Potassium, 24-Hour Urine

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Turnaround Time: Within 1 day
CPT Code:

84133

Test Type: 10 mL aliquot of entire collection, Urine
Reference Range:

Age

Male (mmol/24 hr)

Female (mmol/24 hr)

0 to 5 y

Not established

Not established

6 to 17 y

11-88

10-70

18 to 80 y

20-116

14-95

>80 y

16-83

6-67

Overview:

Evaluate electrolyte balance, acid-base balance; evaluate hypokalemia; Carroll and Oh point out that urinary loss of 40 mmol/24 hours in the presence of hypokalemia <3 mmol/L is excessive.1 In the presence of such hypokalemia, urine excretion is helpful to separate renal from nonrenal losses. Excretion <20 mmol/24 hours is evidence that hypokalemia is not from renal loss.1 Renal loss >50 mmol/L in a hypokalemic, hypertensive patient not on a diuretic may indicate primary or secondary aldosteronism. The kidneys do not respond quickly to potassium deprivation. There is renal wastage of potassium in secondary aldosteronism. Glucocorticoids, including endogenous steroids in Cushing's syndrome, are among the causes of kaliuresis.

Urinary potassium may be elevated with dietary (food and/or medicinal) increase, hyperaldosteronism, renal tubular acidosis, onset of alkalosis, and with other disorders. Time relationships are important in interpretation. Potassium will decrease in Addison's disease and in renal disease with decreased urine flow (nephrosclerosis, pyelonephritis, glomerulonephritis).

1. Carroll HJ, Oh MS. Water Electrolyte and Acid-Base Metabolism: Diagnosis and Management. Philadelphia, Pa: JB Lippincott Co;1978.

Collection Details:

Collection Instructions:

State 24-hour volume on the test request form.

Plastic urine container, no preservative.

If the specimen is a 24-hour collection instruct the patient to void at 8 AM and discard the specimen. Then collect all urine including the final specimen voided at the end of the 24-hour collection period (ie, 8 AM the next morning). Screw the lid on securely. Mix well. Container must be labeled with the patient's full name and dates and times of collections.

Maintain specimen at room temperature.