Test Catalog

Test ID: NIS    
Nickel, Serum

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

Confirmation of an elevated urinary nickel concentration


This test is not useful for the investigation of nickel hypersensitivity.

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

Nickel (Ni) is a highly abundant element with a silvery-white appearance. Nickel is frequently combined with other metals to form alloys and is essential for the catalytic activity of some plant and bacterial enzymes but has no known role in humans.


Nickel and its compounds have no characteristic odor or taste. Ni compounds are used for Ni plating, to color ceramics, to make some batteries, and as substances known as catalysts that increase the rate of chemical reactions. One of the most toxic Ni compounds is nickel carbonyl, Ni(CO)4, which is used as a catalyst in petroleum refining and in the plastics industry, is frequently employed in the production of metal alloys (which are popular for their anticorrosive and hardness properties), in nickel-cadmium rechargeable batteries, and is used as a catalyst in hydrogenation of oils. Ni(CO)4 is very toxic.


Occupational exposure to Ni occurs primarily via inhalation of Ni compounds. Inhalation of dust high in Ni content has been associated with development of lung and nasal cancer.


Food is the major source of exposure to Ni. Foods naturally high in Ni include chocolate, soybeans, nuts, and oatmeal. Individuals may also be exposed to nickel by breathing air, drinking water, or smoking tobacco containing Ni. Stainless steel and coins contain Ni. Some jewelry is plated with Ni or made from Ni alloys. Patients may be exposed to Ni in artificial body parts made from Ni-containing alloys.


The most common harmful health effect of Ni in humans is an allergic reaction. Approximately 10% to 20% of the population is sensitive to Ni. The most serious harmful health effects from exposure to Ni, such as chronic bronchitis, reduced lung function, and cancer of the lung and nasal sinus, have occurred in people who have breathed dust containing certain Ni compounds while working in Ni refineries or nickel-processing plants.


Urine is the specimen of choice for the determination of Ni exposure but serum concentrations can be used to verify an elevated urine concentration.


Patients undergoing dialysis are exposed to Ni and accumulate Ni in blood and other organs; there appear to be no adverse health effects from this exposure. Hypernickelemia has been observed in patients undergoing renal dialysis. At the present time, this is considered to be an incidental finding as no correlation with toxic events has been identified. Routine monitoring of patients undergoing dialysis is currently not recommended.

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.

<2.0 ng/mL

Interpretation Provides information to assist in interpretation of the test results

Values 2.0 ng/mL and higher represent possible environmental or occupational exposure to nickel (Ni).


Toxic Ni concentrations are greater or equal to 10 ng/mL.


Normal Ni values are based on a Mayo Clinic study using healthy volunteers. Toxic values have been deduced from observation and unpublished internal study.


Clinical concern about Ni toxicity should be limited to patients with potential for exposure to toxic Ni compounds. Hypernickelemia, in the absence of exposure, may be an incidental finding or could be due to specimen contamination.

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

This test cannot determine the source compound (eg, nickel sulfate) responsible for the exposure.


Specimen collection procedures for nickel require special collection containers, rigorous attention to ultraclean specimen collection and handling procedures, and analysis in an ultraclean facility. Unless all of these procedures are followed, increased urinary nickel results may be an incidental and misleading finding.

Clinical Reference Recommendations for in-depth reading of a clinical nature

1. Novelli EL, Rodrigues NL, Ribas BO: Superoxide radical and toxicity of environmental nickel exposure. Hum Exp Toxicol 1995;14:248-251

2. Nixon DE, Moyer TP, Squillace DP, McCarthy JT: Determination of serum nickel by graphite furnace atomic absorption spectrometry with Zeeman-effect background correction: values in a normal population and a population undergoing dialysis. Analyst 1989;114:1671-1674

3. US Department of Health and Human Services: Toxicological profile for nickel. Agency for Toxic Substances and Disease Registry. 2005 Accessed: 03/2020. Available at: https://www.atsdr.cdc.gov/ToxProfiles/tp15.pdf

4. Tietz Textbook of Clinical Chemistry and Molecular Diagnostics Sixth edition. Edited by N Rifai, AR Horvath, CT Wittwer. Elsevier, 2018

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