24-Hour Urine Protein Electrophoresis (UPEP)

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24-Hour Urine Protein Electrophoresis (UPEP) Test: Details & Precautions

The 24-hour urine protein electrophoresis (UPEP) test is used to analyze different types of proteins in the urine. It helps in diagnosing kidney disorders, multiple myeloma, and other protein-related conditions.


Test Details

Purpose:

  • Detects and measures abnormal proteins (e.g., Bence Jones proteins) in urine.
  • Helps diagnose multiple myeloma, amyloidosis, nephrotic syndrome, and chronic kidney diseases.
  • Differentiates between glomerular, tubular, and overflow proteinuria.

Proteins Analyzed:

  • Albumin (major protein, low in kidney disease).
  • Globulins (immune-related proteins).
  • Bence Jones Proteins (light chains, associated with multiple myeloma).

Normal Range:

  • Less than 150 mg/day of total protein.
  • Elevated protein levels (>150 mg/day) suggest kidney disease, multiple myeloma, or systemic disorders.

Precautions Before & During the Test

🔹 Before the Test:

  1. Dietary Considerations:

    • Avoid excessive protein-rich foods (red meat, dairy) before the test, unless instructed otherwise.
    • Maintain normal fluid intake (unless otherwise directed).
  2. Medication Considerations:

    • Some drugs affect protein levels (NSAIDs, diuretics, ACE inhibitors, antibiotics like penicillin).
    • Inform your doctor about any medications.
  3. Avoid Strenuous Exercise:

    • Heavy exercise can temporarily increase protein levels in urine.

🔹 During the Test:

  1. Use a Clean Collection Container:

    • Provided by the lab.
  2. Start with an Empty Bladder:

    • Day 1 (Morning): Discard the first urine sample.
    • Collect all urine for the next 24 hours.
    • Day 2 (Morning): Include the first urine sample.
  3. Proper Storage:

    • Refrigerate or keep on ice during collection to prevent sample degradation.
  4. Avoid Contamination:

    • Do not mix with toilet paper or stool.

🔹 After the Test:

  • Return the sample to the lab promptly.
  • Results are usually available in a few days.

Interpreting Results

📉 Low Protein Levels (Normal or Minimal Concern)

  • Typically indicates healthy kidney function.

📈 High Protein Levels (Proteinuria)

  • Possible Causes:

    • Kidney Disease (Nephrotic Syndrome, Glomerulonephritis)
    • Multiple Myeloma (Bence Jones Proteins Present)
    • Amyloidosis
    • Diabetes-related kidney damage
    • Chronic Infections (HIV, Hepatitis, Autoimmune Diseases)
  • Further Tests:

    • Serum Protein Electrophoresis (SPEP) (checks blood protein levels).
    • Immunofixation Electrophoresis (IFE) (identifies specific abnormal proteins).
    • Kidney Function Tests (Creatinine, BUN, GFR).

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