Test Catalog

Test Id : CRCRU

Chromium/Creatinine Ratio, Random, Urine

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

Detecting chromium exposure

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
CRCRR Chromium/Creat Ratio, U No Yes
CRETR Creatinine, Random, U No Yes

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

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

CRCRR: Inductively Coupled Plasma-Mass Spectrometry (ICP-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

Chromium/Creat Ratio, Random, U

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

Cr (Chromium)

Chromium (Cr)

Specimen Type
Describes the specimen type validated for testing

Urine

Ordering Guidance

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.

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

Supplies: Urine Tubes, 10 mL

Collection Container/Tube: Clean, plastic urine container with no metal cap or glued insert

Submission Container/Tube: Plastic vial or clean, plastic aliquot container with no metal cap or glued insert

Specimen Volume: 3 mL

Collection Instructions:

1. Collect a random urine specimen.

2. See Trace 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

0.7 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 chromium exposure

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

Chromium (Cr) has an atomic mass of 51.996, atomic number 24, and valences ranging from 2to 6(+). Hexavalent chromium, Cr(6+), and trivalent chromium, Cr(3+), are the 2 most prevalent forms. Cr(3+) is the only oxidation state present under normal physiologic conditions. Cr(6+) is widely used in industry to make chromium alloys including stainless steel pigments and electroplated coatings. Cr(6+), a known carcinogen, is rapidly metabolized to Cr(3+). Cr(3+) is the only form present in human urine.

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

>17 years: <0.8 mcg/g Creatinine

Interpretation
Provides information to assist in interpretation of the test results

Chromium is principally excreted in the urine. Results greater than the reference range indicate either recent exposure to chromium or specimen contamination during collection.

 

The National Institute for Occupational Safety and Health document on occupational exposure reviews the data supporting use of urine to assess chromium exposure. The biological exposure index (BEI) for total chromium in urine measured at the end of the shift at the end of the workweek is 25 mcg/L. The BEI for the increase in total chromium during a shift is 10 mcg/L. A test for this specific purpose (CRUO / Chromium Occupational Exposure, Random, Urine) is available.

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

Normal specimens have extremely low levels of creatinine; elevated results could easily be a result of external contamination. Precautions must be taken to ensure the specimen is not contaminated. Metal-free urine collection procedures must be followed. Refrigeration is preferred over chemical methods of preservation.

 

Specimen collection procedures for chromium require special specimen collection tubes, rigorous attention to ultraclean specimen collection and handling procedures, and analysis in an ultraclean facility. Unless all of these precautions are taken, elevated urine chromium results may be an incidental and misleading finding.

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

1. U.S. Department of Health and Human Services, Agency for Toxic Substances and Disease Registry. Toxicology profile for chromium. HHS; September 2012. Accessed 11/06/2020. Available at www.atsdr.cdc.gov/ToxProfiles/tp7.pdf

2. Roberts NB, Taylor A, Sodi R: Vitamins and trace elements. Rifai N, Horwath AR, Wittwer CT, eds: Tietz Textbook of Clinical Chemistry and Molecular Diagnostics. 6th ed. Elsevier; 2018:chap 37

3. Centers for Disease Control and Prevention: National Institute for Occupational Safety and Health (NIOSH): Criteria for a recommended standard occupational exposure to hexavalent chromium. CDC; September 2013. Accessed 11/06/2020. Available at www.cdc.gov/niosh/docs/2013-128/pdfs/2013_128.pdf

4. Gianello G, Masci O, Carelli G, Vinci F, Castellino N: Occupational exposure to chromium-an assessment of environmental pollution levels and biological monitoring of exposed workers. Ind Health. 1998 Jan;36(1):74-77. doi: 10.2486/indhealth.36.74.

5. Eliaz N. Corrosion of metallic biomaterials: A review. Materials (Basel). 2019 Jan 28;12(3):407. doi: 10.3390/ma12030407

6. US Food and Drug Administration: Information about Soft Tissue Imaging and Metal Ion Testing. FDA; Updated March 15, 2019. Accessed March 2, 2021. Available at: www.fda.gov/MedicalDevices/ProductsandMedicalProcedures/ImplantsandProsthetics/MetalonMetalHipImplants/ucm331971.htm

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

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

Chromium in urine is analyzed by inductively coupled plasma-mass spectrometry in dynamic reaction cell mode using rhodium as an internal standard and a salt matrix calibration.(Unpublished Mayo method)

 

Creatinine is measured using an enzymatic method 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.(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.

Tuesday, Wednesday, 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.

1 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 Regional Manager. 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. This test 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.

82495

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
CRCRU Chromium/Creat Ratio, Random, U 13464-3
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
607759 Chromium/Creat Ratio, U 13464-3

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