Specimen:

Urine More information

Collection Medium:

Minimum:

10 mL from 24 hr urine collection in a plastic bottle, refrigerate 
during collection.
Pediatric Minimum:  5 mL

Rejection Criteria:

Urine collected within 48 hours after administration of a gadolinium 
(Gd) containing contrast media (may occur with MRI studies). Acid 
preserved urine.

Specimen
Instructions:

Specimen must be collected in a plastic container and should be 
refrigerated during collection. Studies indicate that refrigeration of 
urine alone, during and after collection, preserves specimens as well 
as the preservatives mentioned, if tested within 14 days of collection.

Analytic Time:

1 week

Reference Range:

Reference Interval            Ranges
Components                    Ref. Int.
Arsenic, Urine                0.0-35 ug/l
Arsenic, Urine (24 hour)      0.0-50 ug/d
Arsenic per gram creatinine   No reference interval (ug/g crt)
Creatinine(24 hour)           Male
                              3-8 years:  140-700 mg/d
                              9-12 years:  300-1300 mg/d
                              13-17 years:  500-2300 mg/d
                              18-50 years:  1000-2500 mg/d
                              51-80 years:  800-2100 mg/d
                              81 years and older:  600-2000 mg/d

                              Female
                              3-8 years:  140-700 mg/d
                              9-12 years:  300-1300 mg/d
                              13-17 years:  400-1600 mg/d
                              18-50 years:  700-1600 mg/d
                              51-80 years:  500-1400 mg/d
                              81 years and older:  400-1300 mg/d

Interpretive Data:

Specific toxic thresholds for arsenic are not well defined. The ACGIH 
Biological Exposure Index is 35 ug/L for the sum of the inorganic and 
methylated forms of arsenic. For specimens with a total arsenic 
concentration between 35-2000 ug/L, fractionation is performed to 
determine the proportion of organic, inorganic and methylated forms. If 
low-level chronic poisoning is suspected, the ug/gCRT ratio may be more 
sensitive than the total arsenic concentration. It may be appropriate 
to fractionate specimens with a ug/gCRT ratio >30 ug/gCRT despite a 
total arsenic concentration <35 ug/L; the laboratory will perform this 
on request.

The organic forms of arsenic, most commonly arsenobetaine, are 
considered nontoxic and arise primarily from food. Inorganic forms of 
arsenic [As(III) and As(V)] are most toxic. Methylated forms (MMA and 
DMA) arise primarily from metabolism of inorganic forms but may also 
come from dietary sources and are of moderate toxic potential. As this 
test does not detect all species of arsenic, it is expected that the 
sum of the organic, inorganic and methylated forms will not equal the 
total arsenic concentration.

Comments:

Record:  Total volume and collection time on test requisition.
Commercial laboratory studies indicate that refrgieration of urine 
alone, during and after collection, preserves specimen as well as any 
alternative preservatives added before collection, if specimen is 
tested within eight days of collection.

To differentiate between organic and the more toxic inorganic forms, an 
arsenic speciation test is recommended and can be performed with the 
existing specimen by contacting the clinical laboratory lead scientist 
at pager 131-7283.

If urine, arsenic is abnormal, additional testing is performed by the 
reference laboratory.  The patient will be charged for this testing 
when applicable.

Methodology:

Inductively Coupled Plasma/Mass Spectrometry

CPT Code:

82175

See Additional Information:
Urine Tests Requiring Preservatives, Refrigeration or Special Containers