Test Catalog

Test Id : ORTHP

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Orthostatic Proteinuria, Random, Urine

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Overview

Test Catalog

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

Diagnosis of orthostatic proteinuria

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
PRCON Protein, Total, Random, U No Yes
RATO2 Protein/Creatinine Ratio No Yes
CRETR Creatinine, Random, U No Yes

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

PRCON: Turbidimetry

CRETR: Enzymatic Colorimetric Assay

RATO2: Calculation

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 Proteinuria, Random, U

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

Protein to creatinine ratio

Protein/creatinine ratio

Total Protein

Specimen Type
Describes the specimen type validated for testing

Urine

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

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

Container/Tube: Plastic, 5-mL tube

Specimen Volume: 4 mL

Collection Instructions:

1. This is a nighttime (supine) collection.

2. Void immediately prior to lying down to sleep.

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

4. Upon awaking in the morning, the patient should immediately void into the specimen cup.

4. No preservative.

5. Invert well before taking 4-mL (maximum) aliquot.

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

1 mL

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

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 evaluates for this condition by demonstrating either significant proteinuria, even while supine, or normal protein excretion. Significant proteinuria, even while supine, suggests that the patient does not have orthostatic proteinuria while normal protein excretion supports the diagnosis. This test is typically done on three consecutive mornings to provide more robust support for the diagnosis.

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.

PROTEIN/CREATININE RATIO:

> or =18 years: <0.18 mg/mg creatinine

 

CREATININE:> or =18 years = 16-326 mg/dL

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

Interpretation
Provides information to assist in interpretation of the test results

First-morning urine protein-to-creatinine ratio below 0.20 mg/mg creatinine supports the diagnosis of orthostatic proteinuria, while a result above 0.20 mg/mg creatinine does not support this diagnosis.

 

Further investigation into other etiologies for proteinuria may be warranted.

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

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. Brunzel N: Chemical examination of urine. In: Fundamentals of Urine and Body Fluids. 4th ed. Saunders; 2018:92-94

2. Wilson DM, Anderson RL: Protein-osmolality ratio for the quantitative assessment of proteinuria from a random urinalysis sample. Am J Clin Pathol. 1993 Oct;100(4):419-424

3. Morgenstern BZ, Butani L, Wollan P, Wilson DM, Larson TS: Validity of protein-osmolality versus protein-creatinine ratios in the estimation of quantitative proteinuria from random samples of urine in children. Am J Kidney Dis. 2003 Apr;41(4):760-766

4. Rinehart BK, Terrone DA, Larmon JE, Perry KG Jr, Martin RW, Martin JN Jr: A 12-hour urine collection accurately assesses proteinuria in hospitalized hypertensive gravida. J Perinatol. 1999 Dec;19(8 Pt 1):556-558

5. 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

6. Robinson RR: Isolated proteinuria in asymptomatic patients. Kidney Int. 1980 Sep;18(3):395-406

7. Dube J, Girouard J, Leclerc P, Douville P: Problems with the estimation of urine protein by automated assays. Clin Biochem. 2005 May;(38):479-485

8. Koumantakis G, Wyndham L: Fluorescein interference with urinary creatinine and protein measurements. Clin Chem. 1991 Oct;37(10 Pt 1):1799

9. 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

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

Protein:

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)

 

Creatinine:

The enzymatic method is based on the determination of sarcosine from creatinine with the aid of creatininase, creatinase, and sarcosine oxidase. The liberated hydrogen peroxide is measured via a modified Trinder reaction using a colorimetric indicator. Optimization of the buffer system and the colorimetric indicator enables the creatinine concentration to be quantified both precisely and specifically.(Package insert: Creatinine plus v2. Roche Diagnostics; V15.0, 03/2019)

 

The final result uses a calculation to provide the total protein per creatinine ratio. This calculation is performed by the laboratory information system, SCC Soft.

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 day

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 account representative. 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.

CRETR- 82570

PRCON- 84156

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
ORTHP Orthostatic Proteinuria, Random, U 87434-7
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.
CRETR Creatinine, Random, U 2161-8
PRCON Protein, Total, Random, U 2888-6
RATO2 Protein/Creatinine Ratio 2890-2

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 | PHP Pdf | CMS 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