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HelpTest Code GDUCR Gadolinium/Creatinine Ratio, Random, Urine
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 collection container
Submission Container/Tube: Plastic, 10-mL urine tube or clean, plastic aliquot container with no metal cap or glued insert
Specimen Volume: 3 mL
Collection Instructions:
1. Collect a random urine specimen.
2. See Metals Analysis Specimen Collection and Transport for complete instructions.
Useful For
Assessing chronic exposure and monitoring effectiveness of dialysis in a random urine collection
Profile Information
| Test ID | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| GDCU | Gadolinium/Creat Ratio, U | No | Yes |
| CRETR | Creatinine, Random, U | No | Yes |
Special Instructions
Method Name
GDCU: Inductively Coupled Plasma-Mass Spectrometry (ICP-MS)
CRETR: Enzymatic Colorimetric Assay
Reporting Name
Gadolinium/Creat Ratio, Random, USpecimen Type
UrineSpecimen Minimum Volume
1.5 mL
Specimen Stability Information
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Urine | Refrigerated (preferred) | 28 days | |
| Frozen | 28 days | ||
| Ambient | 14 days |
Reference Values
0-17 years: Not established
≥18 years: <0.8 mcg/g creatinine
Interpretation
Although much of the gadolinium associated with the administration of gadolinium-based contrast agents (GBCA) is cleared in the urine in the first 96 hours, lower concentrations of gadolinium may persist in the urine for months after GBCA exposure. Elevated urine gadolinium results collected after administration of a GBCA confirm past exposure, prolonged elimination of gadolinium, and/or continued exposure through anthropogenic sources. Gadolinium also has been shown to be present in some municipal water sources, which may contribute to the observation of low concentrations of gadolinium in patients who never have been exposed to GBCA.
Elevated gadolinium in a specimen collected more than 96 hours after contrast media infusion does not indicate risk of nephrogenic systemic fibrosis.
Clinical Reference
1. Othersen JB, Maize JC, Woolson RF, Budisavljevic MN. Nephrogenic systemic fibrosis after exposure to gadolinium in patients with renal failure. Nephrol Dial Transplant. 2007;22(11):3179-3185
2. Christensen KN, Lee CU, Hanley MM, et al. Quantification of gadolinium in fresh skin and serum samples from patients with nephrogenic systemic fibrosis. J Am Acad Dermatol. 2011;64(1):91-96
3. Girardi M, Kay J, Elston DM, et al. Nephrogenic systemic fibrosis: Clinicopathological definition and workup recommendations. J Am Acad Dermatol. 2011;65(6):1095-1106
4. Telgmann L, Sperling M, Karst U. Determination of gadolinium-based MRI contrast agents in biological and environmental samples: A review. Analytica Chimica Acta. 2013;764:1-16
5. Daftari Besheli L, Aran S, Shaqdan K, et al. Current status of nephrogenic systemic fibrosis. Clin Radiol. 2014;69(7):661-668
6. Aime S, Caravan P. Biodistribution of gadolinium-based contrast agents, including gadolinium deposition. J. Magn Reson Imaging. 2009;30(6):1259-1267
7. McDonald RJ, McDonald JS, Kallmes DF, et al. Intracranial gadolinium deposition after contrast-enhanced MR imaging. Radiology. 2015;275:772-782
8. Bornhorst J, Wegwerth P, Day P, et al. Urinary reference intervals for gadolinium in individuals without recent exposure to gadolinium-based contrast agents. Clin Chem Lab Med. 2020;58(3):e87-e90. doi: 10.1515/cclm-2019-0607
9. Alwasiyah D, Murphy C, Jannetto P, Hogg M, Beuhler MC. Urinary Gadolinium Levels After Contrast-Enhanced MRI in Individuals with Normal Renal Function: a Pilot Study. J Med Toxicol. 2019;15(2):121-127
Day(s) Performed
Thursday
Report Available
2 to 8 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
83018
82570
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| GDUCR | Gadolinium/Creat Ratio, Random, U | 93854-8 |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| CRETR | Creatinine, Random, U | 2161-8 |
| 615339 | Gadolinium/Creat Ratio, U | 93854-8 |
Forms
If not ordering electronically, complete, print, and send a Renal Diagnostics Test Request (T830) with the specimen.