Test Catalog

Test Id : OPTU

Orthostatic Protein, Timed Collection, Urine

Useful For
Suggests clinical disorders or settings where the test may be helpful

Diagnosis of orthostatic proteinuria

 

As a second-order test for additional characterization of proteinuria of less than 3 grams/24 hours, particularly in children or adolescents

Profile Information
A profile is a group of laboratory tests that are ordered and performed together under a single Mayo Test ID. Profile information lists the test performed, inclusive of the test fee, when a profile is ordered and includes reporting names and individual availability.

Test Id Reporting Name Available Separately Always Performed
DOPTU Daytime Orthostatic Protein, U No Yes
NOPTU Nighttime Orthostatic Protein, U No Yes

Special Instructions
Library of PDFs including pertinent information and forms related to the test

Method Name
A short description of the method used to perform the test

Turbidimetry

NY State Available
Indicates the status of NY State approval and if the test is orderable for NY State clients.

Yes

Reporting Name
Lists a shorter or abbreviated version of the Published Name for a test

Orthostatic Protein, U

Aliases
Lists additional common names for a test, as an aid in searching

Split Protein Excretion

Postural Proteinuria Assessment

Specimen Type
Describes the specimen type validated for testing

Urine

Ordering Guidance

This collection process requires 2 separate urine collections within a 24-hour period.

 

Collect specimen per instructions in Orthostatic Protein Measurement 24-Hour Urine: Collection Site Instructions (T546) in Special Instructions.

Necessary Information

This collection process requires 2 separate urine collections within a 24-hour period.

-Submit start and end times for collection and 16-hour volume (required).

-Submit start and end times for collection and 8-hour volume (required).

ORDER QUESTIONS AND ANSWERS

Question ID Description Answers
DUR4 Daytime collection duration
DUR7 Nighttime collection duration
DVOL Day volume
VL Night volume

Specimen Required
Defines the optimal specimen required to perform the test and the preferred volume to complete testing

Specimens should be collected before fluorescein is given or not collected until at least 24 hour later.

 

Supplies: 2 Sarstedt 5 mL Aliquot Tube (T914)

Daytime Collection

Container/Tube: Plastic, 5-mL tube

Specimen Volume: 4 mL

Collection Instructions:

1. Collect a 16-hour (daytime) urine specimen.

2. No preservative.

3. Invert well before taking 4-mL aliquot.

4. Do not over fill aliquot tube 4 mL at most.

5. Collect specimen per instructions in Orthostatic Protein Measurement 24-Hour Urine: Collection Site Instructions (T546) in Special Instructions.

 

Nighttime (Supine) Collection

Container/Tube: Plastic, 5-mL tube

Specimen Volume: 4 mL

Collection Instructions:

1. Collect an 8-hour (nighttime) urine specimen.

2. No preservative.

3. Invert well before taking 4-mL aliquot at most.

Special Instructions
Library of PDFs including pertinent information and forms related to the test

Forms

1. Orthostatic Protein Measurement 24-Hour Urine: Patient Collection Instructions in Special Instructions

2. If not ordering electronically, complete, print, and send a Renal Diagnostics Test Request (T830) with the specimen.

Specimen Minimum Volume
Defines the amount of sample necessary to provide a clinically relevant result as determined by the Testing Laboratory

1 mL from 16-hour (daytime) urine collection/1 mL from 8-hour (nighttime) urine collection

Reject Due To
Identifies specimen types and conditions that may cause the specimen to be rejected

All specimens will be evaluated at Mayo Clinic Laboratories for test suitability.

Specimen Stability Information
Provides a description of the temperatures required to transport a specimen to the performing laboratory, alternate acceptable temperatures are also included

Specimen Type Temperature Time Special Container
Urine Refrigerated (preferred) 14 days
Frozen 30 days
Ambient 24 hours

Useful For
Suggests clinical disorders or settings where the test may be helpful

Diagnosis of orthostatic proteinuria

 

As a second-order test for additional characterization of proteinuria of less than 3 grams/24 hours, particularly in children or adolescents

Clinical Information
Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test

Orthostatic proteinuria refers to the development of increased proteinuria that develops only when the person is upright and resolves when recumbent or supine. This condition is usually seen in children, adolescents, or young adults, and accounts for the majority of cases of proteinuria in childhood.

 

Orthostatic proteinuria usually does not indicate significant underlying renal pathology, and is usually not associated with other urine abnormalities such as hypoalbuminemia, hematuria, red blood cell casts, fatty casts, etc. Orthostatic proteinuria typically resolves over time.

 

This test characterizes this condition by obtaining 2 urine collections within a 24-hour time frame, one collection obtained while the person is recumbent or supine, the other when upright.

Reference Values
Describes reference intervals and additional information for interpretation of test results. May include intervals based on age and sex when appropriate. Intervals are Mayo-derived, unless otherwise designated. If an interpretive report is provided, the reference value field will state this.

Nighttime (supine) collection: <68 mg/8 hours

Reference values have not been established for patients <18 years of age.

 

Daytime collection: <197 mg/16 hours

Reference values have not been established for patients <18 years of age

Interpretation
Provides information to assist in interpretation of the test results

A supine 8-hour urine protein excretion of less than 68 mg/8 hours together with either 1) an elevated upright (16-hour) excretion of greater than 197 mg/16 hours, or 2) a 24-hour urine protein excretion of greater than 228 mg/24 hours is considered consistent with orthostatic proteinuria.

Cautions
Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances

It is not unusual for urine protein excretion derived from supine collections to be somewhat lower than protein excretion derived from upright collections. However, orthostatic or postural proteinuria is characterized by a supine excretion rate of less than 50 mg/8 hours.

