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Test ID: TP Protein, Total, Serum

Reporting Name

Protein, Total, S

Useful For

Diagnosis and treatment of a variety of diseases involving the liver, kidney, or bone marrow, as well as other metabolic or nutritional disorders

Clinical Information

Plasma proteins are synthesized predominantly in the liver; immunoglobulins are synthesized by mononuclear cells of lymph nodes, spleen and bone marrow. The 2 general causes of alterations of serum total protein are a change in the volume of plasma water and a change in the concentration of 1 or more of the specific proteins in the plasma. Of the individual serum proteins, albumin is present in such high concentrations that low levels of this protein alone may cause hypoproteinemia.


Hemoconcentration (decrease in the volume of plasma water) results in relative hyperproteinemia; hemodilution results in relative hypoproteinemia. In both situations, concentrations of all the individual plasma proteins are affected to the same degree.


Hyperproteinemia may be seen in dehydration due to inadequate water intake or to excessive water loss (eg, severe vomiting, diarrhea, Addison disease, and diabetic acidosis) or as a result of increased production of proteins. Increased polyclonal protein production is seen in reactive, inflammatory processes; increased monoclonal protein production is seen in some hematopoietic neoplasms (eg, multiple myeloma, Waldenstrom macroglobulinemia, monoclonal gammopathy of undetermined significance).


Mild hyperproteinemia may be caused by an increase in the concentration of specific proteins normally present in relatively low concentration, eg, increases in acute phase reactants and polyclonalimmunoglobulins produced in inflammatory states, late-stage liver disease, and infections. Moderate-to-marked hyperproteinemia may also be due to multiple myeloma and other malignant paraproteinemias, although normal total protein levels do not rule out these disorders. A serum protein electrophoresis should be performed to evaluate the cause of the elevated serum total protein.


Hypoproteinemia may be due to decreased production (eg, hypogammaglobulinemia) or increased protein loss (eg, nephrotic syndrome, protein-losing enteropathy). A serum protein electrophoresis should be performed to evaluate the cause of the decreased serum total protein. If a nephrotic pattern is identified, urine protein electrophoresis should also be performed.

Report Available

Same day/1 to 2 days

Day(s) Performed

Monday through Sunday

Clinical Reference

1. Rifai N, Horvath AR, Wittwer CT, eds. Tietz Textbook of Clinical Chemistry and Molecular Diagnostics. 6th ed. Elsevier, 2018

2. Killingsworth LM: Plasma proteins in health and disease. Crit Rev Clin Lab Sci. 1979;11:1-30

Method Name

Colorimetric, Biuret

Specimen Type


Necessary Information

Patient's age and sex are required.

Specimen Required

Collection Container/Tube:

Preferred: Serum gel

Acceptable: Red top

Submission Container/Tube: Plastic vial

Specimen Volume: 0.5 mL

Collection Instructions:

1. Serum gel tubes should be centrifuged within 2 hours of collection.

2. Red-top tubes should be centrifuged, and the serum aliquoted into a plastic vial within 2 hours of collection.

Specimen Minimum Volume

0.25 mL

Specimen Stability Information

Specimen Type Temperature Time Special Container
Serum Refrigerated (preferred) 7 days
  Frozen  180 days

Reference Values

≥1 year: 6.3-7.9 g/dL

Reference values have not been established for patients who are <12 months of age.

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


LOINC Code Information

Test ID Test Order Name Order LOINC Value
TP Protein, Total, S 2885-2


Result ID Test Result Name Result LOINC Value
TP Protein, Total, S 2885-2


If not ordering electronically, complete, print, and send a Renal Diagnostics Test Request (T830) with the specimen.

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