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24-HOUR URINE COLLECTION PROTOCOLAll testing for 24 hour urine samples requires that the specimen be collected in the appropriate container. Depending on the test to be performed, the collection jug should have either no additive or be acid washed (trace element jugs). Note: If two 24 hour urine tests requiring differing additives are collected simultaneously, then a “split jug” kit must be used.Sample CollectionTo begin the collection, have the patient totally empty his/her bladder into the toilet. For a catheter bag collection, be sure to empty the bag before beginning the collection. Note the start time on the requisition. Hydrate the patient with at least 800 mL of water. Note that special orders may have been given by the attending physician of a patient with documented renal disease. These special orders may override recommendations made here with respect to water intake or withholding of medication. Withhold tea and coffee the day of the test. Some tests are susceptible to drug interference, thus depending on the test being collected, some medications should be halted prior to and during the 24 hour collection. Please refer to each individual test page for specific drug interactions. Prescription medications should not be halted without physician approval. During the following 24 hours, every drop of urine must be placed into the 24 hour urine collection container as soon as possible. For a catheter bag collection, empty the bag into the 24 hour urine collection container every 4 hours.5 minutes before the 24 hour collection period is complete, the bladder or catheter collection bag is emptied into the collection container. IMPORTANT! If an error in timing occurs, or if some urine is lost, be sure to note the timing information accurately on the requisition. The physician and the clinical pathologist can then determine whether useful information can still be obtained. Store the 24 hour urine container in the refrigerator or an ice slush bath with the ice level at least as high as the urine level at all times. Outpatients can store the container in the home refrigerator or portable cooler.Deliver the specimen to LMC Lab or affiliated location immediately after collection. 24 Hour Urine Testing – Acceptable Specimen ContainersTest NameOrder CodeEPIC EAPAcceptable SpecimenKeep refrigerated during collectionCan NOT Use For TestingStabilityNOTES17 KETOSTEROIDS17KSTOLAB350PLAIN JUGTRACE ELEMENT JUGAmbient: 4 hoursRefrigerated: 2 weeksFrozen: 1 month5-HIAA (SEROTONIN)5HIAAULAB2084PLAIN JUGTRACE ELEMENT JUGAmbient: UnacceptableRefrigerated: 1 weekFrozen: 2 monthsGive patient diet instructions.ALDOSTERONEALDO24LAB354PLAIN JUGTRACE ELEMENT JUGAmbient: 4 hoursRefrigerated: 5 daysFrozen: 1 monthANTIMONYANTIMLAB1022TRACE ELEMENT JUGACID or PLAIN JUGAmbient: 5 daysRefrigerated: 30 daysFrozen: 30 daysGive patient medication instructions.ARSENICARSENULAB363PLAIN JUGACID or TRACE ELEMENT JUGAmbient: 1 weekRefrigerated: 2 weeksFrozen: 1 yearPatient should avoid seafood consumption for 3 days prior to lab draw.CALCIUMCAURLAB814PLAIN JUGACID or TRACE ELEMENT JUGAmbient: 48 hoursRefrigerated: 4 daysFrozen: 3 weeksTest NameOrder CodeEPIC EAPAcceptable SpecimenKeep refrigerated during collectionCan NOT Use For TestingStabilityNOTESCATECHOLAMINESCATEFULAB373PLAIN JUGTRACE ELEMENT JUGAmbient: UnacceptableRefrigerated: 1 weekFrozen: 6 monthsGive patient medication instructions.CHLORIDECLULAB374PLAIN JUGACID or TRACE ELEMENT JUGAmbient: 24 hoursRefrigerated: 1 weekFrozen: 6 monthsCHROMIUMCR24LAB2050TRACE ELEMENT JUGACID or PLAIN JUGAmbient: 1 weekRefrigerated: 2 weeksFrozen: 1 yearGive patient diet instructions.CITRIC ACIDCITRICLAB3059PLAIN JUGTRACE ELEMENT JUGAmbient: 8 hoursRefrigerated: 