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HelpTest Code CARU Cyclic Adenosine Monophosphate (cAMP), Urinary Excretion, Serum and Urine
Specimen Required
Both serum and urine are required. Serum must be collected at the time of the urine collection.
Specimen Type: Serum
Supplies: Sarstedt Aliquot Tube, 5 mL (T914)
Container/Tube:
Preferred: Serum gel
Acceptable: Red top
Submission Container/Tube: Plastic vial
Specimen Volume: 1 mL
Collection Instructions:
1. Within 2 hours of collection serum gel tubes should be centrifuged.
2. Within 2 hours of collection red-top tubes should be centrifuged, and the serum aliquoted into a plastic vial.
3. Label specimen as serum.
Specimen Type: Urine
Supplies: Sarstedt Aliquot Tube, 5 mL (T914)
Container/Tube: Plastic vial
Specimen Volume: 5 mL
Collection Instructions:
1. Collect a random urine specimen.
2. Label specimen as urine.
Useful For
Differential diagnosis of hypercalcemia
As an adjunct to serum parathyroid hormone measurements, especially in the diagnosis of parathyroid hormone resistance states, such as pseudohypoparathyroidism
Profile Information
| Test ID | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| ACREA | Creatinine, S | Yes, (order CRTS1) | Yes |
| CAMP | Cyclic Amp, Urinary Excretion | No | Yes |
| CRETR | Creatinine, Random, U | Yes, (order RCTUR) | Yes |
Method Name
ACREA, CRETR: Enzymatic Colorimetric Assay
CAMP: Liquid Chromatography-Tandem Mass Spectrometry (LC-MS/MS)
Reporting Name
Cyclic Amp, Urinary ExcretionSpecimen Type
SerumUrine
Specimen Minimum Volume
Serum: 0.5 mL
Urine: 1 mL
Specimen Stability Information
| Specimen Type | Temperature | Time |
|---|---|---|
| Serum | Refrigerated (preferred) | 7 days |
| Frozen | 90 days | |
| Urine | Refrigerated (preferred) | 28 days |
| Frozen | 28 days |
Reference Values
CYCLIC AMP
1.3-3.7 nmol/dL of glomerular filtrate
CREATININE, SERUM
Males
0-11 months: 0.17-0.42 mg/dL
1-5 years: 0.19-0.49 mg/dL
6-10 years: 0.26-0.61 mg/dL
11-14 years: 0.35-0.86 mg/dL
≥15 years: 0.74-1.35 mg/dL
Females
0-11 months: 0.17-0.42 mg/dL
1-5 years: 0.19-0.49 mg/dL
6-10 years: 0.26-0.61 mg/dL
11-15 years: 0.35-0.86 mg/dL
≥16 years: 0.59-1.04 mg/dL
CREATININE, URINE
No reference values apply. Interpret with other clinical data.
Interpretation
3'-5' -cyclic adenosine monophosphate (cAMP) is elevated in about 85% of patients with hyperparathyroidism and in about 50% of patients with humoral hypercalcemia of malignancy.
Minimal to no increase in cAMP levels following parathyroid hormone stimulation suggests type I pseudohypoparathyroidism.
Clinical Reference
1. Shaw JW, Oldham SB, Rosoff L, Bethune JE, Fichman MP. Urinary cyclic AMP analyzed as a function of the serum calcium and parathyroid hormone in the idfferential diagnosis of hypercalcemia. J Clin Invest. 1977;59(1):14-21. doi:10.1172/JCI108611
2. Babka JC, Bower RH, Sode J. Nephrogenous cyclic AMP levels in primary hyperparathyroidism. Arch Intern Med. 1976;136(10):1140-1144
3. Dohan PH, Yamashita K, Larsen PR, Davis B, Deftos L, Field JB. Evaluation of urinary cyclic 3'5'-adenosine monophosphate excretion in the differential diagnosis of hypercalcemia. J Clin Endocrinol Metab. 1972;35(6):775-784. doi:10.1210/jcem-35-6-775
4. Pak CY, Kaplan R, Bone H, Townsend J, Waters O. A simple test for the diagnosis of absorptive, resorptive and renal hypercalciurias. N Engl J Med. 1975;292(10):497-500. doi:10.1056/NEJM197503062921002
5. Neelon FA, Birch BM, Drezner M, Lebovitz HE. Urinary cyclic adenosine monophosphate as an aid in the diagnosis of hyperparathyroidism. Lancet. 1973;1(7804):631-633. doi:10.1016/s0140-6736(73)92199-5
6. Drezner MK, Neelon FA, Curtis HB, Lebovitz HE. Renal cyclic adenosine monophosphate: an accurate index of parathyroid function. Metabolism. 1976;25(10):1103-1112. doi:10.1016/0026-0495(76)90018-4
7. Delrue C, Speeckaert R, Moresco RN, Speeckaert MM. Cyclic Adenosine Monophosphate Signaling in Chronic Kidney Disease: Molecular Targets and Therapeutic Potentials. Int J Mol Sci. 2024;25(17):9441. doi:10.3390/ijms25179441
8. Kaminsky NI, Broadus AE, Hardman JG, et al. Effects of parathyroid hormone on plasma and urinary adenosine 3',5'-monophosphate in man. J Clin Invest. 1970;49(12):2387-95. doi:10.1172/JCI106458
9. Tze WJ, Saunders J, Drummond GI. Urinary 3'5' cyclic AMP. Diagnostic test in pseudohypoparathyroidism. Arch Dis Child. 1975;50(8):656-658. doi:10.1136/adc.50.8.656
10. Ishida M, Seino Y, Simotsuji T, et al. Differential diagnosis of hypoparathyroid disorders during childhood. Calcif Tissue Int. 1980;31(3):203-207. doi:10.1007/BF02407182
11. Mantovani G. Clinical review: Pseudohypoparathyroidism: diagnosis and treatment. J Clin Endocrinol Metab. 2011;96(10):3020-3030. doi:10.1210/jc.2011-1048
Day(s) Performed
Wednesday
Report Available
2 to 11 daysPerforming Laboratory
Mayo Clinic Laboratories in Rochester
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
82030
82570
82565
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| CARU | Cyclic Amp, Urinary Excretion | 21052-6 |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| 179 | Cyclic Amp, Urinary Excretion | 22712-4 |
| ACREA | Creatinine, S | 2160-0 |
| CRETR | Creatinine, Random, U | 2161-8 |