Beth Israel Deaconess Medical Center Laboratory Manual

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Guidelines for collecting urine for multiple tests
 
 

• Obtain a urine container from Laboratory Control (617-667-LABS). Either the patient can stop by our window on Finard 3 with the test requisition or the health care provider can call for it.
• On rising in the morning, the patient should void and discard this urine, noting the time.
• ALL urine passed after this time should be collected in the container provided. This includes urine that might be voided after the patient has gone to sleep. Only urine and not stool should go into the container.
• During the collection period, the patient should keep the container in the refrigerator. If this is not possible, it should be kept in a cool, dark location.
• The next morning (for a 24-hour collection), try to rise and void urine into the container at the same time as the day before. Otherwise, the collection should end at the time you have indicated to the patient.
• The patient should close the container tightly and bring the completed specimen and the requisition slip to the Laboratory on Finard 3 as soon as possible after collection. If there is a delay in transporting the specimen, it should be refrigerated.
• Note that some analytes require preservatives to be present during the collection. Therefore, it is important for the laboratory to know in advance which tests are of interest.

                     TIMED URINE COLLECTIONS:  Methods of sample collection

24 Hour Urine Test	Preservative	Protect from light?	Refrigerate?	Available on Random?
ALA	None	Yes	Yes	Yes
Albumin	None	No	No	Yes
Aluminum	Acid Washed	No	No	Yes
Aldosterone	Boric Acid	No	No	No
Amino Acids	None	No	Yes	Yes
Amylase	None	No	No	2 Hr
Calcium	HCl	No	No	Yes
Catecholamines	HCl	No	Yes	Yes
Chloride	None	No	No	Yes
Citric Acid	None	No	Yes	No
Copper	Acid Washed	No	Yes	Yes
Cortisol	Boric Acid	No	Yes	No
Creatinine	None or HCl or Boric Acid	No	No	Yes
Cystine	None	No	No	Yes
5 HIAA	HCl	No	No	No
17 OH Steroids	Boric Acid	No	Yes	No
17 OH Ketosteroids	Boric Acid	No	Yes	No
Heavy Metals	Acid Washed	No	Yes	No
Homovanillic Acid (HVA)	30 mL HCl	No	Yes	Yes
IFE	None	No	No	Yes
17 Ketosteroids	Boric Acid	No	Yes	Yes
Magnesium	10 mL HCl	No	Yes	Yes
Metanephrines	HCl	No	No	Yes
Microalbumin	None	No	No	Yes
Oxalate	HCl	No	No	No
Phosphorus	None	No	No	Yes
Porphyrins/PBG	Sodium Carbonate	Yes	Yes	Yes
Potassium	None	No	No	Yes
Protein	None	No	No	Yes
PEP	None	No	No	Yes
Sodium	None	No	No	Yes
Urea	None	No	No	Yes
Uric Acid	None	No	No	Yes
Urobilinogen	Sodium Carbonate	Yes	Yes	Yes
VMA	HCl	No	No	Yes
Zinc	Acid Washed	No	Yes	Yes

Preservative dose:
    HCl                              20 mL 6N per 24 hr collection unless otherwise specified
    Boric Acid                 10 g per 24 hr collection
    Sodium Carbonate  5 g per 24 hr collection
    Acid Washed            Specially prepared metal-free container

If several analytes are requested on a timed (e.g. 24-hour) urine collection, note that the preservatives required to be present (see above) may preclude simultaneous performance of some tests. For instance, urine screening for both pheochromocytoma and porphyria may not be possible because catecholamines must be collected under conditions (6N HCl) that would destroy porphyrins (which must be kept at or above neutral pH). Unfortunately, we usually recommend two different urine collections.

A more frequent problem occurs during the evaluation of patients with renal calculi. This may require the simultaneous measurement of calcium, oxalate, and uric acid (all of which have different solubility properties). If separate consecutive 24-hour collections are inconvenient for your patient, it may be possible to collect one 24-hour specimen (without preservative). We can sequentially acidify or alkalinize the urine to allow for accurate analysis. Please notify the laboratory in advance if this is desired.

Revised/Reviewed 4/14/2008