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Test Code ALU Aluminum, 24 Hour, Urine

Reporting Name

Aluminum, 24 Hr, U

Useful For

Monitoring aluminum exposure

 

Preferred matrix for assessment of exposure in patients with normal kidney function since rapidly filtered by kidneys

 

Monitoring metallic prosthetic implant wear

 

This test is not an acceptable substitute for serum aluminum measurements and is not recommended for routine aluminum screening.

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Specimen Type

Urine


Ordering Guidance


The recommended test for routine aluminum screening is AL / Aluminum, 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 either gadolinium- or iodine-containing contrast media has been administered, a specimen should not be collected for 96 hours.

Supplies: Urine Tubes, 10 mL (T068)

Collection Container/Tube: Clean, plastic urine container with no metal cap or glued insert

Submission Container/Tube: Plastic urine tube or clean, plastic aliquot container with no metal cap or glued insert

Specimen Volume: 10 mL

Collection Instructions:

1. Collect urine for 24 hours.

2. Refrigerate specimen within 4 hours of completion of 24-hour collection.

3. 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

Reference Values

0-17 years: Not established

≥18 years: <13 mcg/24 hours

Day(s) Performed

Tuesday

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.

CPT Code Information

82108

LOINC Code Information

Test ID Test Order Name Order LOINC Value
ALU Aluminum, 24 Hr, U 26707-0

 

Result ID Test Result Name Result LOINC Value
8828 Aluminum, 24 Hr, U 26707-0
TM15 Collection Duration 13362-9
VL13 Urine Volume 3167-4

Interpretation

Daily excretion greater than 10 mcg/24 hours indicates exposure to excessive amounts of aluminum. In kidney failure, the ability of the kidney to excrete aluminum decreases, while the exposure to aluminum increases (aluminum-laden dialysis water, aluminum-laden albumin, and aluminum-laden phosphate binders).

 

Patients receiving chelation therapy with desferrioxamine (for iron- or aluminum-overload states) also excrete considerably more aluminum in their urine than normal.

 

Prosthesis wear is known to result in increased circulating concentration of metal ions.(1) Modest increase (10-20 mcg/24 hours) in urine aluminum concentration is likely to be associated with a prosthetic device in good condition. Urine concentrations above 50 mcg/ 24 hours in a patient with an aluminum-based implant and not undergoing dialysis, suggests significant prosthesis wear. Increased urine trace element concentrations in the absence of corroborating clinical information do not independently predict prosthesis wear or failure.

Clinical Reference

1. Liu TK, Liu SH, Chang CH, Yang RS: Concentration of metal elements in the blood and urine in the patients with cementless total knee arthroplasty. Tohoku J Exp Med. 1998;185:253-262

2. O'Shea S, Johnson DW: Review article: Addressing risk factors in chronic kidney disease mineral and bone disorder: Can we influence patient-level outcomes? Nephrology. 2009;14:416-427

3. Meyer-Baron M, Schuper M, Knapp G, van Thriel C: Occupational aluminum exposure: Evidence in support of its neurobehavioral impact. NeuroToxicology. 2007;28:1068-1078

4. Strathmann FG, Blum LM: Toxic elements. In: Rifai N, Chiu RWK, Young I, Burnham CAD, Wittwer CT, eds. Tietz Textbook of Laboratory Medicine. 7th ed. Elsevier; 2023:455.e55

5. US Department of Health and Human Services, Agency for Toxic Substances and Disease Registry. Toxicological Profile for Aluminum. HHS; 2006. Accessed August 29, 2023. Available at www.atsdr.cdc.gov/toxprofiles/tp22.pdf

6. Willhite CC, Karyakina NA, Yokel RA, et al: Systematic review of potential health risks posed by pharmaceutical, occupational and consumer exposures to metallic and nanoscale aluminum, aluminum oxides, aluminum hydroxide, and its soluble salts. Crit Rev Toxicol. 2014;44 Suppl 4(Suppl 4):1-80. doi:10.3109/10408444.2014.934439

Report Available

2 to 8 days

Method Name

Dynamic Reaction Cell Inductively Coupled Plasma Mass Spectrometry (DRC-ICP-MS)