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Test Code PBRU Lead, Random, Urine

Performing Laboratory

Mayo Medical Laboratories in Rochester

Reporting Name

Lead, Random, U

Specimen Type

Urine


Specimen Required


Collection Container/Tube: Clean, plastic urine collection container

Submission Container/Tube: Plastic, 5-mL tube (T465) or a clean, plastic aliquot container with no metal cap or glued insert

Specimen Volume: 2 mL

Collection Instructions:

1. Collect a random urine specimen.

2. See Trace Metals Analysis Specimen Collection and Transport in Special Instructions for complete instructions.

Additional Information: 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.


Reject Due To

Hemolysis

NA

Lipemia

NA

Icterus

NA

Other

NA

Specimen Stability Information

Specimen Type Temperature Time
Urine Refrigerated (preferred) 28 days
  Ambient  28 days
  Frozen  28 days

Specimen Minimum Volume

2 mL

Day(s) and Time(s) Performed

Monday through Friday; 7 p.m., Saturday; 2 p.m.

Specimen Retention Time

14 days

Analytic Time

1 day

Reference Values

0-4 mcg/L

Reference values apply to all ages.

Useful For

Detecting clinically significant lead exposure

Method Name

Inductively Coupled Plasma-Mass Spectrometry (ICP-MS)

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 U.S. Food and Drug Administration.

CPT Code Information

83655

LOINC Code Information

Test ID Test Order Name Order LOINC Value
PBRU Lead, Random, U 5676-2

 

Result ID Test Result Name Result LOINC Value
60246 Lead, Random, U 5676-2

Clinical Information

Increased urine lead concentration indicates significant lead exposure.

 

Measurement of urine lead concentration before AND after chelation therapy has been used as an indicator of significant lead exposure. An increase in lead concentration in the postchelation specimen of up to 6 times the concentration in the prechelation specimen is normal. Blood lead is the best clinical correlate of toxicity.

 

For additional information, see PBBD / Lead with Demographics, Blood.

Interpretation

Urinary excretion of <4 mcg/L is not associated with any significant lead exposure.

 

Urinary excretion >4 mcg /L is usually associated with pallor, anemia, and other evidence of lead toxicity.

Cautions

This test is not a substitute for blood lead screening.

 

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.

Clinical Reference

1. Kosnett MJ, Wedeen RP, Rotherberg SJ, et al: Recommendations for medical management of adult lead exposure. Environ Health Perspect 2007;115:463-471

2. de Burbane C, Buchet JP, Leroyer A, et al: Renal and neurologic effects of cadmium, lead, mercury, and arsenic in children: evidence of early effects and multiple interactions at environmental exposure levels. Environ Health Perspect 2006;114:584-590

3. Pascal DC, Ting BG, Morrow JC, et al: Trace metals in urine of United States residents: reference range concentrations. Environ Res 1998;76(1):53-59

Method Description

This assay is performed on an inductively coupled plasma-mass spectrometer. Calibrating standards and blanks are diluted with an aqueous acidic diluent containing internal standard(s). Quality control specimens and patient samples are diluted in an identical manner. In turn, all diluted blanks, calibrating standards, quality control specimens and patient specimens are aspirated into a pneumatic nebulizer and the resulting aerosol directed to the hot plasma discharge by a flow of argon. In the annular plasma the aerosol is vaporized, atomized, then ionized. The ionized gases plus neutral species formed in the annular plasma space are aspirated from the plasma through an orifice into a quadrupole mass spectrometer. The mass range from 1 amu to 263 amu is rapidly scanned multiple times and ion counts tabulated for each mass of interest. Instrument response is defined by the linear relationship of analyte concentration vs. ion count ratio (analyte ion count/internal standard ion count). Analyte concentrations are derived by reading the ion count ratio for each mass of interest and determining the concentration from the response line.(Nixon DE, Moyer TP: Routine clinical determination of lead, arsenic, cadmium, and thallium in urine and whole blood by inductively coupled plasma mass spectrometry. Spectrochimica Acta Part B-Atomic Spectroscopy 1996;1:13-25)