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Test ID NIRU Nickel, Random, Urine

Useful For

Detecting nickel toxicity in patients exposed to nickel carbonyl

Method Name

Inductively Coupled Plasma-Mass Spectrometry (ICP-MS)

Reporting Name

Nickel, Random, U

Specimen Type

Urine

Collection Container/Tube: Clean, plastic urine collection container

Submission Container/Tube: Plastic, 5-mL tube (Supply T465) or a clean, plastic aliquot container with no metal cap or glued insert

Specimen Volume: 2 mL

Collection Instructions:

1. Collect a random urine specimen.

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

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

Specimen Minimum Volume

0.9 mL

Specimen Stability Information

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

Clinical Information

Nickel (Ni), a silvery white metal widely distributed in the earth's crust, is essential for the catalytic activity of some plant and bacterial Enzymes, but its role in humans has not been defined. Elemental nickel 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. It 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 1 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. 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 nickel exposure via inhalation.

 

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

 

Patients undergoing dialysis are exposed to nickel and accumulate nickel in blood and other organs; there appear to be no adverse health affects 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.

Reference Values

0.0-6.0 mcg/L 

Reference values apply to all ages.

Cautions

Specimen collection procedures for nickel require special collection containers, rigorous attention to ultraclean specimen collection and handling procedures, and analysis in an ultraclean facility. Unless all of these procedures are followed, increased urinary nickel results may be an incidental and misleading finding.

 

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

 

This test cannot determine the source compound (eg, nickel sulfate) responsible for the exposure.

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

83885

NY State Approved

Yes