Test Catalog

Test Id : CDUCR

Order This Test

Cadmium/Creatinine Ratio, Random, Urine

Download
Overview

Test Catalog

Useful For
Suggests clinical disorders or settings where the test may be helpful

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

Profile Information
A profile is a group of laboratory tests that are ordered and performed together under a single Mayo Test ID. Profile information lists the test performed, inclusive of the test fee, when a profile is ordered and includes reporting names and individual availability.

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

Method Name
A short description of the method used to perform the test

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

CRETR: Enzymatic Colorimetric Assay

NY State Available
Indicates the status of NY State approval and if the test is orderable for NY State clients.

Yes

Reporting Name
Lists a shorter or abbreviated version of the Published Name for a test

Cadmium/Creat Ratio, Random,U

Aliases
Lists additional common names for a test, as an aid in searching

Cadmium (Cd)

Cd (Cadmium)

Specimen Type
Describes the specimen type validated for testing

Urine

Specimen Required
Defines the optimal specimen required to perform the test and the preferred volume to complete testing

Patient Preparation: 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 a random urine specimen.

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

Special Instructions
Library of PDFs including pertinent information and forms related to the test

Specimen Minimum Volume
Defines the amount of sample necessary to provide a clinically relevant result as determined by the testing laboratory. The minimum volume is sufficient for one attempt at testing.

1.5 mL

Reject Due To
Identifies specimen types and conditions that may cause the specimen to be rejected

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

Specimen Stability Information
Provides a description of the temperatures required to transport a specimen to the performing laboratory, alternate acceptable temperatures are also included

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

Useful For
Suggests clinical disorders or settings where the test may be helpful

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

Clinical Information
Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test

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 source of the metal leading to reproductive toxicity in both male and female patients.

 

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

 

Occupational Safety and Health Administration 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
Describes reference intervals and additional information for interpretation of test results. May include intervals based on age and sex when appropriate. Intervals are Mayo-derived, unless otherwise designated. If an interpretive report is provided, the reference value field will state this.

CADMIUM/CREATININE:

0-17 years: Not established

> or =18 years: <0.6 mcg/g creatinine

 

CREATININE:

> or =18 years: 16-326 mg/dL

Reference values have not been established for patients who are younger than 18 years of age.

Interpretation
Provides information to assist in interpretation of the test results

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 cadmium standard is less than 3.0 mcg/g creatinine, and the biological exposure index is 5 mcg/g creatinine.

Cautions
Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances

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
Recommendations for in-depth reading of a clinical nature

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(4):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(6):637-647

3. Occupational Safety and Health Administration: Cadmium exposure and control. 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. 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. Wang M, Chen Z, Song W, Hong D, Huang L, Li Y. A review on cadmium exposure in the population and intervention strategies against cadmium toxicity. Bull Environ Contam Toxicol. 2021;106(1):65-74. doi:10.1007/s00128-020-03088-1

Method Description
Describes how the test is performed and provides a method-specific reference

Cadmium:

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

 

Creatinine:

The enzymatic method is based on the determination of sarcosine from creatinine with the aid of creatininase, creatinase, and sarcosine oxidase. The liberated hydrogen peroxide is measured via a modified Trinder reaction using a colorimetric indicator. Optimization of the buffer system and the colorimetric indicator enables the creatinine concentration to be quantified both precisely and specifically.(Package insert: Creatinine plus ver 2. Roche Diagnostics; V15.0, 03/2019)

PDF Report
Indicates whether the report includes an additional document with charts, images or other enriched information

No

Day(s) Performed
Outlines the days the test is performed. This field reflects the day that the sample must be in the testing laboratory to begin the testing process and includes any specimen preparation and processing time before the test is performed. Some tests are listed as continuously performed, which means that assays are performed multiple times during the day.

Monday through Friday

Report Available
The interval of time (receipt of sample at Mayo Clinic Laboratories to results available) taking into account standard setup days and weekends. The first day is the time that it typically takes for a result to be available. The last day is the time it might take, accounting for any necessary repeated testing.

2 to 4 days

Specimen Retention Time
Outlines the length of time after testing that a specimen is kept in the laboratory before it is discarded

14 days

Performing Laboratory Location
Indicates the location of the laboratory that performs the test

Rochester

Fees
Several factors determine the fee charged to perform a test. Contact your U.S. or International Regional Manager for information about establishing a fee schedule or to learn more about resources to optimize test selection.

  • Authorized users can sign in to Test Prices for detailed fee information.
  • Clients without access to Test Prices can contact Customer Service 24 hours a day, seven days a week.
  • Prospective clients should contact their account representative. For assistance, contact Customer Service.

Test Classification
Provides information regarding the medical device classification for laboratory test kits and reagents. Tests may be classified as cleared or approved by the US Food and Drug Administration (FDA) and used per manufacturer instructions, or as products that do not undergo full FDA review and approval, and are then labeled as an Analyte Specific Reagent (ASR) product.

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
Provides guidance in determining the appropriate Current Procedural Terminology (CPT) code(s) information for each test or profile. The listed CPT codes reflect Mayo Clinic Laboratories interpretation of CPT coding requirements. It is the responsibility of each laboratory to determine correct CPT codes to use for billing.

CPT codes are provided by the performing laboratory.

82300

82570

LOINC® Information
Provides guidance in determining the Logical Observation Identifiers Names and Codes (LOINC) values for the order and results codes of this test. LOINC values are provided by the performing laboratory.

Test Id Test Order Name Order LOINC Value
CDUCR Cadmium/Creat Ratio, Random,U 13471-8
Result Id Test Result Name Result LOINC Value
Applies only to results expressed in units of measure originally reported by the performing laboratory. These values do not apply to results that are converted to other units of measure.
CRETR Creatinine, Random, U 2161-8
608902 Cadmium/Creatinine Ratio, U 13471-8

Test Setup Resources

Setup Files
Test setup information contains test file definition details to support order and result interfacing between Mayo Clinic Laboratories and your Laboratory Information System.

Excel | Pdf

Sample Reports
Normal and Abnormal sample reports are provided as references for report appearance.

Normal Reports | Abnormal Reports

SI Sample Reports
International System (SI) of Unit reports are provided for a limited number of tests. These reports are intended for international account use and are only available through MayoLINK accounts that have been defined to receive them.

SI Normal Reports | SI Abnormal Reports