Urine Total Protein, 24-Hour
The total protein that passed into your urine over 24 hours, where healthy kidneys let only a small amount through.
AI-verified against cited sources. Awaiting expert reviewAlso called 24h UPLOINC 2889-4
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What it is
Healthy kidneys keep most protein in your blood and let only small amounts into urine. This test adds up all the protein in the urine you collect over 24 hours and reports it in milligrams per day. A full-day total smooths out changes from hour to hour. It counts several kinds of protein, including albumin, small proteins from the kidney tubules and proteins made by other cells.
Why it matters
Extra protein in urine (proteinuria) can be an early sign that the kidney's filters are under strain. Clinicians use this total to see how much protein is leaking, to follow it over time, and to decide what to check next. Many harmless things raise it for a short time, such as hard exercise, fever or dehydration, so one result is rarely the whole story. The KDIGO kidney guideline groups the daily total into three levels: under 150 mg is normal to mildly increased, 150 to 500 mg is moderately increased, and over 500 mg is severely increased.
If it’s high
A higher total means more protein than usual is passing into your urine. Short-term causes are common and harmless, such as hard exercise, fever, dehydration or standing for long periods. Protein that keeps showing up can be a sign that the kidney filters or tubules are affected, and it is linked to conditions such as diabetes, high blood pressure and kidney inflammation. Your clinician will usually repeat the test and look at your blood pressure, kidney function and other results.
Common causes
- Hard exercise in the past day or so
- Fever or illness
- Dehydration
- Standing upright for long periods (orthostatic proteinuria, seen in some adolescents)
- A sample mixed with menstrual blood, semen or prostate fluid
- Urinary tract infection or inflammation
- Diabetes or high blood pressure affecting the kidneys
- Kidney inflammation or other kidney disease, including nephrotic syndrome
- Heart failure
- High blood pressure in pregnancy (preeclampsia)
- Multiple myeloma and related conditions that make extra proteins that pass into urine
What can help
- Ask your clinician whether to repeat the collection on a calm day, without exercise, fever or dehydration
- Ask whether a urine albumin-to-creatinine ratio or a first-morning sample would help
- Ask about checking blood pressure, blood sugar and kidney function
- Tell your clinician about every medicine and supplement you take
Usual ranges
What labs print as the reference range, by who was tested. Ranges differ a little between labs, so the range on your own report is the one your result is judged against.
For adults: 0–150 mg/24 h. Source: ARUP Laboratories, MedlinePlus Medical Encyclopedia (NIH National Library of Medicine), Kidney International Supplements, Quest Diagnostics, Mayo Clinic Laboratories.
- 18+ (this one applies)0–150 mg/24 h
Sources: ARUP Laboratories, MedlinePlus Medical Encyclopedia (NIH National Library of Medicine), Kidney International Supplements, Quest Diagnostics, Mayo Clinic Laboratories
KDIGO proteinuria categories (protein excretion rate)
- Normal to mildly increased (A1)below 150 mg/24 h
- Moderately increased (A2)150 to under 500 mg/24 h
- Severely increased (A3)500 to under 3,500 mg/24 h
- Severely increased, nephrotic range3,500 and above mg/24 h
What can affect your result
- Exercise: vigorous activity can raise protein for a day or so
- Fever, illness and dehydration
- Posture: some people leak protein only when upright
- Menstrual blood, semen or prostate fluid in the sample
- Pregnancy, when different limits are used
- Collection accuracy: missed urine lowers the total, and extra urine raises it
- The method: standard methods under-measure some proteins, such as light chains
- Incomplete or over-long collections give a falsely low or high total. Labs record the total volume and collection time, and many also measure urine creatinine to judge whether the collection was complete.
- Vigorous exercise can raise urine protein to about 300 mg/24 h in healthy people (Mayo).
- Fever, illness and dehydration can raise it for a short time.
- Menstrual blood, semen, prostate fluid or vaginal discharge in the sample can read as protein. Hemoglobin in the urine also raises the result.
- MedlinePlus lists contrast dye from a scan in the previous 3 days as something that can interfere.
- Some people leak protein only when upright (orthostatic proteinuria).
- Standard total protein methods under-measure some proteins, such as the light chains seen in multiple myeloma (ARUP). Use a test designed for those proteins if they are a concern.
A full 24-hour collection. Empty your bladder at a set time and flush that urine, then collect all urine after that, including the first urine at the same time the next day. The total reflects the day you collected. Changes from treatment or illness can take time to show, so clinicians follow the trend over repeat tests.
