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Chromium, Urine
0025068
Ordering Recommendation

Chromium urine levels may be used to monitor short term exposure. Preferred test for evaluating metal ion release from metal-on-metal joint arthroplasty is Chromium, Serum (0098830).

Mnemonic
CR-U
Methodology
Quantitative Inductively Coupled Plasma-Mass Spectrometry
Performed
Tue, Fri
Reported
1-5 days
New York DOH Approval Status
This test is New York DOH approved.
Submit With Order
ARUP Consult®
Disease Topics
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. Abstinence from iodine-containing medications or contrast agents for at least 1 month prior to collecting specimens for elemental testing is recommended. 
Collect
24-hour or random urine collection. Specimen must be collected in a plastic container. ARUP studies indicate that refrigeration of urine alone, during and after collection, preserves specimens adequately, if tested within 14 days of collection. 
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
Urine collected within 48 hours after administration of a gadolinium (Gd) containing contrast media (may occur with MRI studies). Acid preserved urine. Specimens contaminated with blood or fecal material. Specimens transported in non-trace element-free transport tube (with the exception of the original device). 
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 
Reference Interval
Test Number
Components
Reference Interval
 Chromium, Urine - per volume0.0-5.0 µg/L
 Chromium, Urine - per 24h0.0-6.0 µg/d
 Chromium, Urine - ratio to CRTNo reference interval (µg/g crt)
0020473Creatinine, 24-Hour Urine
Age
Male
Female
3-8 years140-700 mg/d140-700 mg/d
9-12 years300-1300 mg/d300-1300 mg/d
13-17 years500-2300 mg/d400-1600 mg/d
18-50 years1000-2500 mg/d700-1600 mg/d
51-80 years800-2100 mg/d500-1400 mg/d
81 years and older600-2000 mg/d400-1300 mg/d


Interpretive Data
Chromium urine levels can be used to monitor short term exposure. The form of chromium greatly influences distribution. Trivalent chromium resides in the plasma and is usually not of clinical importance. Hexavalent chromium is considered highly toxic. Symptoms associated with chromium toxicity vary based upon route of exposure and dose and may include dermatitis, impairment of pulmonary function, gastroenteritis, hepatic necrosis, bleeding, and acute tubular necrosis.

The ACGIH Biological Exposure Index for daily exposure of hexavalent chromium is an increase of 10 µg/gCRT between pre-shift and post-shift urine collections. The ACGIH Biological Exposure Index for long-and short-term hexavalent chromium is an end-of-shift concentration of 30 µg/gCRT at the end of the work week.

Compliance Statement B: This test was developed and its performance characteristics determined by ARUP Laboratories. The U.S. Food and Drug Administration has not approved or cleared this test; however, FDA clearance or approval is not currently required for clinical use. The results are not intended to be used as the sole means for clinical diagnosis or patient management decisions.

Note
CPT Code(s)
82495
Components
Component Test Code*Component Chart NameLOINC
0020207Creatinine, Urine - per volume2161-8
0020208Creatinine, Urine - per 24h2162-6
0025101Chromium, Urine - per 24h5624-2
0025102Chromium, Urine - ratio to CRT29919-8
0097110Total Volume19153-6
0097111Hours Collected30211-7
0099463Chromium, Urine - per volume21201-9
* 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
  • Cr
  • CRU
  • Urine chromium concentration