Sign in →

Test Code NIUCR Nickel/Creatinine Ratio, Random, Urine


Ordering 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.



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: 3 mL

Collection Instructions:

1. Collect a random urine specimen

2. See Metals Analysis Specimen Collection and Transport for complete instructions.


Useful For

Preferred specimen type for biomonitoring nickel exposure

Profile Information

Test ID Reporting Name Available Separately Always Performed
NIUC Nickel/Creat Ratio, U No Yes
CRETR Creatinine, Random, U No Yes

Method Name

NIUC: Inductively Coupled Plasma-Mass Spectrometry (ICP-MS)

CRETR: Enzymatic Colorimetric Assay

Reporting Name

Nickel/Creat Ratio, Random, U

Specimen Type

Urine

Specimen Minimum Volume

1.2 mL

Specimen Stability Information

Specimen Type Temperature Time Special Container
Urine Refrigerated (preferred) 28 days
  Frozen  28 days
  Ambient  14 days

Reference Values

NICKEL:

0-17 years: Not established

Males ≥18 years: <3.8 mcg/g creatinine

Females ≥18 years: <4.3 mcg/g creatinine

 

CREATININE:

≥18 years old: 16-326 mg/dL

Reference values have not been established for patients younger than 18 years of age.

Interpretation

Values of 3.8 mcg/g creatinine and higher for male patients or 4.3 mcg/g creatinine and higher for female patients represent possible environmental or occupational exposure to nickel (Ni).

 

Ni concentrations above 50 mcg/g creatinine are of concern, suggesting excessive exposure.

 

Hypernickelemia, in the absence of exposure, may be an incidental finding or could be due to specimen contamination.

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;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;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. HHS; 2005. Accessed September 6, 2023. Available at www.atsdr.cdc.gov/ToxProfiles/tp15.pdf

4. Rifai N, Chiu RWK, Young I, Burnham CAD, Wittwer CT, eds: Tietz Textbook of Laboratory Medicine. 7th ed. Elsevier; 2023

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

6. Begum W, Rai S, Banerjee S, et al. A comprehensive review on the sources, essentiality and toxicological profile of nickel. RSC Adv. 2022;12(15):9139-9153. doi:10.1039/d2ra00378c

Day(s) Performed

Thursday

Report Available

2 to 8 days

Performing 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

83885

82570

LOINC Code Information

Test ID Test Order Name Order LOINC Value
NIUCR Nickel/Creat Ratio, Random, U 13472-6

 

Result ID Test Result Name Result LOINC Value
CRETR Creatinine, Random, U 2161-8
614553 Nickel/Creat Ratio, U 13472-6