24-Hour Urine Test

What is a 24-hour urine test?

A 24-hour urine test is a way for your provider to check how well your kidneys are working. It tests the amount of protein or other substances in your pee (urine) that you collect over a 24-hour period. Providers may check the levels of albumin, creatinine and other substances in your pee to help diagnose or monitor conditions that affect your kidneys.

When do you need a 24-hour urine test?

Your provider might get a 24-hour urine test if you’ve done other kidney function tests — like urinalysis or blood tests — and they need more information about how your kidneys are working. The results can help your provider diagnose or evaluate:

• Alport syndrome.
• Bladder cancer.
• Kidney stones.
• Heart failure.
• High blood pressure.
• Multiple myeloma.
• Nephrotic syndrome. This can be caused by amyloidosis, diabetes-related nephropathy, lupus nephritis and other conditions.
• Preeclampsia.
• Rhabdomyolysis.
• Urinary tract infections (UTIs).

How does 24-hour urine collection work?

For a 24-hour urine test, you’ll need to collect your pee every time you go to the bathroom for 24 hours. Your provider will give you a container (or multiple containers) and instructions on how to do this correctly. After you’ve collected for 24 hours, you’ll drop the container off at a lab to be tested.

How do I prepare for a 24-hour urine test?

To prepare for the test:

• Select a day for collection where you can be home most or all of the day and will be able to comfortably collect your pee every time you have to go. If you leave the house, you may need to take the container with you to make sure you don’t miss any urine collection. You should have access to a fridge or a way to keep the container cold all day.
• If your provider asks you to, avoid exercising 24 hours before collection and on the day of your collection. Vigorous exercise can change some results.
• Follow your provider’s instructions about what you can eat or drink the day of collection and the day before.
• Tell your provider about any medications you take, including herbs, supplements and vitamins.

What should I avoid during a 24-hour urine test?

Ask your provider what you can eat or drink during and before the test. They may have you avoid:

• Coffee, tea and other caffeinated beverages.
• Nicotine.
• Alcohol.
• Certain fruits, vegetables and fruit juice.
• Vitamins, supplements or medications. Don’t stop taking any medications unless your provider tells you to.

How do I collect a 24-hour urine sample?

General directions for collecting a 24-hour urine sample include:

1. The first time you have to pee in the morning, go as you normally would, without collecting it. Write down the time as the start time.
2. Every time you pee after that, collect it in the container. Be very careful to get all of your pee into the container and not get any poop or toilet paper into it. Keep the container in the fridge when you’re not using it.
3. Drink water throughout the day. You can eat normally unless there are foods your provider tells you to avoid.
4. Try to collect for the last time as close as possible to 24 hours after you marked the start time. For instance, if you have your first pee — that you didn’t collect — at 8 a.m. on a Monday, try to collect for the last time at 8 a.m. on Tuesday.
5. Make sure the container is marked with your name, start time, end time and any other required information.
6. Drop the container off with the lab as soon as possible. Your provider can tell you where you need to take it.

Your provider may have additional instructions, including when to start collecting and how to use the collection container. Follow their instructions very carefully.

How much water should I drink for 24-hour urine collection?

You should try to drink about eight glasses of water on the day that you’re collecting your pee for the test. A glass of water is about 6 to 8 ounces.

Are there any risks or downsides to a 24-hour urine test?

There are no risks to you while you’re taking the test. There’s a chance that collecting the sample incorrectly or other factors could cause inaccurate results. These include:

• Collecting your pee for more or less than 24 hours, or missing collections during that time.
• Certain foods, medications or supplements.
• Strenuous exercise.
• Extreme stress.
• Dehydration.

What kind of results do you get after a 24-hour urine collection?

Your test results might give your total level of protein or a protein/creatinine ratio. The lab should also provide a reference range, which tells you the range of results considered normal or average.

What are normal results for a 24-hour urine test?

For most adults, a protein level less than 150 milligrams per day and a protein-to-creatinine ratio of less than 0.2 is considered normal. Numbers higher than that (proteinuria) could mean your kidneys aren’t working as they should.

When should I know the results?

It can take a few days to get the results of a 24-hour urine test. Some people will get their results the same day.

If the results are abnormal, what are the next steps?

If your results are abnormal or not what your provider expects, they’ll discuss next steps with you. They may need additional testing to get a diagnosis or determine treatment.

When should I call my doctor?

Contact your healthcare provider if you have any questions about how to collect the sample or what the results of the test mean.

A note from Cleveland Clinic

A 24-hour urine test is a simple, noninvasive way for your healthcare provider to get more information about how your kidneys are working. There are many reasons you might need to do one, including monitoring existing conditions and following up on other tests. If you’re concerned about what the results might be, it can be helpful to talk to your provider about what to expect. Knowing the results can help you and your provider make the best decisions about your health and any treatments you need.