Sign in →

Test Code CDUCR Cadmium/Creatinine Ratio, Random, Urine


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: 3 mL

Collection Instructions:

1. Collect urine a random urine specimen.

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


Secondary ID

608906

Useful For

Detecting exposure to cadmium, a toxic heavy metal, using random urine specimens

Profile Information

Test ID Reporting Name Available Separately Always Performed
CDCU Cadmium/Creatinine Ratio, U No Yes
CRETR Creatinine, Random, U No Yes

Method Name

CDCU: Inductively Coupled Plasma-Mass Spectrometry (ICP-MS)

CRETR: Enzymatic Colorimetric Assay

Reporting Name

Cadmium/Creat Ratio, Random,U

Specimen Type

Urine

Specimen Minimum Volume

1.5 mL

Specimen Stability Information

Specimen Type Temperature Time Special Container
Urine Refrigerated (preferred) 28 days
  Frozen  28 days
  Ambient  14 days

Reject Due To

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

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.

 

Chronic exposure to cadmium causes accumulated renal damage. The excretion of cadmium is proportional to creatinine except when renal damage has occurred. Renal damage due to cadmium exposure can be detected by increased cadmium excretion relative to creatinine.

 

The Occupational Safety and Health Administration (OSHA) mandated (Fed Reg 57:42,102-142,463, September 1992) that all monitoring of employees exposed to cadmium in the workplace should be done using the measurement of urine cadmium and creatinine, expressing the results of mcg of cadmium per gram of creatinine.

Reference Values

0-17 years: not established

≥18 years: <0.6 mcg/g creatinine

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.

Cautions

Collection of urine specimens through a catheter frequently results in elevated values, because rubber contains trace amounts of cadmium that are extracted as urine passes through the catheter.

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 control. Updated 9/2/2008. Accessed July 17, 2020. US Department of Labor 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. Available at www.atsdr.cdc.gov/ToxProfiles/tp5.pdf

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

Method Description

Cadmium (Cd) in urine is analyzed by inductively coupled plasma-mass spectrometry (ICP-MS) in kinetic energy discrimination (KED) mode using gallium (Ga), rhodium (Rh), and iridium (Ir) as internal standards and a 5% nitric acid salt matrix calibration.(Unpublished Mayo method)

Specimen Retention Time

14 days

Performing Laboratory

Mayo Clinic Laboratories in Rochester

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

82570

LOINC Code Information

Test ID Test Order Name Order LOINC Value
CDUCR Cadmium/Creat Ratio, Random,U In Process

 

Result ID Test Result Name Result LOINC Value
608902 Cadmium/Creatinine Ratio, U 13471-8
CRETR Creatinine, Random, U 2161-8