what is a 24 hour urine test

[willsmom]

What is i and how does one get sent for it? I am assuming it´s to check protein levels...
what is the significance of high protien levels post partum??
If after the test you still have protein in your uirne what should they do about it?
sorry lots of questions but this is stuff i have never heard about..and i don´t think my doc would ever think of testing me for..
jane

[anathor21]

What: It's a test of how much protein is excreeted in your urine during a 24 hour period

How: You collect all your urine for 24 hours in one or more jugs (talk to your lab or nurse for specifics on how they want this done - generally you collect in a plastic container that fits in the toilet that we called a "hat" that then can be poured into the actual collection jugs). You need to keep the jugs cold (or on ice) during the collection for best results. After collection you then turn in the whole thing (all jugs) to the lab and they do the rest of their magic, whatever exactly the do to measure the protein and other things asked of them (if necessary) by the doctor.

Significance: The amount of protein that is "spilled" by your kidneys in a 24hour period is one of the two critical diagnostic criteria for preeclampsia. If the amount is over 300mg AND your BP is over 140/90 (twice over a period of time) then you have met the criteria for a diagnosis of PE). Generally speaking, the greater the amount you are spilling the bigger the problem you may have. Note, however, that there are other things that can cause protein in your urine (none of them particularly good - kidney damage, infections etc...)

What will they do about it? : Well this depends on how much is found, as well as the results of other tests and lab work that is generally done around the same time. Reactions could be anything from as relatively mild as just keeping an eye on things (repeating the collection every few days/weeks) to as severe as immediate hospitalization - again, this really depends on results from other tests and diagnostic criteria, all alone without ANY other things going on a high 24hr protein number may just result in a referral to a kidney specialist for followup (then again, I assume you are at least pregnant to be posting the question here).

I hope this helps...

[melissam]

Well, he pretty much answered the questions.

I am in the middle of doing one right now. They are so much fun (NOT!!!)

Another thing that will happen when you take the lovely jug in, is that they will take a blood sample for the Creatinine (sp?) clearance. I believe the test isn't any good if they don't also take a blood sample. Just wanted to throw that one in there.

My docs did this right at the beginning of my pregnancy to see what the levels were. They are doing another one right now (Just shy of 29 weeks) even though things are looking really good in the bp department. I know that some doctors will do it after you have delivered just to make certain that the levels go back to normal and such.

[willsmom]

Thanks for the info.. it was very informative. I´m not pregnant but i had pe with my son 8 months ago. when he was 5 days old i developed severe post partum eclampsia and had to be admitted to hospital again while they stabilised it.. I´ve been doing alot of research on pe since as we are desperate to start trying for #2. Since i came home from hospital no medical professional has ever checked my blood pressure or urine. I do a daily bp monitoring myself because i am terrified of getting the hbp i had post partum again and seeing it in the low/normal range puts me at ease.I guess a lot of this may be because i live in denmark rather than the us and they have their own way of doing things here... I am struggling to find a perinatologist or as high risk ob to see me here in dk. At the moment it looks like our best chance to get some answers will be to travel to see a private specialist in london.. and that will be expensive... Is it recommended to have one of these tests post partum to check that there is nolonger protein in my urine before ttc...?thanks everyone for your input

[julie f]

Here is a link to an Expert response post that touches on postpartum proteinuria. http://www.preeclampsia.org/forum/viewtopic.php?t=116

I had different opinions on the issue. My regular OB gave me a 24 hour urine postpartum and the numbers were around 120mg. She said that it would be fine, to go ahead and start TTC again. My peri looked at the numbers and wanted to have them lowered first. So, he put me on an ACE Inhibitor, Lisinopril, to try and resolve the issue. He felt that going into a pregnancy, spilling as little protein as possible, would put me in a better position. After about two months on the medication my levels dropped into the 60mg range and we started TTC again.

Also, here is the link to the International Society for the Study of Hypertension in Pregnancy home page: http://www.ncl.ac.uk/isshp/index.htm I'm not sure but maybe you would be able to locate a doctor closer to home. You could also try contacting one of the doctors to see if they have any recommendations on a peri in your area.

I wish you the best!

[mamas]

I didn't get to do the 24 hour level at home. That must have been nice. I didn;t even know that was an option. MY dr walked in and said "well young lady, looks like you just earne yourself a trip to the hospital." I was admitted that day. got my results the next day (5600 mg) and delivered at 36 weeks the day after that! Sounds like fun I know. It's still a little blurry. I can remember thinking "I don't have a baby book yet." It's silly the things you think of in a crisis situation. Good luck with having another. I'm interested in another as well (three) but I don't think it is in the books. I just requested my records so I can exactly what was going on, things are a little blurry. At my post partum check up, the dr said I could try again but before the age of 30. After talking on this forum, I think I nee a second opinion just to make sure. Have you talked to a specialist at all? What were their recs if you don't mind me asking?

[willsmom]

the response we finally got was that it was ok to start ttc ... but i should try to ensure my weight at the start was within the bmi recommended weight.. ie bmi less than 25... so i´m on a diet. I also managed to track down some of my blood results from when i had our son.. and it´s seems that they were heading in the right direction at that time... coupled with normal bp he seemed content. I asked about the 24hr urine and was told it wasn´t necessary... Also been reassured that he will wathc me like a hawk next pregnancy and i should expect to have a consult every 4 weeks until 6months and then every 2 weeks until week 36 then every week from there on.. This i think kinda is reassuring as i feel that they missed alot of changes last time because the appointments were so far apart.. until it was almost too late..
Jane