine test. Depending on your symptoms and your health problems, your doctor might need you to do other tests. These might be:

  • A blood test to measure antinuclear antibody
  • A blood test to measure complement
  • Kidney ultrasound
  • Albumin-to-creatinine ratio urine test

24-Hour Urine Protein Test Results

Results can be different depending on your gender, age, and health history.‌

Normal protein levels in adults are less than 150 mg per day. If you have more than 150 mg over a 24 hour period, your doctor might do further testing.

Your test results don’t always mean you have a problem though. It’s possible to get false positives. These results are high but are not accurate. This can happen if you:

  • Have a urinary tract infection
  • Have blood in your urine
  • Have alkaline urine
  • Are dehydrated
  • Recently exercised
  • Have a fever
  • Have sudden, severe stress

Sometimes collecting too much urine or not enough urine and drinking too much can also affect the results.‌

Medications and other things can also interfere with your test results. Things that can interfere with your test results include:

  • Vitamin C supplements
  • Antibiotics
  • Parkinson’s medications
  • Warm urine samples‌

Your doctor will order this test for you based on your symptoms and your health conditions. If you notice swelling, bloody urine, or other symptoms, make sure to talk to your doctor.

WebMD Medical Reference

Sources

SOURCES:

American Kidney Fund: “Protein in urine.”

CDC: “High Blood Pressure During Pregnancy.”

Haider, M. Aslam, A. Proteinuria. StatPearls Publishing, 2021.

JOHNS HOPKINS MEDICINE: “24-Hour Urine Collection.”

NHS: “Chronic kidney disease – Diagnosis,” “Pre-eclampsia.”

University of Minnesota Health: “24-HOUR URINE PROTEIN.”

University of Rochester Medical Center: “24-Hour Urine Protein.”

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