When to talk to a clinician
Contact your clinician soon if you notice foamy urine together with swelling around your eyes, legs or belly, fast weight gain, or blood in your urine. A total above 3,500 mg a day (3.5 g) is called nephrotic range, and clinicians usually look into it promptly. If you are pregnant, a severe headache, vision changes or sudden swelling of your face or hands needs same-day care.
Questions you could ask
- How will we follow this number over time?
- Could exercise, illness or the way I collected the sample explain this?
- Should we repeat the test, or check a urine albumin-to-creatinine ratio?
- Do my blood pressure, blood sugar and kidney function need a closer look?
Questions people ask
Why do I have to collect urine for a whole day?
Protein leaks vary through the day and with activity, so a full-day total smooths those swings out. A single-sample test such as a urine albumin-to-creatinine ratio is easier and is often the first choice. The 24-hour test is used when a more exact daily total is needed.
I exercised hard before my test. Does that matter?
It can. Hard exercise can raise urine protein for a day or so, and healthy people can reach about 300 mg a day. Fever and dehydration can also raise it. Tell your clinician, since a repeat collection on a calm day may be suggested.
Why does my lab say under 229 when other sources say under 150?
Labs use different methods and populations. Mayo prints under 229 mg/24 h, ARUP prints 40–150, Quest prints under 150, and the KDIGO kidney guideline calls under 150 normal to mildly increased. Use the range printed on your report and ask your clinician how to read it.
Show the science and sources
Units
- 1 mg/24 h = 1 mg/24 h
- 1 mg/24 h = 0.001 g/24 h
Open the Urine Protein 24h unit converter
Is a change real?
Urine Protein 24h naturally varies about 35.5% from test to test in the same healthy person. Between two results from the same lab, a rise of 192% or more, or a fall of 66% or more, is unlikely to be day-to-day noise or lab variation (95% reference change value). Source: Desirable Biological Variation Database specifications, 2014 update (Minchinela J, Ricos C, et al.; the 'Ricos database', a compilation of median published CVI/CVG).
For clinicians and researchers
Urinary protein is a mix of plasma proteins that passed the glomerulus and escaped proximal tubular reabsorption, plus proteins secreted by the tubules and urinary tract. Mayo (PTU) lists adults 18 years and older as under 229 mg/24 h, none established under 18; total protein above 500 mg/24 h should be evaluated by immunofixation for a monoclonal light chain; exercise can raise it to 300 mg/24 h; false positives come from menstrual blood, prostatic secretions or semen; hemoglobin raises the result; newborns excrete more in the first 3 days. ARUP lists 40–150 mg/d and notes that its total protein method characteristically underestimates urinary light chains. MedlinePlus lists 30–150 mg per 24 hours, and Quest prints under 150 mg/24 h. KDIGO 2012 (Table 7) defines protein excretion rate (PER) categories of under 150, 150–500 and over 500 mg/24 h (A1, A2, A3) and defines nephrotic-range proteinuria as PER above 3,500 mg/24 h; the equivalent protein-to-creatinine ratio cutoffs are under 150, 150–500 and over 500 mg/g, and the albumin-based categories are approximate equivalents that assume about 1 g of creatinine excretion per day. KDIGO 2024 notes that 24-hour collections have problems with completeness, storage and timing, that a spot albumin-to-creatinine ratio has similar diagnostic performance to 24-hour albumin excretion and is the common first choice, that orthostatic proteinuria is estimated to affect 2%–5% of adolescents, and that for children over 2 years under 150 mg/m2/day is usually considered normal. Check collection adequacy with total volume, collection time and urine creatinine. Pregnancy uses different thresholds.
LOINC 2889-4 (primary), 21482-5. Specimen: urine-24h.
Sources
- PTU - Protein, Total, 24 Hour, Urine, Mayo Clinic Laboratories
- Protein, Total, Urine (test 0020479), ARUP Laboratories
- Urine protein dipstick test (includes the 24-hour urine protein range), MedlinePlus Medical Encyclopedia (NIH National Library of Medicine)
- KDIGO 2012 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease, Chapter 1: Definition and classification of CKD, Kidney International Supplements (2013)
- KDIGO 2024 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease, Kidney International (2024)
- Protein, Total, 24-Hour Urine without Creatinine (test code 11320), Quest Diagnostics
AI-verified against cited sources. Awaiting expert review. Last reviewed 2026-10-03. How we build and check these pages.