Biomarker discovery approaches in urine have been hindered by concerns for reproducibility and inadequate standardization of proteomics protocols. In this study, we describe an optimized quantitative proteomics strategy for urine biomarker discovery, which is applicable to fresh or long frozen samples. We used urine from healthy controls to standardize iTRAQ (isobaric tags for relative and absolute quantitation) for variation induced by protease inhibitors, starting protein and iTRAQ label quantities, protein extraction methods, and depletion of albumin and immunoglobulin G (IgG). We observed the following: With ongoing advances in mass spectrometry (MS) and proteomics technology, proteomics analysis is progressively occupying a central position in biomarker discovery platforms. Biofluids such as urine and blood are the preferred media for proteomics analysis because of their ease of collection and extensive history of use in clinical laboratory practice. Urine, in particular, is an information-rich fluid that can be collected non-invasively and in large quantities. Many urine proteins are produced or shed in the kidney and urogenital tract (1), making urine a promising proximal source of biomarkers for diseases affecting these structures.However, proteomics-based biomarker discovery in urine faces multiple challenges. Urine proteomics is complicated by low urine protein concentration, variations in pH, and high concentrations of salts and urea or other urine components that interfere with sample processing. The urine proteome can also change with individual variables such as hydration, diurnal change, diet, and physical activity as well as variation in sample collection, processing, and storage. In addition, urine proteomics shares the usual challenges of biomarker discovery in other biofluids such as throughput, cost, and the need for a reproducible and quantitative work flow.Isotopic or isobaric labeling methods to reduce variation, increase throughput, and enable quantitative analysis have been developed to address some of these challenges. One such method, isobaric tags for relative and absolute quantitation (iTRAQ) 1 (2), combines relative and absolute peptide quantification with multiplexing ability to enable an increased throughput as well as simultaneous comparison of up to eight samples within one experimental run. Variations induced by urine sample processing have been systematically evaluated for proteomics analyses using two-dimensional gel electrophoresis (3-6), differential gel electrophoresis (7), and liquid chromatography-coupled mass spectrometry (LC-MS) (5,8,9). However, no systematic analyses of urine sample collection and processing have been reported for iTRAQ.Before utilizing iTRAQ-based quantitative proteomics for urine biomarker discovery, we evaluated the impact of variation in several processing steps (addition of protease inhibitors, the starting protein quantities, quantity of the iTRAQ label, protein extraction methods, and depletion of abundant proteins) on iTRAQ protein identifica...