Heavy Metals with Cadmium, Ur




Test Mnemonic

UTXM4

CPT Codes

  • 82175 - QTY (1)
  • 83655 - QTY (1)
  • 83825 - QTY (1)
  • 82300 - QTY (1)

Aliases

  • Toxic Metals + Cadmium, Urine

Includes

  • Hours Collected
  • Total Volume
  • Creatinine, Urine - per volume
  • Creatinine, Urine - per 24h
  • Cadmium, Urine - per volume
  • Cadmium, Urine - per 24h
  • Cadmium, Urine - ratio to CRT
  • Lead, Urine - per volume
  • Lead, Urine - per 24h
  • Lead, Urine - ratio to CRT
  • Mercury, Urine - per volume
  • Mercury, Urine - per 24h
  • Mercury, Urine - ratio to CRT
  • Arsenic Urine - per volume
  • Arsenic Urine - per 24h
  • Arsenic, Urine - ratio to CRT
  • Arsenic, Ur Fractionated (if indicated)

Performing Laboratory

ARUP


Specimen Requirements

Volume Type Container Collect Temperature Transport Temperature Special Instructions
8 mLUrine, 24-hour (well-mixed)Plastic containerRefrigerate during collection.RefrigeratedHEAVY METALS FORM REQUIRED to meet State Health Department requirements. Patient Prep: High concentrations of iodine may interfere with testing. Diet, medication, and nutritional supplements may introduce interfering substances. Patients should be encouraged to discontinue nutritional supplements, vitamins, minerals, non-essential over-the-counter medications (upon the advice of their physician) and avoid seafood for 48 hours. Avoid iodinated or gadolinium-based contrast media for at least 72 hours or 14 days for patients with impaired kidney function. Collection: Collect in a plastic container, mix well and aliquot into a trace metal free transport tube (ARUP #43116). Record total volume and collection time interval on specimen.

Alternate Specimen Requirements

Volume Type Container Collect Temperature Transport Temperature Special Instructions
8 mLUrine, randomPlastic containerN/ARefrigeratedHEAVY METALS FORM REQUIRED to meet State Health Department requirements. Patient Prep: High concentrations of iodine may interfere with testing. Diet, medication, and nutritional supplements may introduce interfering substances. Patients should be encouraged to discontinue nutritional supplements, vitamins, minerals, non-essential over-the-counter medications (upon the advice of their physician) and avoid seafood for 48 hours. Avoid iodinated or gadolinium-based contrast media for at least 72 hours or 14 days for patients with impaired kidney function. Collection: Collect in a plastic container, mix well and aliquot into a trace metal free transport tube (ARUP #43116). Record total volume and collection time interval on specimen.

Minimum Specimen Requirements

Volume Type Container Collect Temperature Transport Temperature Special Instructions
2 mL     

Stability

Environmental Condition Description
Ambient1 week
Refrigerated2 weeks
Frozen1 year

Days Performed

Sun - Sat

Turnaround Time

2 - 6 days

Methodology

Name Description
Inductively Coupled Plasma / Mass Spectrometry (ICP-MS) 

Reference Range

Arsenic - per volume (ug/L)
Sex Age From Age To Type Range Range Unit
   Years99 YearsNormal0.0 - 34.9 (Based on Biological Exposure Index)ug/L
Arsenic - per24h (ug/day)
Sex Age From Age To Type Range Range Unit
   Years99 YearsNormal0.0 - 49.9ug/d
Arsenic - ratio to CRT (ug/g CRT)
Sex Age From Age To Type Range Range Unit
   Years99 YearsNormal0.0 - 29.9ug/g crt
Cadmium Urine per Volume (ug/L)
Sex Age From Age To Type Range Range Unit
   Years99 YearsNormal0.0 - 1.0ug/L
Cadmium, Urine-per 24 hour
Sex Age From Age To Type Range Range Unit
   Years99 YearsNormal0.0 - 3.2ug/d
Cadmium, Urine-ratio to CRT
Sex Age From Age To Type Range Range Unit
   Years99 YearsNormal0.0 - 3.2ug/g crt
Lead, per 24h (ug/day)
Sex Age From Age To Type Range Range Unit
       Normal0.0 - 8.1ug/d
Lead, per volume (ug/L)
Sex Age From Age To Type Range Range Unit
       Normal0.0 - 5.0ug/L
Lead, ratio to creatinine (ug/g CRT)
Sex Age From Age To Type Range Range Unit
       Normal0.0 - 5.0ug/g crt
Mercury, Urine per 24 hours
Sex Age From Age To Type Range Range Unit
       Normal0.0 - 20.0ug/d
Mercury, Urine per volume
Sex Age From Age To Type Range Range Unit
       Normal0.0 - 5.0ug/L
Mercury, Urine ratio to creatinine
Sex Age From Age To Type Range Range Unit
   Years99 YearsNormal0.0 - 20.0ug/g crt

Special Info

HEAVY METALS FORM REQUIRED to meet State Health Department requirements. Patient Prep: High concentrations of iodine may interfere with testing. Diet, medication, and nutritional supplements may introduce interfering substances. Patients should be encouraged to discontinue nutritional supplements, vitamins, minerals, non-essential over-the-counter medications (upon the advice of their physician) and avoid seafood for 48 hours. Avoid iodinated or gadolinium-based contrast media for at least 72 hours or 14 days for patients with impaired kidney function. Collection: Collect in a plastic container, mix well and aliquot into a trace metal free transport tube (ARUP #43116). Record total volume and collection time interval on specimen. Urine transported in a non-trace element-free tube or contaminated with iodine, gadolinium, blood, fecal material or acid preservative will be rejected. This test is New York DOH approved.

Clinical Info

This test may be useful in the assessment of acute and chronic exposure to arsenic, cadmium, mercury, and lead. Urine cadmium levels can be used to assess cadmium body burden. In chronic exposures, the kidneys are the primary target organ. Symptoms associated with cadmium toxicity vary based upon route of exposure and may include tubular proteinuria, fever, headache, dyspnea, chest pain, conjunctivitis, rhinitis, sore throat and cough. Ingestion of cadmium in high concentration may cause vomiting, diarrhea, salivation, cramps, and abdominal pain. Quantification of urine excretion rates before or after chelation therapy has been used as an indicator of lead exposure. Urinary excretion of >125 mg of lead per 24 hours is usually associated with related evidence of lead toxicity. Urinary mercury levels predominantly reflect acute or chronic elemental or inorganic mercury exposure. Urine concentrations in unexposed individuals are typically less than 10 µg/L. 24 hour urine concentrations of 30 to 100 µg/L may be associated with subclinical neuropsychiatric symptoms and tremor while concentrations greater than 100 µg/L can be associated with overt neuropsychiatric disturbances and tremors. Urine mercury levels may be useful in monitoring chelation therapy. The ACGIH Biological Exposure Index (BEI) for arsenic in urine is 35 µg/L. The ACGIH BEI is based on the sum of inorganic and methylated species. For specimens with elevated total arsenic results, fractionation is automatically performed at additional cost to determine the proportions of inorganic, methylated and organic species.

Patient Info Sheet