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HelpTest Code SOFT: Z1000 Nickel, 24 Hour, Urine
Additional Codes
| Ordering Mnemonic | Mayo Test ID |
|---|---|
| HOM: MISC LAB | NIU |
Reporting Name
Nickel, 24 Hr, UUseful For
Preferred test for biomonitoring patients for nickel exposure to minimize any potential diurnal variation
Method Name
Inductively Coupled Plasma-Mass Spectrometry (ICP-MS)
Performing Laboratory
Mayo Clinic Laboratories in Rochester
Specimen Type
UrineOrdering Guidance
This test is preferred for the determination of nickel exposure, but serum concentrations can be used to verify an elevated urine concentration. For more information see NIS / Nickel, Serum.
Necessary Information
24-Hour volume (in milliliters) is required.
Specimen Required
Patient Preparation: High concentrations of gadolinium and iodine are known to interfere with most metal tests. If gadolinium- or iodine-containing contrast media has been administered, a specimen should not be collected for 96 hours.
Supplies: Urine Tubes, 10 mL (T068)
Container/Tube: Plastic, 10-mL urine tube or clean, plastic aliquot container with no metal cap or glued insert
Specimen Volume: 0.5 mL
Collection Instructions:
1. Collect urine for 24 hours.
2. Refrigerate specimen within 4 hours of completion of 24-hour collection.
See Metals Analysis Specimen Collection and Transport for complete instructions.
Additional Information: See Urine Preservatives-Collection and Transportation for 24-Hour Urine Specimens for multiple collections.
Specimen Minimum Volume
0.3 mL
Specimen Stability Information
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Urine | Refrigerated (preferred) | 28 days | |
| Ambient | 28 days | ||
| Frozen | 28 days |
Reject Due To
All specimens will be evaluated at Mayo Clinic Laboratories for test suitability.Special Instructions
Reference Values
0-17 years: not established
≥18 years: <6.0 mcg/24h
Day(s) Performed
Thursday
CPT Code Information
83885
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| NIU | Nickel, 24 Hr, U | 5705-9 |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| 8626 | Nickel, 24 Hr, U | 5705-9 |
| TM18 | Collection Duration | 13362-9 |
| VL30 | Urine Volume | 3167-4 |
Test Classification
This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. It has not been cleared or approved by the US Food and Drug Administration.Clinical Information
Nickel (Ni) is a highly abundant element with a silvery-white appearance. Nickel is frequently combined with other metals to form alloys and is essential for the catalytic activity of some plant and bacterial enzymes (including in several pathogenic and symbiotic species in humans) but has no known role in humans. Most nickel is used to make stainless steel.
Nickel and its compounds have no characteristic odor or taste. Ni compounds are used for Ni plating, to color ceramics, to make some batteries, and as catalysts that increase the rate of chemical reactions. One of the most toxic nickel compounds is nickel carbonyl, Ni(CO)4, which is used as a catalyst in petroleum refining and in the plastics industry, is frequently employed in the production of metal alloys (which are popular for their anticorrosive and hardness properties), in nickel-cadmium rechargeable batteries, and is used as a catalyst in hydrogenation of oils. Ni(CO)4 is very toxic and is lipid-soluble, allowing it to cross cell membranes.
Occupational exposure to Ni occurs primarily via inhalation of Ni compounds. Inhalation of dust high in Ni content has been associated with development of lung and nasal cancer.
Food is the major source of exposure to Ni. Foods naturally high in Ni concentrations include chocolate, soybeans, nuts, and oatmeal. Individuals may also be exposed to Ni by breathing air, drinking water, or smoking tobacco containing Ni. Stainless steel and coins contain Ni. Some jewelry is plated with Ni or made from Ni alloys. Patients may be exposed to Ni in implanted devices including joint prostheses, sutures, clips, and screws made from Ni-containing alloys.
The most common harmful health effect of Ni in humans is an allergic reaction. Approximately 10% to 20% of the population is sensitive to Ni. The most serious harmful health effects from exposure to Ni, such as chronic bronchitis, reduced lung function, and cancer of the lung and nasal sinus, have occurred in people who have breathed dust containing certain Ni compounds while working in Ni refineries or nickel-processing plants.
Urine is the specimen of choice for the determination of Ni exposure, but serum concentrations can be used to verify an elevated urine concentration.
Patients undergoing dialysis are exposed to Ni and accumulate Ni in blood and other organs; there appear to be no adverse health effects from this exposure. Hypernickelemia has been observed in patients undergoing kidney dialysis. At the present time, this is considered to be an incidental finding as no correlation with toxic events has been identified. Routine monitoring of patients undergoing dialysis is currently not recommended.
Interpretation
Values of 6.0 mcg/24-hour specimen and higher represent possible environmental or occupational exposure.
Hypernickelemia, in the absence of exposure, may be an incidental finding or could be due to specimen contamination.
Cautions
Specimen collection procedures for nickel (Ni) require special collection containers, rigorous attention to ultraclean specimen collection and handling procedures, and analysis in an ultraclean facility. Unless all of these procedures are followed, increased urinary Ni results may be an incidental and misleading finding.
This test cannot determine the source compound (eg, Ni sulfate) responsible for the exposure.
Clinical Reference
1. Moreno ME, Acosta-Saavedra LC, Mez-Figueroa D, et al: Biomonitoring of metal in children living in a mine tailings zone in Southern Mexico: A pilot study. Int J Hyg Environ Health. 2010 Jul;213(4):252-258. doi: 10.1016/j.ijheh.2010.03.005
2. Schulz C, Angerer J, Ewers U, Heudorf U, Wilhelm M, Human Biomonitoring Commission of the German Federal Environment Agency: Revised and new reference values for environmental pollutants in urine or blood of children in Germany derived from the German Environmental Survey on Children 2003-2006 (GerES IV). Int J Hyg Environ Health. 2009 Nov;212(6):637-647. doi: 10.1016/j.ijheh.2009.05.003
3. US Department of Health and Human Services: Toxicological profile for nickel. Agency for Toxic Substances and Disease Registry. 2005 Accessed: March 2020. Available at: www.atsdr.cdc.gov/ToxProfiles/tp15.pdf
4. Rifai N, Horvath AR, Wittwer CT, eds: Tietz Textbook of Clinical Chemistry and Molecular Diagnostics. 6th ed. Elsevier; 2018
5. Zambelli B, Ciurli S: Nickel and human health. In: Sigel A, Sigel H, Sigel R, eds. Interrelations between Essential Metal Ions and Human Diseases. Metal Ions in Life Sciences. Vol 13. Springer, Dordrecht; 2013:321-357
Method Description
The metal of interest is analyzed by inductively coupled plasma mass spectrometry.(Unpublished Mayo method)