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Test Name:
Heavy Metals, Urine, 24-Hour
- SBMF No:
23263 - Performance Lab Name:
Manual Lab - Test Mnemonic:
U HEAVY24- - ABN:
Not required - CPT Code:
82175; 82300; 83655; 83825 - LOINC Code:
20624-3; 2162-6; 19150-2; 3167-4; 13362-9; 5587-1; 6693-6; 5677-0; 5612-7 - Test Includes:
Heavy Metals (Arsenic, Cadmium, Mercury, Lead)
Creatinine - Also Known As:
Arsenic (As)
Cadmium (Cd)
Lead (Pb)
Mercury (Hg) - Also See:
23260 Arsenic, 24-Hour Urine
23259 Cadmium, 24-Hour Urine
23262 Lead, 24-Hour Urine
23261 Mercury, 24-Hour Urine - Spec Type:
Urine, 24-hour - Spec Container:
Plastic, metal-free container with tightly fitting lid
IMPORTANT: Prior to collection, add 20.0 mL 6N Hydrochloric Acid as preservative - Pref Vol:
80.0 mL aliquot from well-mixed 24-hour collection
Note: Send urine aliquot with notation of 24-hour volume on aliquot label and on requisition - Fasting:
No - Patient Prep:
Avoid ingestion of seafood for 48 hours before specimen collected
Instruct patient to avoid contact with preservative in container
Patient must not void directly into container
Instruct patient to store container securely away from children - Spec Collect:
Do not collect urine in metal urinals, pans, or metal-based container
To begin collection of timed specimen, have patient urinate, noting date and exact time
Discard first portion of urine, but document date and time of voiding on container label and test requisition as "start" of timed specimen
Save all urine voided during designated time period, including portion voided at exact end of time period
Refrigerate entire specimen (2-8°C) throughout collection
Document date and time of final voiding on label and requisition as "end" of timed specimen - Spec Process:
Upon completion of collection, mix entire specimen well and note 24-hour volume (do not pour into separate measuring container unless it has been determined to be trace metal-free)
Pour 80.0 mL of urine into separate plastic, trace metal-free container
Refrigerate urine aliquot and transport refrigerated
Send urine aliquot with notation of 24-hour urine volume on aliquot label and on requisition - Spec Store Transport:
Refrigerated - Spec Stability:
1 week refrigerated (2-8°C) - Spec Reject:
Specimen in contact with metal during collection - Spec Remarks:
24-hour urine sample optimal for heavy metal testing - Methodology:
Inductively Coupled Plasma-Mass Spectrometry (ICP-MS) - Use:
Screen for heavy metal poisoning and toxic exposure - Clinical Significance:
The level of trace elements in human body fluids is of great importance for the diagnosis and treatment of a patient’s condition. It is also crucial to monitor individuals who may be exposed to high levels of toxins, such as lead and arsenic. - Reference Range:
Lead:
– Reference Range: 0-80 µg/day
– Industrial Exposure: 0-120 µg/day
– Excessive: 60-400 µg/day
– Toxic: greater than 400 µg/day
Note: Urine lead levels may not correlate with clinical symptoms of lead toxicity or blood lead levels.
A normal urine lead may be observed in lead poisoning.
A whole blood lead test is preferred for lead poisoning.
Mercury:
– Expected value: less than 20 µg/day
– Possible Toxic concentration: greater than 50 µg/day
Note: The concentration at which toxicity is expressed is widely variable between patients
– 50 µg/L is the lowest concentration at which toxicity is usually apparent.
Arsenic:
– Reference Range: 0-50 µg/day
– High Arsenic (seafood) Diet 0-300 µg/day
– Industrial Exposure: 0-1000 µg/day
Cadmium:
– Reference Range: less than 3 µg/day
– Excessive Exposure: greater than 3.0 µg/day
– Severe Exposure : greater than 15 µg/day - Additional Test Info:
Record total specimen volume, collection times, and pH [if required] on test requisition - Day Run:
Mon, Thu - Time Run:
6:00 am - Time Reported:
5:00 pm - Test Type:
CHEMISTRY
