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Test ID: CDU Cadmium, 24 Hour, Urine

Reporting Name

Cadmium, 24 Hr, U

Useful For

Detecting exposure to cadmium, a toxic heavy metal in 24-hour urine specimens

Clinical Information

The toxicity of cadmium resembles the other heavy metals (arsenic, mercury, and lead) in that it attacks the kidney; renal dysfunction with proteinuria with slow onset (over a period of years) is the typical presentation. Measurable changes in proximal tubule function, such as decreased clearance of para-aminohippuric acid also occur over a period of years, and precede overt renal failure.

 

Breathing the fumes of cadmium vapors leads to nasal epithelial deterioration and pulmonary congestion resembling chronic emphysema.

 

For nonsmokers, the primary source of cadmium exposure is from the food supply. In general, leafy vegetables such as lettuce and spinach, potatoes and grains, peanuts, soybeans, and sunflower seeds contain high levels of cadmium. For smokers, the most common source of cadmium exposure is tobacco smoke, which has been implicated as the primary sources of the metal leading to reproductive toxicity in both males and females.

 

The concentration of cadmium in the kidneys and in the urine is elevated in some patients exposed to cadmium.

 

See also CDUOE / Cadmium, Occupational Exposure, Random, Urine. If employees are being monitored in the workplace, the Occupational Safety and Health Administration (OSHA) requires that laboratory reports express the cadmium excretion rate per gram of creatinine rather than per 24 hours. This alternative test is available to accommodate that requirement. Mayo Clinic Laboratories is certified to provide this test.

Interpretation

Urine cadmium levels primarily reflect total body burden of cadmium. Cadmium excretion above 3.0 mcg/g creatinine indicates significant exposure to cadmium.

 

For occupational testing, the Occupational Safety and Health Administration (OSHA) cadmium standard is less than 3.0 mcg/g creatine and the biological exposure index is 5 mcg/g creatinine.

Analytic Time

1 day

Day(s) and Time(s) Performed

Monday through Saturday; 7 p.m.

Clinical Reference

1. deBurbure C, Buchet J-P, Leroyer A, et al: Renal and neurologic effects of cadmium, lead, mercury, and arsenic in children: Evidence of early effects and multiple interactions at environmental exposure levels. Environ Health Perspect. 2006;114:584-590

2. Schulz C, Angerer J, Ewers U, et al: Revised and new reference values for environmental pollutants in urine or blood of children in Germany derived from the German Environmental Survey on Children 2003-2006(GerESIV) Int J Hyg Environ Health. 2009;212:637-647

3. Occupational Safety and Health Administration:: Cadmium exposure and controls. US Department of Labor Updated 9/2/2008. Accessed July 17, 2020. Available at osha.gov/SLTC/cadmium/evaluation.html

4. Agency for Toxic Substances and Disease Registry: Toxicological profile for cadmium. US Department of Health and Human Services. September 2012. Avaliable at www.atsdr.cdc.gov/ToxProfiles/tp5.pdf

5. Strathmann FG, Blum LM: Toxic elements. In: Rafai N, Horwath AR., Wittwer CT, eds. Tietz Textbook of Clinical Chemistry and Molecular Diagnostics. 6th ed. Elsevier; 2018:chap 42

Method Name

Inductively Coupled Plasma-Mass Spectrometry (ICP-MS)

Specimen Type

Urine


Necessary Information


24 Hour volume is required.



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.

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: 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.


Specimen Minimum Volume

2 mL

Specimen Stability Information

Specimen Type Temperature Time Special Container
Urine Refrigerated (preferred) 28 days
  Ambient  28 days
  Frozen  28 days

Reference Values

0-17 years: not established

≥18 years: <0.7 mcg/24 hour

Test Classification

This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. This test has not been cleared or approved by the U.S. Food and Drug Administration.

CPT Code Information

82300

LOINC Code Information

Test ID Test Order Name Order LOINC Value
CDU Cadmium, 24 Hr, U 5612-7

 

Result ID Test Result Name Result LOINC Value
31106 Cadmium, 24 Hr, U 5612-7
TIME7 Collection Duration 13362-9
VL83 Total Volume 3167-4

Urine Preservative Collection Options

Note: The addition of preservative or application of temperature controls must occur within 4 hours of completion of the collection.

Ambient

OK

Refrigerate

Preferred

Frozen

OK

50% Acetic Acid

OK

Boric Acid

No

Diazolidinyl Urea

No

6M Hydrochloric Acid

OK

6M Nitric Acid

OK

Sodium Carbonate

No

Thymol

No

Toluene

No

Mayo Clinic Laboratories | Neurology Catalog Additional Information:

mml-Neuromuscular