Urine for Phosphorus (Phosphates), 24 hours Urine sample

Sample

1. The test sample is urine.
2. Collect urine for 24 hours.
3. Procedure to collect the 24 hours urine sample:
   1. Note down the time and empty the urinary bladder.
   2. Now collect all the urine samples till the 24 hours are completed.
   3. Empty the urinary bladder when the time is finished.
4. Acidify the urine with acid. Add HCL.
   1. Acidify with HCL, and If pH <3 then urine is stable for 6 months.
   2. Vial should be washed with acid.
   3. Containers should be detergent free.
   4. Instruct the patient to void the first sample and note the time.
   5. After that, collect all the samples until 24 hours are completed.
   6. Now void the last sample in the container.
5. Refrigerate the urine sample during collection.

indications

1. It helps in finding kidney problems.
2. It helps to find the causes of kidney stones.
3. Phosphorus levels will give an idea about renal or bone disease.

 Pathophysiology

1. Phosphorus in the body is in the form of phosphate, so phosphorus and phosphate are used interchangeably.
2. The urine phosphate test measures the amount of mineral phosphate in the urine sample collected over a 24 hours period.
3. The body needs phosphate :
   1. To build and repair the bones and teeth.
   2. To help nerves function.
   3. To help in muscle contraction.

4. 85% of the phosphate is in the bones.

5. The kidneys help and control the amount of phosphate in the blood.
   1. The extra amount of phosphate is excreted by the kidneys in urine.
   2. Phosphate is a charged particle (ion) that contains the mineral phosphorus.
   3. The extra phosphate is filtered by the kidneys and passes out of the body in the urine.
   4. Kidney diseases can affect the phosphate level in the urine.
6. If the blood has less phosphate, then it is less in the urine.
7. Eating a meal high in phosphorus will increase the phosphate level.
8. High levels of vitamin D and overactive parathyroid gland increase the phosphorus level.

 Normal

Source 1

Phosphorus, inorganic in the urine:

• Constant daily diet = <1.0 g/day (<32.3 mmol/day).
• Nonrestricted diet = 0.4 to 1.31 g/day  (12.9 to 42.0 mmol/day).
  • Constant daily diet = 0.9 to 1.5 g (29 to 48 mmol)phosphorus and calcium 10 mg/kg (0.25 mmol/Kg)

Another source

• Adult = 0.4 to 1.3 grams / 24 hour urine sample.
• Calcium- and phosphate-restricted diet = < 1.0 g per 24 hour urine sample.

 Raised urine phosphate is seen in:

1. Kidney diseases.
2. Hyperparathyroidism).
3. Excessive intake of vitamin D.

 Decreased phosphate level in the blood is seen in:

1. When the level is <2.5 mg/dL in the blood.
   1. Hypoparathyroidism.
   2. Kidney diseases.
   3. Liver diseases.
   4. Severe malnutrition.
   5. In hospitalized patients.
      

      Normal urine picture:

      Physical features	Chemical features	Microscopic findings
      Color = Pale yellow or amber Appearance = Clear to slightly hazy pH = 4.5 to 8.0 Specific gravity = 1.015 to 1.025	Blood = Negative Glucose = Negative Ketones= Negative Protein = Negative Bilirubin = Negative Urobilinogen = Negative (±) Leucocyte esterase = Negative Nitrite for bacteria = Negative	RBCs = Rare or Negative WBC = Rare or Negative Epithelial cells = Few Cast = Negative (Occasional hyaline) Crystal = Negative (Depends upon the pH of the urine) Bacteria = Negative

       

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