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Urine 24 Hour Nitrogen

Urinalysis

24 hour urinary nitrogenTotal urinary nitrogen, 24 hourTUN

Review status

Currently under review

Pending specialist review and validation.

What it shows

The 24 hour urine nitrogen test measures the total amount of nitrogen your kidneys excrete in a full day of urine collection. Nitrogen comes mainly from the breakdown of protein in food and from the normal turnover of body tissues. Because most nitrogen leaves the body in urine, this test offers a practical snapshot of your overall protein metabolism.

Clinicians use this measurement to estimate dietary protein intake and to assess nitrogen balance, especially when you are ill, recovering from surgery, or receiving nutrition support. The result reflects nitrogen from urea as well as other nitrogen containing compounds, so it captures more than a single analyte.

Why it matters

This test helps your care team judge whether you are getting enough protein, too little, or more than your body needs. It is commonly ordered when there are concerns about malnutrition, unintended weight loss, wounds that require protein for healing, or conditions that increase protein breakdown such as severe infection, trauma, or burns. It is also used to monitor the effectiveness of tube feeding or parenteral nutrition.

Kidney and liver function can influence how nitrogen is processed and excreted. Your clinician may pair this test with other labs and a careful diet history to guide nutrition prescriptions and to reduce risks such as muscle loss, poor wound healing, and prolonged recovery.

Understanding your results

Interpreting the result starts with confirming a complete and accurate 24 hour collection. Missing any urine or collecting for the wrong time can make the value appear lower or higher than it truly is. Your team may check urine creatinine from the same collection to assess completeness.

A higher than expected result can be seen with high protein intake or when the body is breaking down more tissue than usual. A lower result can occur with low protein intake, poor absorption, or reduced kidney excretion. Liver problems that impair urea production may also lower urinary nitrogen. If your result is outside the expected range, your clinician may adjust your diet, repeat the test, or order additional studies such as kidney and liver panels to clarify the cause.

Reference ranges

430710 mmol/d
All sexes
0 days – 150 years

Reference intervals vary by laboratory, analyzer, methodology, population, and units. The ranges shown here are for education only. Always interpret your results against the reference interval printed on your own lab report.

Factors that could impact Urine 24 Hour Nitrogen

  • Incomplete 24 hour collection

    Missing any urine, starting late, stopping early, or spilling the container will usually make the result falsely low. Carefully follow the collection instructions and record start and stop times.

  • Dietary protein and supplements

    Higher protein intake, protein shakes, amino acid supplements, or high nitrogen tube feeds increase urinary nitrogen. Very low intake or poor appetite can lower the result.

  • Catabolic stress and medications

    Fever, infection, trauma, surgery, burns, and hyperthyroidism increase tissue breakdown and raise urinary nitrogen. Corticosteroids can increase catabolism, while anabolic agents may lower excretion.

  • Kidney function and urine output

    Reduced kidney function or very low urine output can decrease nitrogen excretion, while high urine output may dilute other markers but not the total amount collected. Results must be interpreted alongside kidney tests.

  • Liver function and urea production

    The liver converts ammonia to urea. Liver disease that impairs this process can lower urinary nitrogen even when protein breakdown is increased.

  • Hydration, diuretics, and timing

    Fluid intake and diuretic use change urine volume and timing of excretion. Complete the full collection period and avoid missing any voids to keep the result accurate.

  • Special populations

    Pregnancy, rapid growth, and advanced age can alter protein needs and nitrogen handling. Your provider may use different targets or repeat testing in these situations.

2026

References

  1. McGill University Health Centre. (2017, May 05). Urine 24 Hour Nitrogen (Task CD 317732). Laboratory reference ranges.
  2. McClave, S. A., Taylor, B. E., Martindale, R. G., Warren, M. M., Johnson, D. R., Braunschweig, C., ... & the Society of Critical Care Medicine and American Society for Parenteral and Enteral Nutrition. (2016). Guidelines for the provision and assessment of nutrition support therapy in the adult critically ill patient. Journal of Parenteral and Enteral Nutrition, 40(2), 159-211.
  3. Singer, P., Blaser, A. R., Berger, M. M., Alhazzani, W., Calder, P. C., Casaer, M. P., ... & Bischoff, S. C. (2019). ESPEN guideline on clinical nutrition in the intensive care unit. Clinical Nutrition, 38(1), 48-79.