How should I prepare for Urine Collection?

24 Hour Urine Collection


The accurately timed urine collection you are about to perform is a part of your care. Important health decisions depend on it. The test is valid only if the collection includes all the urine you pass in a 24 hour period . The test will be Inaccurate and may have to be repeated if, For any reason, some of the urine you pass during the 24-hour period is not put into the collection container. Your physician may have requested several urine tests. If the tests require different preservatives, you will need to collect urine in separate 24-hour periods. You will be given container(S) for each 24-hour urine collection if needed.

Preparing the container

Remove the cap from the container. Collect the urine in different sterile container and then pour it into the supplied container. Do not pass the urine directly into the supplied container as it may contain preservatives.

Recording start and stop times

For your information and for laboratory documentation, record your start and stop times on the label pasted on the collection container. Stop time is 24 hours after the start time (for example, start at 7: 00am. a day and finish at 7:00am the next day)
Start : day am /p.m./Stop: day a.m /p.m
Urinate at the start time, but do not save the urine. (This urine was formed before your collection period began and should not be part of your collection.)
  • Begin the urine collection in the morning after you wake up, after you have emptied your bladder for the first time.
  • Urinate (empty the bladder) for the first time and flush it down the toilet. Note the exact time (eg , 6:15 AM). You will begin the urine collection at this time.
  • Collect every drop of urine during the day and night in the supplied container.
  • Finish by collecting the first urine passed the next morning adding it to the collection bottle.
This should be within ten minutes before or after the time of the first morning void on the first day (which was flushed). In this example ,you would try to void between 6:05 and 6:25 on the second day.
If you need to urinate one hour before the final collection time, drink a full glass of water so that you can void again at the appropriate time. If you have to urinate 20 minutes before, try to hold the urine until the proper time. Please note the exact time of the final collection.


The bottle(s) should be kept cool or refrigerated. On the day you finish your 24-hour urine collection, take the collection container(S) and return specimen to the laboratory , for measuring and processing. 

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Microalbuminuria Test

What is being tested?

Albumin is a protein made by the liver. The urine albumin test detects and measures the amount of albumin in the urine. A small amount of albumin in the urine is an early indicator of kidney damage. In the past, these small amounts of albumin were referred to as "microalbumin" and some health practitioners may continue to use the term, although it is being phased out.
A urine albumin test is used to screen people with chronic conditions such as diabetes and high blood pressure who are at high risk for kidney damage. It can detect small amounts of albumin that escape from the kidneys into the urine several years before significant kidney damage becomes apparent.
Drawing of a kidney and the urinary tract
Plasma, the liquid portion of blood, contains many different proteins. One of the many functions of the kidneys is to conserve plasma proteins so that they are not excreted along with waste products when urine is produced. There are two mechanisms that normally prevent protein from passing into urine: (1) the glomeruli provide a barrier that keeps most larger plasma proteins inside the blood vessels and (2) the smaller proteins that do get through are almost entirely reabsorbed by the tubules. (For additional details on kidneys and how they function, see the video on  How Kidneys Work on the Davita web site.)
Protein in the urine (proteinuria) most often occurs when either the glomeruli or tubules in the kidney are damaged. Inflammation and/or scarring of the glomeruli can allow increasing amounts of protein to leak into the urine. Damage to the tubules can prevent protein from being reabsorbed.
Albumin is a plasma protein that is present in high concentrations in the blood, and when the kidneys are functioning properly, virtually no albumin is present in the urine. If a person's kidneys become damaged or diseased, however, they begin to lose their ability to conserve albumin and other proteins. This is frequently seen in chronic diseases, such as diabetes and hypertension, with increasing amounts of protein in the urine reflecting increasing kidney failure.
Albumin is one of the first proteins to be detected in the urine with kidney damage. People who have consistently detectable small amounts of albumin in their urine (a condition called microalbuminuria) have an increased risk of developing progressive kidney failure and cardiovascular disease in the future.
Most of the time, both albumin and creatinine are measured in a random urine sample and an albumin/creatinine ratio (ACR) is calculated. This may be done to more accurately determine how much albumin is escaping from the kidneys into the urine. The concentration (or dilution) of urine varies throughout the day with more or less liquid being excreted in addition to the body's waste products. Thus, the concentration of albumin in the urine may also vary. Creatinine, a byproduct of muscle metabolism, is normally excreted into the urine at a constant rate and its level in the urine is an indication of the amount of liquid being excreted as urine. This property of creatinine allows its measurement to be used as a corrective factor in random urine samples. The American Diabetes Association has stated a preference for the ACR for screening for microalbuminuria.

