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
Method Name
A short description of the method used to perform the test
Triple-Quadrupole Inductively Coupled Plasma Mass Spectrometry (ICP-MS/MS)
NY State Available
Indicates the status of NY State approval and if the test is orderable for NY State clients.
Reporting Name
Lists a shorter or abbreviated version of the Published Name for a test
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
Ordering 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.
ORDER QUESTIONS AND ANSWERS
| Question ID | Description | Answers |
|---|---|---|
| TIME7 | Collection Duration (h) | |
| VL83 | Volume (mL) |
Specimen Required
Defines the optimal specimen required to perform the test and the preferred volume to complete testing
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 potentially interfere with most inductively coupled plasma mass spectrometry-based 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.
Special Instructions
Library of PDFs including pertinent information and forms related to the test
Urine Preservative Collection Options
Note: The addition of preservative or application of temperature controls must occur within 4 hours of completion of the collection.
| Ambient (no additive) | OK |
| Refrigerate (no additive) | Preferred |
| Frozen (no additive) | OK |
| 50% Acetic Acid | OK |
| Boric Acid | No |
| Diazolidinyl Urea | No |
| 6M Hydrochloric Acid | OK |
| 6M Nitric Acid | OK |
| Sodium Carbonate | No |
| Thymol | No |
| Toluene | No |
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
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 | |
| Ambient | 28 days | ||
| Frozen | 28 days |
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; kidney dysfunction with proteinuria and a 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 men and women.
The concentration of cadmium in the kidneys and urine is elevated in some patients exposed to cadmium.
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 h
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, OSHA cadmium standard is less than 3.0 mcg/g creatinine, and the biological exposure index is 5.0 mcg/g creatinine.
Collection of urine over 24 hours minimizes fluctuations of observed cadmium concentrations in random urine samples.
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. 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
Describes how the test is performed and provides a method-specific reference
The metal of interest is analyzed by triple-quadrupole inductively coupled plasma mass spectrometry.(Unpublished Mayo method)
PDF Report
Indicates whether the report includes an additional document with charts, images or other enriched information
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.
Specimen Retention Time
Outlines the length of time after testing that a specimen is kept in the laboratory before it is discarded
Performing Laboratory Location
Indicates the location of the laboratory that performs the test
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.
CPT codes are provided by the performing laboratory.
82300
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 |
|---|---|---|
| CDU | Cadmium, 24 Hr, U | 5612-7 |
| 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.
|
|---|---|---|
| 31106 | Cadmium, 24 Hr, U | 5612-7 |
| TIME7 | Collection Duration (h) | 13362-9 |
| VL83 | Volume (mL) | 3167-4 |