Citrate 24 Hour Urine Test
Short Name: Citrate 24Hr Urine
Also known as: 24-Hour Urine Citrate, Urinary Citrate Test, Urine Citrate 24 Hour, Citrate Excretion Test
Citrate 24 Hour Urine Test test available at DNA Labs India for ₹959. Uses Spectrophotometry, Enzymatic Method on 24-Hour Urine samples. Results in Same-day report available for samples received by 4:00 PM at the laboratory.. Free home collection in 300+ cities across India.
🩺 Medically Reviewed By
Dr Ramarao Paidisetty
Consultant Biochemist · Reg: 21504
Last reviewed: September 7, 2026
Overview
The primary purpose of the Citrate 24 Hour Urine Test is to evaluate the risk of kidney stone formation and recurrence by measuring the amount of citrate excreted in a 24-hour urine sample. Low urinary citrate (hypocitraturia) is a well-established risk factor for calcium oxalate and calcium phosphate kidney stones. This test helps clinicians identify the underlying metabolic cause of recurrent stones, guide treatment decisions such as potassium citrate supplementation, monitor the effectiveness of preventive therapy, and assess patients with suspected renal tubular acidosis (RTA), a condition in which the kidneys fail to adequately acidify urine, leading to low citrate excretion. It is an essential component of a complete kidney stone metabolic workup.
- Test Code
- 322
- CPT Code
- 82507
- ICD Code
- E72.29
- Price
- ₹959
- Sample Type
- 24-Hour Urine
- Result Time
- Same-day report available for samples received by 4:00 PM at the laboratory.
- Fasting Required
- No
- Method
- Spectrophotometry, Enzymatic Method
Sample Collection
No special fasting or dietary preparation is required unless advised by your physician. Inform your doctor about all medications and supplements you are taking, as some may affect citrate levels. Maintain your usual fluid intake and diet during the collection period for accurate results.
Method: 24-hour urine collection with 25 mL of 50% concentrated HCl as preservative to maintain pH below 3
Laboratory Analysis
Begin collecting urine from the second morning void on Day 1. Collect ALL urine passed over the next 24 hours, including the first morning void on Day 2. Add the provided acid preservative (25 mL of 50% concentrated HCl) to the collection container before starting. Keep the container refrigerated or on ice throughout the collection period. Record the exact start and end times of collection. Record the total 24-hour urine volume on the test request form and the urine vial.
Report Delivery
After completing the 24-hour collection, mix the urine thoroughly. Transfer the required aliquot (minimum 10 mL, recommended 5 mL min.) to the provided transport vial. Ensure the transport vial is clearly labeled with your name, date, and total urine volume. The sample should be shipped refrigerated or frozen to the laboratory. Hand over the sample to the phlebotomist or deliver it to the nearest DNA Labs India collection center on the same day.
Timeline: Same-day report available for samples received by 4:00 PM at the laboratory.
Patient Instructions
About This Test
Who Should Get This Test
The primary purpose of the Citrate 24 Hour Urine Test is to evaluate the risk of kidney stone formation and recurrence by measuring the amount of citrate excreted in a 24-hour urine sample. Low urinary citrate (hypocitraturia) is a well-established risk factor for calcium oxalate and calcium phosphate kidney stones. This test helps clinicians identify the underlying metabolic cause of recurrent stones, guide treatment decisions such as potassium citrate supplementation, monitor the effectiveness of preventive therapy, and assess patients with suspected renal tubular acidosis (RTA), a condition in which the kidneys fail to adequately acidify urine, leading to low citrate excretion. It is an essential component of a complete kidney stone metabolic workup.
How to Prepare
- Start collection from the second morning urine on Day 1; discard the first morning void
- Collect all urine for exactly 24 hours, including the first morning void on Day 2
- Add 25 mL of 50% concentrated HCl preservative to the collection container before starting
- Keep the container refrigerated or in an ice bath during the entire collection period
- Record the total 24-hour urine volume on the request form and the sample vial
- Transfer a 10 mL aliquot to the transport vial and ship refrigerated or frozen
- Avoid contamination of urine with stool, toilet paper, or other foreign material
Doctor's Notes
Reviewed by Dr Ramarao Paidisetty — MBBS, MD (Biochemistry) · Reg. No. 21504
"Low urinary citrate is one of the most common metabolic abnormalities found in patients with recurrent calcium-based kidney stones. A 24-hour urine citrate measurement helps identify individuals at risk and guides targeted preventive strategies such as potassium citrate supplementation and dietary modification. This test should be interpreted alongside other metabolic parameters including calcium, oxalate, uric acid, and urine pH for a comprehensive kidney stone evaluation."
