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Order Code HMUCR Heavy Metal/Creatinine Ratio, with Reflex, Random, Urine


Specimen Required


1. For 48 hours before collection, patient should not eat seafood.

2. High concentrations of gadolinium and iodine are known to potentially interfere with most inductively coupled plasma mass spectrometry-based metal tests. If either gadolinium- or iodine-containing contrast media has been administered, a specimen should not be collected for 96 hours.

Supplies: Urine Tubes, 10 mL (T068)

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

Submission Container/Tube: Plastic, 10-mL urine tube or clean, plastic aliquot container with no metal cap or glued insert

Specimen Volume: 6 mL

Collection Instructions:

1. Collect a random urine specimen.

2. See Metals Analysis Specimen Collection and Transport for complete instructions.


Useful For

Preferred screening test for detection of arsenic, cadmium, mercury, and lead in random urine specimens

Profile Information

Test ID Reporting Name Available Separately Always Performed
ASCU Arsenic/Creatinine Ratio, U Yes, (order ASUCR) Yes
CDCU Cadmium/Creatinine Ratio, U Yes, (order CDUCR) Yes
HGCU Mercury/Creatinine Ratio, U Yes, (order HGUCR) Yes
PBCU Lead/Creatinine Ratio, U Yes, (order PBUCR) Yes
CRETR Creatinine, Random, U No Yes

Reflex Tests

Test ID Reporting Name Available Separately Always Performed
SPAS Arsenic Speciation, Random, U Yes No

Testing Algorithm

If the total arsenic concentration is 10 mcg/L or greater, then speciation will be performed at an additional charge.

 

For more information see Porphyria (Acute) Testing Algorithm

Method Name

ASCU, CDCU, HGCU, PBCU: Triple-Quadrupole Inductively Coupled Plasma Mass Spectrometry (ICP-MS/MS)

CRETR: Colorimetric

Reporting Name

Heavy Metal/Creat Ratio,w/Reflex,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

  All specimens will be evaluated at Mayo Clinic Laboratories for test suitability.

Reference Values

ARSENIC/CREATININE:

<18 years: Not established

≥18 years: <24 mcg/g creatinine

 

CADMIUM/CREATININE:

<18 years: Not established

≥18 years: <0.6 mcg/g creatinine

 

MERCURY/CREATININE:

<18 years: Not established

≥18 years: <2 mcg/g creatinine

 

LEAD/CREATININE:

<18 years: Not established

≥18 years: <2 mcg/g creatinine

 

CREATININE:

<18 years: Not established

≥18 years: 16-326 mg/dL

Method Description

Arsenic, Cadmium, Mercury, Lead:

The metal analytes of interest are analyzed by triple-quadrupole inductively coupled plasma mass spectrometry.(Unpublished Mayo method)

 

Creatinine:

This enzymatic method is based on the conversion of creatinine with the aid of creatininase, creatinase, and sarcosine oxidase to form glycine, formaldehyde, and hydrogen peroxide. Catalyzed by peroxidase the liberated hydrogen peroxide reacts with 4-aminophenazone and HTIB (2,4,6-triiodo03-hydroxybenzoic acid) to form a quinone imine chromogen. The color intensity of the quinone imine chromogen formed is directly proportional to the creatinine concentration in the reaction mixture.(Package insert: Creatinine plus ver.2. Roche Diagnostics; 07/2024)

Performing Laboratory

Mayo Clinic Laboratories in Rochester

CPT Code Information

82175

82300

83825

83655

82570

LOINC Code Information

Test ID Test Order Name Order LOINC Value
HMUCR Heavy Metal/Creat Ratio,w/Reflex,U 29589-9

 

Result ID Test Result Name Result LOINC Value
608902 Cadmium/Creatinine Ratio, U 13471-8
608903 Mercury/Creatinine Ratio, U 13465-0
608904 Lead/Creatinine Ratio, U 13466-8
CRETR Creatinine, Random, U 2161-8
608900 Arsenic/Creatinine Ratio, U 13463-5
608901 Total Arsenic Concentration 5586-3

Day(s) Performed

Monday through Friday