Sign in →

Test Code 0207977 Heavy Metals Screen, with Reflex, 24 Hour, Urine

Additional Codes

 

Mayo Test ID
HMU24

 


Specimen Required


Patient Preparation:

-High concentrations of gadolinium and iodine are known to interfere with most metals tests. If either gadolinium- or iodine-containing contrast media has been administered, a specimen should not be collected for 96 hours.

-Patient should not eat seafood for a 48-hour period prior to start of collection.

Supplies: Urine Tubes, 10 mL (T068)

Collection Container/Tube: Clean, plastic aliquot container with no metal cap or glued insert

Submission Container/Tube: Plastic, 10-mL urine tube (T068)

Specimen Volume: 10 mL

Collection Instructions:

1. Collect urine for 24 hours.

2. Refrigerate specimen within 4 hours of completion of 24-hour collection.

3. See Trace Metals Analysis Specimen Collection and Transport in Special Instructions for complete instructions.

Additional Information: See Urine Preservatives-Collection and Transportation for 24-Hour Urine Specimens in Special Instructions for multiple collections.


Useful For

Detecting arsenic, cadmium, mercury, and lead exposure and toxicity in 24-hour urine specimen

Profile Information

Test ID Reporting Name Available Separately Always Performed
ASHU Arsenic, 24 Hr, U Yes, (order ASU24) Yes
CDHMU Cadmium, 24 Hr, U Yes, (order CDU) Yes
HGHU Mercury, 24 Hr, U Yes, (order HGU) Yes
PBHU Lead, 24 Hr, U Yes, (order PBU) Yes

Reflex Tests

Test ID Reporting Name Available Separately Always Performed
ASFR Arsenic Fractionation, 24 Hr, U Yes No

Testing Algorithm

If arsenic concentration is greater than or equal to 35 mcg/L, then fractionation will be performed at an additional charge.

Method Name

Inductively Coupled Plasma-Mass Spectrometry (ICP-MS)

Reporting Name

Heavy Metal Scrn w/Reflex, 24 Hr, U

Specimen Type

Urine

Specimen Minimum Volume

3 mL

Specimen Stability Information

Specimen Type Temperature Time
Urine Refrigerated (preferred) 7 days
  Frozen  7 days

Reject Due To

Hemolysis

NA

Lipemia

NA

Icterus

NA

Other

NA

Reference Values

ARSENIC:

0-17 years: not established

≥18 years: <18 mcg/24 hour

 

CADMIUM:

0-17 years: not established

≥18 years: <0.6 mcg/24 hour

 

MERCURY:

0-17 years: not established

≥18 years: <2 mcg/24 hour

Toxic concentration: >50 mcg/24 hour

 

The concentration at which toxicity is expressed is widely variable between patients. 50 mcg/24 hour is the lowest concentration at which toxicity is usually apparent.

 

LEAD:

0-17 years: not established

≥18 years: <1 mcg/24 hour

Interpretation

Arsenic:

Normally, humans consume 5 to 25 mcg of arsenic each day as part of their normal diet; therefore, normal urine arsenic output is less than 25 mcg/specimen. After a seafood meal (seafood contains a nontoxic, organic form of arsenic), the urine output of arsenic may increase to 300 mcg/specimen for 1 day, after which it will decline to less than 25 mcg/specimen.

 

Exposure to inorganic arsenic, the toxic form of arsenic, causes prolonged excretion of arsenic in the urine for many days.

 

Urine excretion rates greater than 1,000 mcg/specimen indicate significant exposure. The highest level observed at Mayo Clinic was 450,000 mcg/specimen in a patient with severe symptoms of gastrointestinal distress, shallow breathing with classic "garlic breath," intermittent seizure activity, cardiac arrhythmias, and later onset of peripheral neuropathy.

 

Cadmium:

In chronic cadmium exposure, the kidneys are the primary target organ. Urine concentrations of cadmium can be useful to assess long-term exposure and determine cadmium body burden. Collection of urine over 24 hours minimizes fluctuations of observed cadmium concentrations in random urine samples.

 

Mercury:

Daily urine excretion of mercury above 50 mcg/day indicates significant exposure (per World Health Organization standard).

 

Lead:

Urinary excretion of less than 125 mcg of lead per 24 hours is not associated with any significant lead exposure.

 

Urinary excretion of more than 125 mcg of lead per 24 hours is usually associated with pallor, anemia, and other evidence of lead toxicity.

Day(s) and Time(s) Performed

Monday through Saturday; 7 p.m.

Analytic Time

1 day

Specimen Retention Time

14 days

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Test Classification

See Individual Test IDs

CPT Code Information

82175

82300

83825

83655

LOINC Code Information

Test ID Test Order Name Order LOINC Value
HMU24 Heavy Metal Scrn w/Reflex, 24 Hr, U In Process

 

Result ID Test Result Name Result LOINC Value
8678 Cadmium, 24 Hr, U 5612-7
48539 Arsenic, 24 Hr, U 5587-1
92408 Mercury, 24 Hr, U 6693-6
92409 Lead, 24 Hr, U 5677-0
TIME4 Collection Duration 13362-9
92215 Arsenic Concentration w/Reflex 21074-0
VL16 Total Volume 3167-4

Urine Preservative Collection Options

Ambient

No

Refrigerated

Preferred

Frozen

Yes

6N HCl

Yes

50% Acetic Acid

Yes

Na2CO3

No

Toluene

Yes

6N HNO3

No

Boric Acid

No

Thymol

No