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Hydroxyproline Levels Urine Test

Last updated March 31, 2016

What are other Names for this Test? (Equivalent Terms)

  • 24-Hour Urine Test, Hydroxyproline Level

What is the Hydroxyproline Levels Urine Test? (Background Information)

  • Hydroxyproline is an amino acid found in collagen. Hydroxyproline levels in the urine are increased during collagen destruction
  • Collagen is a structural protein found in bones, skin, and cartilage. It is very abundant, making up one-fifth to one-third of all protein in the body
  • When collagen is broken down, hydroxyproline is released in the urine. Generally, collagen breakdown occurs as a result of bone disorders
  • The Hydroxyproline Levels Urine Test helps determine the level of hydroxyproline in urine. It is used to diagnose bone disorders such as Paget’s disease of the bone. It is also used to monitor the treatment for bone disorders

What are the Clinical Indications for performing the Hydroxyproline Levels Urine Test?

Following are the clinical indications for performing the Hydroxyproline Levels Urine Test:

  • Monitoring the treatment of bone disorders
  • Bone pain
  • Bone deformities
  • Weakness
  • Unusual bone break
  • Loss of height

How is the Specimen Collected for Hydroxyproline Levels Urine Test?

Following is the specimen collection process for Hydroxyproline Levels Urine Test:

Sample required: Urine

Process of obtaining a sample in adults: Urination into a sterile container over a 2-hour or 24-hour period.

Preparation required: It is recommended to drink 6 to 8 glasses of water or other fluids prior to the test.

What is the Significance of the Hydroxyproline Levels Urine Test Result?

A high value for the Hydroxyproline Levels Urine Test depends on the age of an individual, and is as follows:

  • 1-5 years - greater than 65 mg/24 hr
  • 6-10 years - greater than 100 mg/24 hr
  • 11-16 years - greater than 180 mg/24 hr
  • 18-39 years - greater than 50 mg/24 hr
  • 40+ years - greater than 42 mg/24 hr

A high value for the test may indicate: 

  • Paget’s disease
  • Metastatic bone tumor
  • Osteoporosis
  • Bone growth
  • Acromegaly

A low value for the Hydroxyproline Levels Urine Test also depends on the age of an individual, and is as follows: 

  • 1-5 years - less than 20 mg/24 hr
  • 6-10 years - less than 35 mg/24 hr
  • 11-16 years - less than 65 mg/24 hr
  • 18-39 years - less than 14 mg/24 hr
  • 40+ years - less than 15 mg/24 hr

A low value for the test may indicate: 

  • Malnutrition
  • Hypopituitarism
  • Hypoparathyroidism

The laboratory test results are NOT to be interpreted as results of a "stand-alone" test. The test results have to be interpreted after correlating with suitable clinical findings and additional supplemental tests/information. Your healthcare providers will explain the meaning of your tests results, based on the overall clinical scenario.

Additional and Relevant Useful Information:

  • Certain factors interfere with the results of the Hydroxyproline Levels Urine Test. This includes the consumption of collagen-rich foods, prior to administering the test

Certain medications that you may be currently taking may influence the outcome of the test. Hence, it is important to inform your healthcare provider of the complete list of medications (including any herbal supplements) you are currently taking. This will help the healthcare provider interpret your test results more accurately and avoid unnecessary chances of a misdiagnosis.

What are some Useful Resources for Additional Information?

The following DoveMed website link is a useful resource for additional information: http://www.dovemed.com/osteosarcoma-arising-in-pagets-disease-of-bone/

Please visit our Laboratory Procedures Center for more physician-approved health information:


References and Information Sources used for the Article:

Kee, J. L. (2010). Laboratory and diagnostic tests with nursing implications (8th ed.). Upper Saddle River, NJ: Pearson.

Martini, F., Nath, J. L., & Bartholomew, E. F. (2012). Fundamentals of anatomy & physiology (9th ed.). San Francisco: Benjamin Cummings.

Schnell, Z. B., Van, L. A., & Kranpitz, T. R. (2003). Davis's Comprehensive handbook of laboratory and diagnostic tests: With nursing implications. Philadelphia: F.A. Davis. 

Helpful Peer-Reviewed Medical Articles:

Das, M., Biswas, U. K., & Kumar, A. (2015). 24 Hours Urinary Hydroxyproline-A Noninvasive, Cost-Effective and Early Biochemical Marker Which May be Used to Screen the Osteoporotic Lesion in Postmenopausal Women. Asian Journal of Medical Sciences (E-ISSN 2091-0576; P-ISSN 2467-9100), 6(4), 21-24.

Dahiya, K., Bansal, A., Dabla, S., Dhankhar, R., Singh, V., Kumar, H. D., & Dalal, D. (2015). Bone mineral density and urinary hydoxyproline are already abnormal in newly diagnosed patients with epilepsy in this North Indian study. Neurology Asia, 20(3).

Akiduki, S., Ito, H., Morishita, K., & Kamimura, A. (2015). A single-blind, parallel trial of l-hydroxyproline in healthy adult subjects. Urolithiasis, 43(3), 289.

Das, S., Ghosh, S., Pal, K., Chaudhuri, A., & Datta, S. (2015). Changes in biochemical markers in blood and urine in case of malunion and nonunion after fracture of long bones. Saudi Journal of Sports Medicine, 15(3), 269.

Perinpam, M., Ware, E. B., Smith, J. A., Turner, S. T., Kardia, S. L., & Lieske, J. C. (2015). Effect of Demographics on Excretion of Key Urinary Factors Related to Kidney Stone Risk. Urology, 86(4), 690-696.

Reviewed and Approved by a member of the DoveMed Editorial Board
First uploaded: March 31, 2016
Last updated: March 31, 2016