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Test ID UPH24 pH, 24 Hour, Urine

Reporting Name

pH, 24 HR, U

Useful For

Assessment of patients with metabolic acidosis, crystalluria, as well as monitoring the effectiveness of alkalinization or acidification of urine for certain medical conditions (eg, treatment of uric acid nephrolithiasis) using a 24-hour collection period

Specimen Type

Urine


Necessary Information


24-Hour volume (in milliliters) is required.



Specimen Required


Supplies:

Diazolidinyl Urea (Germall), 5.0 mL (T822)

Urine Tubes, 10 mL (T068)

Container/Tube: Plastic, 10-mL urine tube or a clean, plastic aliquot container

Specimen Volume: 10 mL

Collection Instructions:

1. Collect urine for 24 hours

2. Add 5 mL of diazolidinyl urea as preservative at start of collection or refrigerate specimen during and after collection.

3. Specimen pH should be between 4.5 and 8 and will stay in this range if kept refrigerated. Specimens with pH >8 indicate bacterial contamination, and testing will be cancelled. Do not attempt to adjust pH as it will adversely affect results.

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


Specimen Minimum Volume

1 mL

Specimen Stability Information

Specimen Type Temperature Time Special Container
Urine Refrigerated (preferred) 7 days
  Frozen  7 days

Reference Values

4.5-8.0

Test Classification

This test has been cleared, approved, or is exempt by the US Food and Drug Administration and is used per manufacturer's instructions. Performance characteristics were verified by Mayo Clinic in a manner consistent with CLIA requirements.

CPT Code Information

83986

Clinical Information

Urine pH is a measure of the acidity/alkalinity of urine and, by itself, usually provides little useful information. Under normal conditions its value is influenced by the type of diet. Some diets (eg, diets rich in meat) have more acid content than others (eg, vegetarian diets).

 

Changes in urine pH may reflect systemic acid-base disorders. For example, the normal response during metabolic acidosis is a lowering of the urine pH to less than 5. If the pH is greater than 5, then a defect in urine acidification should be considered. A urine pH of greater than 8 is suggestive of infection by a urea-splitting organism such as Proteus mirabilis.

 

Therapeutic interventions to either alkalinize or acidify the urine are necessary for some diseases. For example, some crystals have a propensity to form in alkaline urine, while others form in relative acidic urine, and changing the pH may reduce stone formation.

Interpretation

Dependent on clinical condition.

 

A pH greater than 8 suggests the presence of urinary tract infection with a urea-splitting organism.

Method Description

The pH meter is composed of a glass electrode, calomel electrode and voltmeter. The glass electrode has a fixed acid concentration, yielding a corresponding voltage. The calomel electrode is the reference electrode. Its voltage is independent of the H+ ion concentration. The two electrodes constitute a galvanic cell whose electromotive force is measured by the voltmeter. The meter is calibrated to read in pH units, reflecting the H+ ion concentration. The meter is used to determine pH in 0 to 14 range.(Instruction manual: Fisher Scientific accumet Basic (AB) Benchtop Meters. Fisher Scientific; 68x613601.0 07/2012)

Reject Due To

All specimens will be evaluated at Mayo Clinic Laboratories for test suitability.

Cautions

No significant cautionary statements

NY State Approved

Yes

Method Name

pH Meter

Urine Preservative Collection Options

Note: The addition of preservative or application of temperature controls must occur at the beginning of the collection.

Ambient

No

Refrigerate

OK

Frozen

OK

50% Acetic Acid

No

Boric Acid

No

Diazolidinyl Urea

Preferred

6M Hydrochloric Acid

No

6M Nitric Acid

No

Sodium Carbonate

No

Thymol

No

Toluene

No

Clinical Reference

1. Menezes CJ, Worcester EM, Coe FL, Asplin J, Bergsland KJ, Ko B: Mechanisms for falling urine pH with age in stone formers. Am J Physiol Renal Physiol. 2019 Jul 1;317(7):F65-F72

2. Ilyas R, Cho K, Young JG: What is the best method to evaluate urine pH? A trial of three urinary pH measurement methods in a stone clinic. J Endourol. 2015 Jan;29(1):70-74

3. Davidsohn I, Henry JB: Todd-Sanford Clinical Diagnosis by Laboratory Methods. 15th ed. Elsevier; 1974; 43-44

4. Free AH, Free HBS: Urodynamics, concepts relating to urinalysis. Ames Co; 1974:57-61

5. Kaplan LA, Pesce AJ: Clinical Chemistry: Theory, Analysis, Correlation. 3rd ed. Mosby-Year Book Inc; 1996:823

Day(s) Performed

Monday through Sunday

Report Available

1 to 3 days