Ordering Recommendation

May be useful in the assessment of acute exposure.

New York DOH Approval Status

This test is New York state approved.

Specimen Required

Patient Preparation

Diet, medication, and nutritional supplements may introduce interfering substances. Patients should be encouraged to discontinue nutritional supplements, vitamins, minerals, and non-essential over-the-counter medications (upon the advice of their physician). High concentrations of iodine may interfere with elemental testing. Collection from patients receiving iodinated or gadolinium-based contrast media must be avoided for a minimum of 72 hours post-exposure. Collection from patients with impaired kidney function should be avoided for a minimum of 14 days post contrast media exposure.

Collect

24 Hour Urine. Refrigerate during collection. Specimen must be collected in a plastic container. Also acceptable: Random Urine.

Specimen Preparation

Transfer an 8 mL aliquot from a well-mixed collection to ARUP Trace Element-Free Transport Tubes (ARUP supply #43116) available online through eSupply using ARUP Connect™ or contact ARUP Client Services at (800) 522-2787. (Min: 1 mL)

Storage/Transport Temperature

Refrigerated. Also acceptable: Room temperature or frozen.

Unacceptable Conditions

Specimens collected within 72 hours after administration of iodinated or gadolinium-based contrast media. Acid preserved urine. Specimens transported in containers other than specified. Specimens contaminated with blood or fecal material.

Remarks

Record total volume and collection time interval on transport tube and on test request form.

Stability

Ambient: 1 week; Refrigerated: 2 weeks; Frozen: 1 year

Methodology

Quantitative Inductively Coupled Plasma-Mass Spectrometry

Performed

Sun-Sat

Reported

1-5 days

Reference Interval

Test Number
Components
Reference Interval
  Creatinine, Urine - per 24h
Age
Male (mg/d)
Female (mg/d)
3-8 years 140-700 140-700
9-12 years 300-1300 300-1300
13-17 years 500-2300 400-1600
18-50 years 1000-2500 700-1600
51-80 years 800-2100 500-1400
81 years and older 600-2000 400-1300

  Cobalt, Urine - per volume 0.0-1.2 µg/L
  Cobalt, Urine - per 24h 0.0-4.4 µg/d
  Cobalt, Urine - ratio to CRT 0.0-4.2 µg/g CRT

Interpretive Data

Cobalt urine levels can be used to monitor acute exposure as the reported half-life of cobalt is on the order of several days. Urine cobalt levels generally do not exceed 1.0 µg/L in the general population and are rarely used in the management of chronic exposure. Symptoms associated with cobalt toxicity vary based upon route of exposure and may include cardiomyopathy, allergic dermatitis, pulmonary fibrosis, cough and dyspnea.

Per 24h calculations are provided to aid interpretation for collections with a duration of 24 hours and an average daily urine volume. For specimens with notable deviations in collection time or volume, ratios of analytes to a corresponding urine creatinine concentration may assist in result interpretation.

This test was developed and its performance characteristics determined by ARUP Laboratories. It has not been cleared or approved by the US Food and Drug Administration. This test was performed in a CLIA certified laboratory and is intended for clinical purposes.

Compliance Category

Laboratory Developed Test (LDT)

Note

Hotline History

N/A

CPT Codes

83018

Components

Component Test Code* Component Chart Name LOINC
0020207 Creatinine, Urine - per volume 2161-8
0020208 Creatinine, Urine - per 24h 2162-6
0025033 Cobalt, Urine - per volume 21208-4
0025034 Cobalt, Urine - per 24h 29916-4
0025035 Cobalt, Urine - ratio to CRT 29934-7
0097110 Total Volume 19153-6
0097111 Hours Collected 30211-7
* Component test codes cannot be used to order tests. The information provided here is not sufficient for interface builds; for a complete test mix, please click the sidebar link to access the Interface Map.

Aliases

  • Co
  • Co Urine, Normalized
  • Cobalt, 24-Hour Urine
  • Cobalt/Creatinine, Random, Urine
  • COU
  • Normalized Urine Co
  • Normalized Urine Cobalt
  • Urine cobalt concentration
Cobalt, Urine