1 weekFrozen: IndefinitelyCOPPERCU24LAB380TRACE ELEMENT JUGACID or PLAIN JUGAmbient: 1 weekRefrigerated: 2 weeksFrozen: 1 yearGive patient diet instructions.CREATININECRE24LAB712PLAIN JUGACID or TRACE ELEMENT JUGRefrigerated: 5 daysTest NameOrder CodeEPIC EAPAcceptable SpecimenKeep refrigerated during collectionCan NOT Use For TestingStabilityNOTESCREATININE CLEARANCECREACLLAB1765PLAIN JUGACID or TRACE ELEMENT JUGRefrigerated: 5 daysAlso collect SST or Lithium Heparin Plasma Tube. Please include patient height & weight.DELTA AMINOLEVULINIC ACIDDELTABLAB2031PLAIN JUGACID or TRACE ELEMENT JUGAmbient: UnacceptableRefrigerated: 4 daysFrozen: 1 monthPatient should avoid alcohol consumption for 24 hours prior to lab draw.HEAVY METALS (Arsenic, Lead, Mercury and Cadmium)HMPURLAB398TRACE ELEMENT JUGACID or PLAIN JUGAmbient: 48 hoursRefrigerated: 5 daysFrozen: 14 daysPatient should avoid seafood consumption for 3 days prior to lab draw.IMMUNOFIXATION ELECTROPHORESISIFXU24LAB2226PLAIN JUGACID or TRACE ELEMENT JUGRefrigerated: 7 daysMAGNESIUMMAGULAB405PLAIN JUGTRACE ELEMENT JUGAmbient: 1 weekRefrigerated: 1 weekFrozen: 1 yearTest NameOrder CodeEPIC EAPAcceptable SpecimenKeep refrigerated during collectionCan NOT Use For TestingStabilityNOTESMERCURYMISC1LAB1978TRACE ELEMENT JUGACID or PLAIN JUGAmbient: 1 weekRefrigerated: 2 weeksFrozen: 1 yearPatient should avoid seafood consumption for 3 days prior to lab draw.METANEPHRINES (Normetanephrine, Metanephrine, and Total metanephrine)METAFULAB409PLAIN JUGTRACE ELEMENT JUGAmbient: UnacceptableRefrigerated: 2 weeksFrozen: 1 monthGive patient medication instructions.OXALIC ACIDOXAL24LAB421ACID JUGTRACE ELEMENT JUGAmbient: 6 daysRefrigerated: 7 daysFrozen: 4 monthsGive patient diet instructions.PHOSPHORUSPHOSUBLAB2117PLAIN JUGTRACE ELEMENT JUGAmbient: 8 hoursRefrigerated: 48 hoursFrozen: 6 monthsPORPHOBILINOGENPORBIBLAB1071PLAIN JUGACID or TRACE ELEMENT JUGAmbient: UnacceptableRefrigerated: 4 daysFrozen: 1 monthMUST PROTECT FROM LIGHTPORPHYRINSPOR24LAB2083PLAIN JUGACID or TRACE ELEMENT JUGAmbient: UnacceptableRefrigerated: 7 daysFrozen: 30 daysMUST PROTECT FROM LIGHTTest NameOrder CodeEPIC EAPAcceptable SpecimenKeep refrigerated during collectionCan NOT Use For TestingStabilityNOTESPOTASSIUMKU24LAB436PLAIN JUGACID or TRACE ELEMENT JUGRefrigerated: 2 daysPROTEIN ELECTROPHORESISPEU24LAB1904PLAIN JUGACID or TRACE ELEMENT JUGRefrigerated: 2 daysPROTEIN, TOTALTPU24LAB441PLAIN JUGACID or TRACE ELEMENT JUGRefrigerated: 3 daysSODIUMNAU24LAB446PLAIN JUGACID or TRACE ELEMENT JUGRefrigerated: 7 daysTHALLIUMMISC1LAB1978PLAIN JUGACID or TRACE ELEMENT JUGAmbient: 1 weekRefrigerated: 2 weeksFrozen: 1 yearUREA CLEARANCE, 12HRUREA12LAB1910PLAIN JUGACID or TRACE ELEMENT JUGRefrigerated: 7 daysAlso collect SST or Lithium Heparin Plasma Tube.UREA CLEARANCE, 24HRUREA24LAB1911PLAIN JUGACID or TRACE ELEMENT JUGRefrigerated: 7 daysAlso collect SST or Lithium Heparin Plasma Tube.Test NameOrder CodeEPIC EAPAcceptable SpecimenKeep refrigerated during collectionCan NOT Use For TestingStabilityNOTESUREA NITROGEN, 12 HRUUNLAB1908PLAIN JUGACID or TRACE ELEMENT JUGRefrigerated: 7 daysAlso collect SST or Lithium Heparin Plasma Tube.UREA NITROGEN, 24HRUUN24LAB1909PLAIN JUGACID or TRACE ELEMENT JUGRefrigerated: 7 daysAlso collect SST or Lithium Heparin Plasma Tube.URIC ACIDURIC24LAB841PLAIN JUGACID or TRACE ELEMENT JUGAmbient: 13 daysRefrigerated: 13 daysFrozen: 25 monthVANILLYLMANDELIC ACIDVMALAB452PLAIN JUGACID or TRACE ELEMENT JUGAmbient: UnacceptableRefrigerated: 1 weekFrozen: 2 weeksGive patient diet instructions.ZINCZINCULAB3089TRACE ELEMENT JUGACID or PLAIN JUGAmbient: 1 weekRefrigerated: 2 weeksFrozen: 1 yearGive patient diet instructions. ................
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