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Epic Code LAB1230732 Mercury/Creatinine Ratio, Random, Urine

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Useful For

Detecting mercury toxicity, a toxic heavy metal, using random urine specimens

Specimen Type

Urine


Specimen Required


Patient Preparation: High concentrations of gadolinium and iodine are known to interfere with most metals 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 Trace Metals Analysis Specimen Collection and Transport in Special Instructions for complete instructions.


Specimen Minimum Volume

1.5 mL

Specimen Stability Information

Specimen Type Temperature Time Special Container
Urine Refrigerated (preferred) 7 days
  Frozen  7 days

Reject Due To

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

Cautions

To avoid contamination by dust, specimen should be collected away from the site of suspected exposure.

Clinical Information

The correlation between the levels of mercury (Hg) excretion in the urine and the clinical symptoms is considered poor.

 

It had always been thought that urine was a more appropriate marker of inorganic mercury, because organic mercury represented only a small fraction of urinary mercury. Based on possible demethylation of methylmercury within the body, urine may represent a mixture of dietary methylmercury and inorganic mercury. Seafood consumption can contribute to urinary mercury levels (up to 30%),(1) which is consistent with the suggestion that due to demethylation processes in the human body, a certain proportion of urinary mercury can originate from dietary consumption of fish/seafood.(2)

 

For additional information, see HG / Mercury, Blood.

Method Name

HGCU: Inductively Coupled Plasma-Mass Spectrometry (ICP-MS)

CRETR: Enzymatic Colorimetric Assay

Report Available

1 to 3 days

Reporting Name

Mercury/Creat Ratio, Random,U

Reference Values

0-17 years: not established

≥18 years: <2 mcg/g creatinine

Interpretation

Daily urine excretion of mercury above 50 mcg/day indicates significant exposure (per World Health Organization standard).

Method Description

Mercury(Hg) in urine is analyzed by inductively coupled plasma-mass spectrometry (ICP-MS) in kinetic energy discrimination (KED) mode using gallium (Ga), rhodium (Rh), and iridium (Ir) as internal standards and a 5% nitric acid salt matrix calibration.(Unpublished Mayo method)

Day(s) Performed

Monday through Friday

Clinical Reference

1.  Snoj Tratniid J, Falnoga I, Mazej D, et al. Results of the first national human biomonitoring in Slovenia: Trace elements in men and lactating women, predictors of exposure and reference values Int. J. Hyg Environ Health. 2019;222(3):563-582.

2. Sherman LS, Blum JD, Franzblau A, Basu N: New insights into biomarkers of human mercury exposure using naturally occurring mercury stable isotopes. Envrn Sci and Tech. 2013;47(7):3403-3409.

3. Lee R, Middleton D, Caldwell K, et al. A review of events that expose children to elemental mercury in the United States. Environ Health Perspect. 2009 Jun;117(6):871-878

4. Bjorkman L, Lundekvam BF, Laegreid T, et al: Mercury in human brain, blood, muscle and toenails in relation to exposure: an autopsy study. Environ Health. 2007 Oct 11;6:30

Test Classification

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

83825

82570

LOINC Code Information

Test ID Test Order Name Order LOINC Value
HGUCR Mercury/Creat Ratio, Random,U 13465-0

 

Result ID Test Result Name Result LOINC Value
608903 Mercury/Creatinine Ratio, U 13465-0
CRETR Creatinine, Random, U 2161-8

Profile Information

Test ID Reporting Name Available Separately Always Performed
HGCU Mercury/Creatinine Ratio, U No Yes
CRETR Creatinine, Random, U No Yes