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Test ID NIU Nickel, 24 Hour, Urine

Reporting Name

Nickel, 24 Hr, U

Useful For

Detecting nickel toxicity in patients exposed to nickel carbonyl

Specimen Type

Urine


Necessary Information


24-Hour volume is required.



Specimen Required


Patient Preparation: High concentrations of gadolinium and iodine are known to interfere with most metals tests. If gadolinium- or iodine-containing contrast media has been administered, a specimen should not be collected for 96 hours.

Supplies: Plastic, 10-mL urine tube (T068)

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. Aliquot 10 mL in a plastic 10-mL urine tube (T068) or a clean, plastic aliquot container with no metal cap or glued insert

4. See Trace Metals Analysis Specimen Collection and Transport in Special Instructions for complete instructions.


Specimen Minimum Volume

0.9 mL

Specimen Stability Information

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

Reference Values

0-17 years: not established

≥18 years: <3.6 mcg/24h

Day(s) and Time(s) Performed

Thursday; 8 a.m.

Test Classification

This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. This test has not been cleared or approved by the U.S. Food and Drug Administration.

CPT Code Information

83885

LOINC Code Information

Test ID Test Order Name Order LOINC Value
NIU Nickel, 24 Hr, U 5705-9

 

Result ID Test Result Name Result LOINC Value
8626 Nickel, 24 Hr, U 5705-9
TM18 Collection Duration 13362-9
VL30 Urine Volume 3167-4

Clinical Information

Nickel (Ni) is a silvery white metal that is widely distributed in the earth's crust. Nickel is essential for the catalytic activity of some plant and bacterial enzymes but its role in humans has not been defined. Elemental Ni may be essential for life at very low concentrations and is virtually nontoxic.

 

Nickel is commonly used in industry. It is a pigment in glass, ceramics, and fabric dyes; is converted in the Mond process to nickel carbonyl, Ni(CO)4, and used as a catalyst in petroleum refining and in the plastics industry, is frequently employed in the production of metal alloys (which are popular for their anticorrosive and hardness properties) in nickel-cadmium rechargeable batteries, and is used as a catalyst in hydrogenation of oils.

 

Ni(CO)4, a liquid with low vapor pressure, is one of the most toxic chemicals known to man. Ni(CO)4 is absorbed after inhalation, readily crosses all biological membranes, and noncompetitively inhibits ATP-ase and RNA polymerase. Breathing the vapors of Ni(CO)4 binds avidly to hemoglobin with resultant inability to take up oxygen. The affinity for hemoglobin is higher than carbon monoxide. The binding to hemoglobin is the main transport mechanism for spreading Ni(CO)4 throughout the body. Urine is the specimen of choice for the determination of Ni exposure via inhalation.

 

Patients undergoing dialysis are exposed to Ni and accumulate Ni in blood and other organs; there appears to be no adverse health effects from this exposure. Hypernickelemia has been observed in patients undergoing renal dialysis. At the present time, this is considered to be an incidental finding as no correlation with toxic events has been identified. Routine monitoring of patients undergoing dialysis is currently not recommended.

 

Breathing dust high in Ni content has been associated with development of neoplasms of the respiratory system and nasal sinuses. Most reactions to Ni are localized skin sensitivity and allergic skin disorders that occur on contact with nickel-containing alloys. These reactions do not correlate to blood concentrations; patients experiencing skin sensitivity reactions to nickel are likely to have normal circulating concentrations of Ni.

Interpretation

Values of 3.6 mcg/24-hour specimen and higher represent possible environmental or occupational exposure.

 

Nickel (Ni) concentrations above 50 mcg/24-hour specimen are of concern, suggesting excessive exposure.

 

Clinical concern about Ni toxicity should be limited to patients with potential for exposure to toxic Ni compounds such as nickel carbonyl. Hypernickelemia, in the absence of exposure to that specific form of Ni, may be an incidental finding or could be due to specimen contamination.

Clinical Reference

1. Moreno ME, Acosta-Saavedra LC, Meza-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 Hlth 2010;213:252-258

2. Schulz C, Angerer J, Ewers U, et al: 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;212:637-647

Analytic Time

1 day

Method Name

Inductively Coupled Plasma-Mass Spectrometry (ICP-MS)

Urine Preservative Collection Options

Ambient

Yes

Refrigerated

Preferred

Frozen

Yes

6N HCl

No

50% Acetic Acid

Yes

Na2CO3

No

Toluene

No

6N HNO3

Yes

Boric Acid

No

Thymol

No