How is the sample collected for testing?

A random sample of urine, a timed urine sample (such as 4 hours or overnight), or a complete 24-hour urine sample is collected in a clean container. The health care provider or laboratory will provide a container and instructions for properly collecting the sample that is needed.

Is any test preparation needed to ensure the quality of the sample?

No test preparation is needed.

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Estimated Glomerular Filtration Rate (eGFR)

What is the use of this test?
The eGFR is used to monitor kidney status and to detect early kidney damage and . A creatinine test is
performed and estimated glomerular filtration rate is calculated. Your physician may order for a creatinine test if you already have chronic kidney disease(CKD). This test is also recommended for those with hypertension nd dialysis as these diseases may lead to kidney damage.

When is eGFR ordered?
The eGFR can be performed when we go for a creatinine test. This test will give early warning signs of kidney disease. The doctor will order this test for any of the following symptoms:
  • Swelling or puffiness, particularly around the eyes or in the face, wrists, abdomen, thighs, or ankles
  • Urine that is foamy, bloody, or coffee-colored
  • A decrease in the amount of urine
  • Problems urinating, such as a burning feeling or abnormal discharge during urination, or a change in the frequency of urination, especially at night
  • Mid-back pain (flank), below the ribs, near where the kidneys are located
  • High blood pressure (hypertension)
As kidney disease worsens, symptoms may include:
  • Urinating more or less often
  • Feeling itchy
  • Tiredness, loss of concentration
  • Loss of appetite, nausea and/or vomiting
  • Swelling and/or numbness in hands and feet
  • Darkened skin
  • Muscle cramps

What does the test result mean? Looking for reference ranges?

The eGFR helps to detect kidney disease in its early stages more reliably than the creatinine test alone. Because the calculation works best for estimating reduced kidney function, the National Kidney Foundation (NKF) suggests only reporting actual results once values are < 60 mL/min (they state normal values as 90-120 mL/min). An eGFR below 60 mL/min suggests that some kidney damage has occurred.

The NKF recommends that everyone "know their GFR number." A person's eGFR should be intepreted in relation to the person's clinical history and presenting conditions, utilizing the following table:

Kidney damage stage description gfr Other Findings
1 Normal or minimal kidney damage with normal GFR 90+ Protein or albumin in urine are high, cells or casts seen in urine
2 Mild decrease in GFR 60-89 Protein or albumin in urine are high, cells or casts seen in urine
3 Moderate decrease in GFR 30-59
4 Severe decrease in GFR 15-29
5 Kidney failure <15

Is there anything else I should know?

Another method of evaluating kidney function and potentially estimating GFR involves the measurement of the blood level of cystatin C. There is increasing interest in the use of this test for these purposes and several studies have been performed comparing calculations of eGFR using creatinine, cystatin C, or both. According to the National Kidney Foundation, two meta-analyses concluded that cystatin c is superior to creatinine as a marker of kidney function. The NKF also states that a formula for calculating eGFR that includes both blood creatinine and cystatin C values may improve that estimate.

The creatinine clearance test also provides an estimate of kidney function and of the actual GFR. However, in addition to the serum creatinine, this test requires a timed urine collection (24 hours) for urine creatinine measurement in order to compare blood and urine creatinine concentrations and to calculate the clearance.

The actual amount of creatinine that a person produces and excretes is affected by their muscle mass and by the amount of protein in their diet. Men tend to have higher creatinine levels than women and children.

A person's GFR decreases with age and some illnesses and can increase during pregnancy.

A slightly different equation should be used to calculate the eGFR for those under the age of 18. The eGFR equations are not valid for those who are 75 year of age or older because muscle mass normally decreases with age.

An eGFR may not be as useful for those who differ from normal creatinine concentrations. This may include people who have significantly more muscle (such as a body builder) or less muscle (such as a muscle-wasting disease) than the norm, those who are extremely obese, malnourished, follow a strict vegetarian diet, ingest little protein, or who take creatine dietary supplements.

The eGFR may also be affected by a variety of drugs, such as gentamicin, cisplatin, and cefoxitin that increase creatinine levels, and by any condition that decreases blood flow to the kidneys.

The calculation for eGFR is intended to be used when kidney function and creatinine production are stable. If a creatinine level is measured when the kidney function is changing rapidly, such as with acute kidney failure, then it will not give a useful estimate of the filtration rate.

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