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Test ID: CDU    
Cadmium, 24 Hour, Urine

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

Detecting exposure to cadmium, a toxic heavy metal in 24-hour 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; 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.

 

The concentration of cadmium in the kidneys and in the urine is elevated in some patients exposed to cadmium.

 

See also CDUOE / Cadmium, Occupational Exposure, Random, Urine. If employees are being monitored in the workplace, the Occupational Safety and Health Administration (OSHA) requires that laboratory reports express the cadmium excretion rate per gram of creatinine rather than per 24 hours. This alternative test is available to accommodate that requirement. Mayo Clinic Laboratories is certified to provide this test.

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.

0-17 years: not established

> or =18 years: <0.7 mcg/24 hour

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 (OSHA) cadmium standard is less than 3.0 mcg/g creatine 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;114:584-590

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 controls. 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. Avaliable at www.atsdr.cdc.gov/ToxProfiles/tp5.pdf

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

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