Ordering Recommendation

May be useful in the assessment of acute exposure.

Mnemonic
COBALT U
Methodology

Quantitative Inductively Coupled Plasma-Mass Spectrometry

Performed

Sun-Sat

Reported

1-5 days

New York DOH Approval Status
This test is New York DOH 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

Reference Interval
Test Number
Components
Reference Interval
  Cobalt, Urine - per volume Effective August 21, 2017
0.0-1.2 µg/L
  Cobalt, Urine - per 24h Effective August 21, 2017
0.0-4.4 µg/d
0020473 Creatinine, Urine - per 24h
Age
Male
Female
3-8 years 140-700 mg/d 140-700 mg/d
9-12 years 300-1300 mg/d 300-1300 mg/d
13-17 years 500-2300 mg/d 400-1600 mg/d
18-50 years 1000-2500 mg/d 700-1600 mg/d
51-80 years 800-2100 mg/d 500-1400 mg/d
81 years and older 600-2000 mg/d 400-1300 mg/d

  Cobalt, Urine - ratio to CRT Effective August 21, 2017
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.

Compliance Statement B: For laboratory developed tests not using a RUO kit, and for FDA approved, cleared or 510(k) exempt assays with alterations. 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
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