Last medically reviewed: September 7, 2026
Test Parameters & Specifications
Sample Stability
- Incomplete 24-hour urine collection (less than 24 hours)
- Total urine volume not recorded on the request form or vial
- Sample collected without acid preservative
- Sample contaminated with stool or other material
- Sample received at room temperature without preservative after 24 hours
- Unlabeled or mislabeled sample
- Sample volume insufficient for analysis (< 5 mL aliquot)
Understanding Your Results
Low urinary citrate (hypocitraturia). Increased risk of calcium-based kidney stones. May indicate renal tubular acidosis, chronic diarrhea, high-protein diet, metabolic acidosis, or idiopathic cause. Clinical correlation and further evaluation recommended.
Range: Below 320 mg/24 hours
Normal urinary citrate excretion. Adequate citrate levels that help protect against calcium stone formation. Continue standard dietary and hydration practices.
Range: 320–1240 mg/24 hours
Elevated urinary citrate. Generally not clinically concerning and may be seen with citrus-rich diets, alkali therapy, or supplementation. Usually protective against stone formation.
Range: Above 1240 mg/24 hours
Consult a nephrologist or urologist if your urinary citrate levels are below 320 mg/24 hours, especially if you have a history of recurrent kidney stones, flank pain, blood in urine, or a family history of nephrolithiasis. Low citrate levels may require potassium citrate supplementation and dietary modifications. If you experience symptoms such as severe back or side pain, painful urination, nausea, vomiting, or fever, seek immediate medical attention.
Limitations
- ⚠Single 24-hour urine collection may not reflect long-term metabolic trends; repeat testing may be needed
- ⚠Does not identify all causes of kidney stones (e.g., cystine or uric acid stones require additional tests)
- ⚠Must be interpreted in conjunction with other metabolic parameters such as calcium, oxalate, uric acid, and pH
- ⚠Preservative handling errors can affect sample integrity
- ⚠Results may vary with diet, fluid intake, and medications
Risks & Considerations
- ●The Citrate 24 Hour Urine Test is a non-invasive urine collection with no direct physical risks
- ●If acid preservative (HCl) is used, handle with care to avoid skin or eye contact
- ●Ensure adequate hygiene during collection to prevent sample contamination
Interfering Factors
- ●Inadequate or incomplete 24-hour urine collection leading to inaccurate results
- ●Excessive intake of citrus fruits or citrus-based juices may falsely elevate citrate levels
- ●Acid-preservative (HCl) not added or insufficient, causing citrate degradation
- ●Metabolic acidosis from uncontrolled diabetes may lower urinary citrate
- ●Use of carbonic anhydrase inhibitors (e.g., acetazolamide) can reduce urinary citrate
- ●Alkali therapy or sodium bicarbonate supplements may increase urinary citrate
- ●Dietary changes (high-protein or high-sodium diet) may alter citrate excretion
Compare With Similar Tests
| Test | Citrate 24 Hour Urine Test | 24 Hour Urine Calcium Test | Urine Routine and Microscopy | CT KUB (Non-Contrast CT) |
|---|---|---|---|---|
| Comparison | Citrate 24 Hour Urine Test | Measures urinary calcium excretion. While calcium test identifies hypercalciuria (excess calcium), the citrate test identifies hypocitraturia (low citrate). Both are complementary and typically ordered together as part of a metabolic stone workup. | A general screening test that detects crystals, blood, pus, and pH in a spot urine sample. The citrate 24-hour test is a quantitative measurement over 24 hours that specifically evaluates citrate levels for stone risk assessment. | CT KUB is an imaging test that detects the presence, size, and location of kidney stones. The citrate test does not detect stones but identifies a metabolic risk factor for stone recurrence. |
Frequently Asked Questions
What is the Citrate 24 Hour Urine Test?
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Is fasting required for the Citrate 24 Hour Urine Test?
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What does a low urinary citrate level mean?
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Is home sample collection available for this test?
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What other tests are usually done along with the Citrate 24 Hour Urine Test?
How can I increase my urinary citrate levels naturally?
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