Urine Protein Electrophoresis (UPEP), Random with Reflex To UIFE

Label Mnemonic: RSMPU
Epic code: LAB9835
Commercial Mailout Laboratory
6240-8 RCP
356-8593
Specimen(s):
Urine
Specimen Instructions:

Collect urine in a sterile cup.  Transfer 30–50 mL into 3 or more BD Vacutainer No Additive Yellow Top Tubes.

Collection Medium:
Urine
Minimum:

30 mL random urine; no preservatives are acceptable.

Testing Schedule:

Monday through Friday

Reference Range:

CREATININE:

> or =18 years old: 16-326 mg/dL

Reference values have not been established for patients younger than 18 years.

 

PROTEIN/CREATININE RATIO:

> or =18 years: <0.18 mg/mg creatinine

Reference values have not been established for patients younger than 18 years.

 

ELECTROPHORESIS, PROTEIN

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

  • Albumin
  • Alpha-1-globulin
  • Alpha-2-globulin
  • Beta-globulin
  • Gamma-globulin

No reference values apply to random urines.

 

M-PROTEIN ISOTYPE:

No monoclonal protein detected

 

Flag M-protein Isotype MS:

Negative

Comments:

The use of a random urine specimen is sufficient for identifying the presence or absence of monoclonal proteins, but a 24-hour specimen is preferred for quantitating and monitoring the abnormality.

 

The laboratory will evaluate the urine for M-proteins with the Mayo Clinic MASSFIX method, and if positive for M-protein, protein electrophoresis will be performed at an additional charge.

 

The presence of a monoclonal immunoglobulin light chain in the urine is seen in multiple myeloma, macroglobulinemia, primary systemic amyloidosis and light-chain deposition disease, monoclonal gammopathy of undetermined significance, and idiopathic Bence-Jones proteinuria. The presence of a monoclonal light chain can produce renal insufficiency, may be deposited as amyloid fibrils, may damage the proximal tubes producing Fanconi syndrome, or light chains may deposit in the glomerulus and cause light-chain deposition disease.

 

Heavy chain fragments as well as light chains may be seen in the urine of patients with multiple myeloma or amyloidosis.

 

Monoclonal gammopathies are rarely seen in patients younger than 30 years.

 

Hemolysis may cause a discrete band on protein electrophoresis, which will be negative on isotyping.

 

Penicillin may split the albumin band.

 

Radiographic agents may produce an uninterpretable pattern.

 

New method introduced March 3, 2026

 

References: 

 

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

Methodology:

Electrophoresis, MALDI-ToF

CPT Code:
84156
82570
84166 Electrophoresis, protein (if appropriate)
0077U