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HelpEPIC ORDER CODE LAB370 Cadmium, 24 Hour, Urine
Additional Codes
SQ: UCD24M
Reporting Name
Cadmium, 24 Hr, UUseful For
Detecting exposure to cadmium, a toxic heavy metal, in 24-hour urine specimens
Performing Laboratory
Mayo Clinic Laboratories in Rochester
Specimen Type
UrineOrdering Guidance
If employees are being monitored in the workplace, OSHA requires that laboratory reports express the cadmium excretion rate per gram of creatinine rather than per 24 hours. Order CDUOE / Cadmium, Occupational Exposure, Random, Urine to accommodate that requirement. Mayo Clinic Laboratories is certified to provide this test.
Necessary Information
24-Hour volume (in milliliters) is required.
Specimen Required
Patient Preparation:
1. For the 48-hour period prior to start of collection, as well as during the collection, patient should not eat seafood.
2. High concentrations of gadolinium and iodine are known to interfere with most 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: 3 mL
Collection Instructions:
1. Collect urine for 24 hours.
2. Refrigerate specimen within 4 hours of completion of 24-hour collection.
3. See Metals Analysis Specimen Collection and Transport for complete instructions.
Additional Information: See Urine Preservatives-Collection and Transportation for 24-Hour Urine Specimens for multiple collections.
Specimen Minimum Volume
1.5 mL
Specimen Stability Information
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Urine | Refrigerated (preferred) | 28 days | |
| Ambient | 28 days | ||
| Frozen | 28 days |
Special Instructions
Reference Values
0-17 years: Not established
≥18 years: <0.7 mcg/24 h
Day(s) Performed
Monday through Friday
Test Classification
This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. It has not been cleared or approved by the US 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 |
Clinical Information
The toxicity of cadmium resembles the other heavy metals (arsenic, mercury, and lead) in that it attacks the kidney; kidney 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 kidney 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.
Clinical Reference
1. de Burbure C, Buchet JP, 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(4):584-590
2. Schulz C, Angerer J, Ewers U, Heudorf U, Wilhelm M; Human Biomonitoring Commission of the German Federal Environment Agency. 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(6):637-647
3. Occupational Safety and Health Administration. Cadmium exposure and control. Updated 09/02/2008. Accessed August 30, 2024. 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, Chiu RWK, Young I, Burnham CD, Wittwer CT, eds. Tietz Textbook of Laboratory Medicine. 7th ed. Elsevier; 2023:chap 44
6. Zhang H, Reynolds M. Cadmium exposure in living organisms: A short review. Sci Total Environ. 2019;678:761-767. doi:10.1016/j.scitotenv.2019.04.395
Method Description
The metal of interest is analyzed by triple-quadrupole inductively coupled plasma mass spectrometry.(Unpublished Mayo method)
Report Available
1 to 3 daysSpecimen Retention Time
14 daysReject Due To
All specimens will be evaluated at Mayo Clinic Laboratories for test suitability.Method Name
Triple-Quadrupole Inductively Coupled Plasma Mass Spectrometry (ICP-MS/MS)
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, OSHA cadmium standard is less than 3.0 mcg/g creatinine and, the biological exposure index is 5 mcg/g creatinine.
Collection of urine over 24 hours minimizes fluctuations of observed cadmium concentrations in random urine samples.