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Test ID GDU Gadolinium, 24 Hour, Urine

Useful For

An aid in documenting past exposure to gadolinium-containing chelates

Method Name

Inductively Coupled Plasma-Mass Spectrometry (ICP-MS)

Reporting Name

Gadolinium, 24 Hr, U

Specimen Type

Urine

Container/Tube: Plastic, 10-mL urine tube (Supply T068) or clean, plastic aliquot container with no metal cap or glued insert

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

Additional Information:

1. 24-Hour volume is required.

2. See Urine Preservatives in Special Instructions for multiple collections.

 

Urine Preservative Collection Options

Ambient

Yes

Refrigerated

Preferred

Frozen

Yes

6N HCl

Yes

50% Acetic Acid

No

Na2CO3

No

Toluene

Yes

6N HNO3

Yes

Boric Acid

No

Thymol

No

Specimen Minimum Volume

0.4 mL

Specimen Stability Information

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

Clinical Information

Gadolinium is a member of the lanthanide series of the periodic table of elements and is considered a nonessential element. Due to its paramagnetic properties, chelated gadolinium is commonly employed as contrast media for magnetic resonance imaging and computer tomography scanning.

 

Gadolinium is eliminated primarily by the renal filtration. In healthy subjects with normal renal function, the plasma half-life of gadolinium is approximately 90 minutes. Patients with reduced renal function exhibit an increased gadolinium excretion half-life.

 

Gadolinium has been associated with nephrogenic systemic fibrosis (NSF) in patients with impaired renal function. In this syndrome, prolonged retention of gadolinium is thought to allow the gadolinium cation to dissociate from its synthetic organic chelator and deposit predominantly in the skin, although other organs may be affected as well. These patients are often severely debilitated by progressive skin thickening and tightening. Fibrosis of skeletal muscle, lungs, liver, testes, and myocardium have also been observed, often with fatal results. Because the ionic radius of gadolinium (3+) is similar to that of calcium (2+), it may also deposit in bone.

 

Three hemodialysis treatments are required to substantially remove gadolinium from patents with impaired renal function; peritoneal dialysis is not effective.

Reference Values

0.0-0.4 mcg/specimen

Reference values apply to all ages.

Cautions

Urine gadolinium concentration will be elevated if the specimen is collected <96 hours after administration of gadolinium-containing contrast media. This elevation is due to residual gadolinium present from contrast media infusion. Elevated gadolinium in a specimen collected <96 hours after contrast media infusion does not indicate risk of nephrogenic systemic fibrosis (NSF).

 

Evaluation of urine for gadolinium content has minimal value in making the diagnosis of NSF. Gadolinium is present in the effluent of metropolitan sewage treatment plants and in the rivers near metropolitan areas. Sewage treatment does not remove gadolinium. Anthropogenic sources of gadolinium could contribute to low concentrations of gadolinium excreted in the urine.

Day(s) Performed

Thursday; 8 a.m.

Report Available

1 day

Performing Laboratory

Mayo Medical Laboratories in Rochester

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

83018

NY State Approved

Yes