 

False-proteinuria may be due to contamination of urine with menstrual blood, prostatic secretions, or semen.

 

The urinary protein concentration may rise to 300 mg/24 hours in healthy individuals after vigorous exercise.

 

Normal newborn infants may have higher excretion of protein in urine during the first 3 days of life.

 

The presence of hemoglobin elevates protein concentration.

 

Protein electrophoresis and immunofixation may be required to characterize and interpret the proteinuria.

Clinical Reference
Recommendations for in-depth reading of a clinical nature

1. Rinehart BK, Terrone DA, Larmon JE, et al: A 12-hour urine collection accurately assesses proteinuria in hospitalized hypertensive gravida. J Perinatol. 1999;19:556-558

2. Adelberg AM, Miller J, Doerzbacher M, Lambers DS: Correlation of quantitative protein measurements in 8-, 12-, and 24-hour urine samples for diagnosis of preeclampsia. Am J Obstet Gynecol. 2001 Oct;185(4):804-807

3. Rytand DA, Spreiter S: Prognosis in postural (orthostatic) proteinuria: forty to fifty-year follow-up of six patients after diagnosis by Thomas Addis. N Engl J Med. 1981;305(11):618-621

4. Robinson RR: Isolated proteinuria in asymptomatic patients. Kidney Int. 1980;18:395-406

5. Dube J, Girouard J, Leclerc P et al: Problems with the estimation of urine protein by automated assays. Clin Biochem. 2005:38(5) 479-485

6. Koumantakis G, Wyndham, L: Fluorescein interference with urinary creatinine and protein measurements. Clin Chem. 1991;37(10):1799

7. Lamb EJ, Jones GRD: Kidney function tests. In: Rifai N, Horvath AR, Wittwer CT, eds. Tietz Textbook of Clinical Chemistry and Molecular Diagnostics. 6th ed. Elsevier; 2018:479-517

Special Instructions
Library of PDFs including pertinent information and forms related to the test

Method Description
Describes how the test is performed and provides a method-specific reference

The sample is preincubated in an alkaline solution containing EDTA, which denatures the protein and eliminates interference from magnesium ions. Benzethonium chloride is then added, producing turbidity.(Package insert: Total Protein Urine/CSF. Roche Diagnostics; V13.0 11/2018)

PDF Report
Indicates whether the report includes an additional document with charts, images or other enriched information

No

Day(s) Performed
Outlines the days the test is performed. This field reflects the day that the sample must be in the testing laboratory to begin the testing process and includes any specimen preparation and processing time before the test is performed. Some tests are listed as continuously performed, which means that assays are performed multiple times during the day.

Monday through Sunday

Report Available
The interval of time (receipt of sample at Mayo Clinic Laboratories to results available) taking into account standard setup days and weekends. The first day is the time that it typically takes for a result to be available. The last day is the time it might take, accounting for any necessary repeated testing.

Same day/1 to 4 days

Specimen Retention Time
Outlines the length of time after testing that a specimen is kept in the laboratory before it is discarded

7 days

Performing Laboratory Location
Indicates the location of the laboratory that performs the test

Rochester

Fees
Several factors determine the fee charged to perform a test. Contact your U.S. or International Regional Manager for information about establishing a fee schedule or to learn more about resources to optimize test selection.

  • Authorized users can sign in to Test Prices for detailed fee information.
  • Clients without access to Test Prices can contact Customer Service 24 hours a day, seven days a week.
  • Prospective clients should contact their Regional Manager. For assistance, contact Customer Service.

Test Classification
Provides information regarding the medical device classification for laboratory test kits and reagents. Tests may be classified as cleared or approved by the US Food and Drug Administration (FDA) and used per manufacturer instructions, or as products that do not undergo full FDA review and approval, and are then labeled as an Analyte Specific Reagent (ASR) product.

This test has been cleared, approved, or is exempt by the US Food and Drug Administration and is used per manufacturer's instructions. Performance characteristics were verified by Mayo Clinic in a manner consistent with CLIA requirements.

CPT Code Information
Provides guidance in determining the appropriate Current Procedural Terminology (CPT) code(s) information for each test or profile. The listed CPT codes reflect Mayo Clinic Laboratories interpretation of CPT coding requirements. It is the responsibility of each laboratory to determine correct CPT codes to use for billing.

CPT codes are provided by the performing laboratory.

84156 x 2

LOINC® Information
Provides guidance in determining the Logical Observation Identifiers Names and Codes (LOINC) values for the order and results codes of this test. LOINC values are provided by the performing laboratory.

Test Id Test Order Name Order LOINC Value
OPTU Orthostatic Protein, U 1755-8
Result Id Test Result Name Result LOINC Value
Applies only to results expressed in units of measure originally reported by the performing laboratory. These values do not apply to results that are converted to other units of measure.
DPTU Total Protein, 16 HR, U 49002-9
DUR4 Daytime collection duration 13362-9
DVOL Day volume 19153-6
DPRO Total Protein Conc, 16 HR, U 35663-4
NPTU Total Protein, 8 HR, U 50209-6
DUR7 Nighttime collection duration 13362-9
VL Night volume 19153-6
NPRO Total Protein Conc, 8 HR, U 35663-4

Test Setup Resources

Setup Files
Test setup information contains test file definition details to support order and result interfacing between Mayo Clinic Laboratories and your Laboratory Information System.

Excel | Pdf

Sample Reports
Normal and Abnormal sample reports are provided as references for report appearance.

Normal Reports | Abnormal Reports

SI Sample Reports
International System (SI) of Unit reports are provided for a limited number of tests. These reports are intended for international account use and are only available through MayoLINK accounts that have been defined to receive them.

SI Normal Reports | SI Abnormal Reports