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Test ID: EPU Electrophoresis, Protein, 24 Hour, Urine

Reporting Name

Electrophoresis, Protein, 24 Hr, U

Useful For

Monitoring patients with monoclonal gammopathies

Clinical Information

Urine proteins can be grouped into 5 fractions by protein electrophoresis:







The urine total protein concentration, the electrophoretic pattern, and the presence of a monoclonal immunoglobulin light chain may be characteristic of monoclonal gammopathies such as multiple myeloma, primary systemic amyloidosis, and light chain deposition disease.


The following algorithms are available in Special Instructions:

-Laboratory Approach to the Diagnosis of Amyloidosis

-Laboratory Screening Tests for Suspected Multiple Myeloma


A characteristic monoclonal band (M-spike) is often found in the urine of patients with monoclonal gammopathies. The initial identification of an M-spike or an area of restricted migration should be followed by immunofixation to identify the immunoglobulin heavy chain and/or light chain.


Immunoglobulin heavy chain fragments as well as free light chains may be seen in the urine of patients with monoclonal gammopathies. The presence of a monoclonal light chain M-spike of greater than 1 g/24 hours is consistent with a diagnosis of multiple myeloma or macroglobulinemia.


The presence of a small amount of monoclonal light chain and proteinuria (total protein >3 g/24 hours) that is predominantly albumin is consistent with amyloidosis (AL) or light chain deposition disease (LCDD).


Because patients with AL and LCDD may have elevated urinary protein without an identifiable M-spike, urine protein electrophoresis is not considered an adequate screen for these disorders and immunofixation is also recommended.

Profile Information

Test ID Reporting Name Available Separately Always Performed
PTU Protein, Total, U Yes Yes
PEU Protein Electrophoresis, 24 Hr, U No Yes

Reflex Tests

Test ID Reporting Name Available Separately Always Performed
IFXU Immunofixation, 24 Hr, U No No

Testing Algorithm

Urine protein electrophoresis alone is not considered an adequate screening for monoclonal gammopathies.


If a discrete electrophoresis band is identified, the laboratory will evaluate the urine protein electrophoresis and, if necessary, perform immunofixation at an additional charge.


The following algorithms are available in Special Instructions:

-Laboratory Approach to the Diagnosis of Amyloidosis

-Laboratory Screening Tests for Suspected Multiple Myeloma

Analytic Time

2 days

Day(s) and Time(s) Performed

Protein, total: Monday through Sunday; Continuously

Electrophoresis, protein: Monday through Friday; 12 p.m.

Clinical Reference

1. Abraham RS, Barnidge DR: Protein analysis in the clinical immunology laboratory. In: Detrick BD, Hamilton RG, Schmitz JL eds. Manual of Molecular and Clinical Laboratory Immunology. 8th ed. 2016:chap 4

2. Sykes E, Posey Y: Immunochemical characterization of immunoglobulins in serum, urine, and cerebrospinal fluid. In: Detrick B, Hamilton RG, Schmitz JL, eds. Molecular and Clinical Laboratory Immunology. 8th ed. Wiley; 2016:chap 9

Method Name

PTU: Turbidimetry

PEU: Agarose Gel Electrophoresis

IFXU: Immunofixation

Specimen Type


Shipping Instructions

Refrigerate specimen during collection and send refrigerated.

Necessary Information

24-Hour volume is required.

Specimen Required


Urine Container, 60 mL (T313)

Aliquot Tube, 5 mL (T465)

Submission Container/Tube: Plastic, 60-mL urine bottle and plastic, 5-mL tube

Specimen Volume: 50 mL

Collection Instructions:

1. Collect urine for 24 hours.

2. Aliquot at least 25-mL specimen in plastic, 60-mL urine bottle and at least 1-mL of specimen in plastic, 5-mL tube.

3. Label specimens appropriately (60-mL bottle for protein electrophoresis and 5-mL tube for protein, total).

Additional Information: See Urine Preservatives-Collection and Transportation for 24-Hour Urine Specimens in Special Instructions for multiple collections.

Specimen Minimum Volume

25 mL

Specimen Stability Information

Specimen Type Temperature Time Special Container
Urine Refrigerated (preferred) 14 days
  Frozen  5 days
  Ambient  24 hours

Reference Values


<229 mg/24 hours


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

Reference value applies to 24-hour collection. 



The following fractions, if present, will be reported as mg/24 hours:






Test Classification

This test has been modified from the manufacturer's instructions. Its performance characteristics were determined by Mayo Clinic in a manner consistent with CLIA requirements. This test has not been cleared or approved by the U.S. Food and Drug Administration.

CPT Code Information



86335-Immunofixation (if appropriate)

LOINC Code Information

Test ID Test Order Name Order LOINC Value
EPU Electrophoresis, Protein, 24 Hr, U 81231-3


Result ID Test Result Name Result LOINC Value
607970 Albumin 6941-9
TP2 Total Protein 2889-4
TM23 Collection Duration 13362-9
607971 Alpha-1 globulin 6794-2
607972 Alpha-2 globulin 6795-9
VL21 Urine Volume 19153-6
CONC1 Concentration 57369-1
607973 Beta globulin 94714-3
607974 Gamma globulin 94715-0
2833 A/G Ratio 44294-7
21446 M spike 42482-0
22307 M spike 42482-0
21447 Impression 32210-7

Urine Preservative Collection Options

Note: The addition of preservative or application of temperature controls must occur within 4 hours of completion of the collection.







50% Acetic Acid


Boric Acid


Diazolidinyl Urea


6M Hydrochloric Acid


6M Nitric Acid


Sodium Carbonate







If not ordering electronically, complete, print, and send a Renal Diagnostics Test Request (T830) with the specimen.

Mayo Clinic Laboratories | Neurology Catalog Additional Information:

mml-Neuroimmunology, mml-Neuromuscular, mml-Autonomic, mml-Neuro-oncology, mml-Pediatric, mml-Pain, mml-Spinal-Cord