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Heavy Metals Panel 6, Urine with Reflex to Arsenic Fractionated
Ordering Recommendation
Useful in the assessment of acute and chronic exposure to arsenic, cadmium, copper, mercury, lead, and zinc. The preferred test for the assessment of lead exposure is Lead, Blood (Venous) (0020098). For occupational exposure, consider Lead, Industrial Exposure Panel, Adults (0025016) and/or Cadmium Exposure Panel - OSHA (0025013).
New York DOH Approval Status
Specimen Required
Diet, medication, and nutritional supplements may introduce interfering substances. Patients should be encouraged to discontinue nutritional supplements, vitamins, minerals, non-essential over-the-counter medications (upon the advice of their physician), and avoid shellfish and seafood for 48 to 72 hours. 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.
24 Hour Urine. Refrigerate during collection. Specimen must be collected in a plastic container. Also acceptable: Random Urine.
Transfer 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: 2 mL)
Refrigerated. Also acceptable: Room temperature or frozen.
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.
Trace Elements requisition form may be required (ARUP form #32990-Barcode; #32991-No Barcode). Record total volume and collection time interval on transport tube and on test request form.
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 |
|||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Copper, Urine - per volume | Less than or equal to 3.2 µg/dL | ||||||||||||||||||||||
| Copper, Urine - per 24h | 3.0-45.0 µg/d | ||||||||||||||||||||||
| Zinc, Urine - per volume | 15.0-120.0 µg/dL | ||||||||||||||||||||||
| Zinc, Urine - per 24h | 150.0-1200.0 µg/d | ||||||||||||||||||||||
| Creatinine, Urine - per 24h |
|
||||||||||||||||||||||
| Arsenic Urine - per volume | 0.0-34.9 µg/L | ||||||||||||||||||||||
| Arsenic Urine - per 24h | 0.0-49.9 µg/d | ||||||||||||||||||||||
| Cadmium, Urine - ratio to CRT | 0.0-3.2 µg/g CRT | ||||||||||||||||||||||
| Cadmium, Urine - per 24h | 0.0-3.2 µg/d | ||||||||||||||||||||||
| Cadmium, Urine - per volume | 0.0-1.0 µg/L | ||||||||||||||||||||||
| Mercury, Urine - per 24h | 0.0-20.0 µg/d | ||||||||||||||||||||||
| Mercury, Urine - per volume | 0.0-5.0 µg/L | ||||||||||||||||||||||
| Mercury, Urine - ratio to CRT | 0.0-20.0 µg/g CRT | ||||||||||||||||||||||
| Arsenic, Urine - ratio to CRT | 0.0-29.9 µg/g CRT | ||||||||||||||||||||||
| Lead, Urine - per 24h | 0.0-8.1 µg/d | ||||||||||||||||||||||
| Lead, Urine - per volume | 0.0-5.0 µg/L | ||||||||||||||||||||||
| Zinc, Urine - ratio to CRT | 110.0-750.0 µg/g CRT | ||||||||||||||||||||||
| Copper, Urine - ratio to CRT | 10.0-45.0 µg/g CRT | ||||||||||||||||||||||
| Lead, Urine - ratio to CRT | 0.0-5.0 µg/g CRT |
Interpretive Data
Refer to report
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.
Laboratory Developed Test (LDT)
Note
High concentrations of iodine or gadolinium may interfere with elemental testing. If total arsenic concentration is found to be elevated based on reference intervals, then Arsenic, Fractionated, will be added to determine the proportion of organic, inorganic, and methylated forms. Additional charges apply.
Hotline History
CPT Codes
82175; 82300; 82525; 83655; 83825; 84630; if reflexed, add 82175
Components
| Component Test Code* | Component Chart Name | LOINC |
|---|---|---|
| 0020100 | Copper, Urine - per volume | 5632-5 |
| 0020101 | Copper, Urine - per 24h | 5633-3 |
| 0020102 | Zinc, Urine - per volume | 21610-1 |
| 0020103 | Zinc, Urine - per 24h | 5765-3 |
| 0020207 | Creatinine, Urine - per volume | 2161-8 |
| 0020208 | Creatinine, Urine - per 24h | 2162-6 |
| 0025001 | Arsenic Urine - per volume | 5586-3 |
| 0025002 | Arsenic Urine - per 24h | 5587-1 |
| 0025038 | Cadmium, Urine - ratio to CRT | 13828-9 |
| 0025041 | Cadmium, Urine - per 24h | 5612-7 |
| 0025042 | Cadmium, Urine - per volume | 5611-9 |
| 0025051 | Mercury, Urine - per 24h | 6693-6 |
| 0025052 | Mercury, Urine - per volume | 5689-5 |
| 0025054 | Mercury, Urine - ratio to CRT | 13465-0 |
| 0025058 | Arsenic, Urine - ratio to CRT | 13463-5 |
| 0025061 | Lead, Urine - per 24h | 5677-0 |
| 0025062 | Lead, Urine - per volume | 5676-2 |
| 0025063 | Zinc, Urine - ratio to CRT | 27201-3 |
| 0025064 | Copper, Urine - ratio to CRT | 13829-7 |
| 0025065 | Lead, Urine - ratio to CRT | 13466-8 |
| 0097110 | Total Volume | 19153-6 |
| 0097111 | Hours Collected | 30211-7 |
Aliases
- Arsenic
- As fractionation
- Cadmium
- Cd
- Copper
- Cu
- heavy metals urine screen
- Hg
- Inorganic As
- Lead
- Mercury
- methylated As
- Organic As
- Pb
- Zinc
- Zn
