Arsenic, Urine with Reflex to Fractionated
| Label Mnemonic: | ARSU |
| Epic code: | LAB361 |
| Downtime form: | Doctor/Provider Orders - Pathology Core and Specialty Care Nursery |
6240-8 RCP
356-8593
Refrigerate during 24 hr collection in plastic container.
Commercial laboratory studies indicate that refrigeration of urine alone, during and after collection, preserves specimen as well as any alternative preservatives added before collection, if specimen is tested within 14 days of collection.
Diet, medication, and nutritional supplements may introduce interfering substances. Patients should be encouraged to discontinue nutritional supplements, vitamins, minerals, nonessential over-the-counter medications (upon the advice of their physician), and avoid shellfish and seafood for 48 to 72 hours.
High concentrations of iodine may interfere with elemental testing. Abstinence from iodine-containing medications or contrast agents for at least 1 month prior to collecting specimens for elemental testing is recommended.
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| Urine - 24 hour/timed plastic urine container |
Preferred Minimum: 8 mL urine from a well-mixed, refrigerated, 24 hr urine collection.
Absolute Minimum: 2 mL urine from a well-mixed, refrigerated, 24 hr urine collection.
Urine collected within 48 hours after administration of a gadolinium (Gd) containing contrast media (may occur with MRI studies). Acid preserved urine. Specimens contaminated with blood or fecal material. Specimens transported in non-trace element transport tube (with the exception of the original device).
1–5 days upon receipt at reference laboratory
| Components | Reference Interval | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Arsenic, Urine - per 24h | Less than or equal to 49.9 microg/d | |||||||||||||||||||||
| Arsenic, Urine - per volume | Less than or equal to 34.9 migrog/L | |||||||||||||||||||||
| Arsenic, Urine - ratio to CRT | Less than or equal to 29.9 microg/g CRT | |||||||||||||||||||||
| Creatinine, Urine - per 24h |
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The ACGIH Biological Exposure Index (BEI) for arsenic in urine is 35 ug/L measured at the end of the work week. The ACGIH BEI is based on the sum of inorganic and methylated species. For specimens with elevated total arsenic results, fractionation is automatically performed to determine the proportions of inorganic, methylated and organic species. Elevated results may be due to skin or collection-related contamination, including the use of collection containers that are not certified to be trace element-free. If an elevated result is suspected to be due to contamination, confirmation with a second specimen collected in a certified trace element-free container is recommended.
Elevated results may be due to skin or collection-related contamination, including the use of collection containers that are not certified to be trace element-free. If an elevated result is suspected to be due to contamination, confirmation with a second specimen collected in a certified trace element-free container is recommended.
Quantitative High Performance Liquid Chromatography/Quantitative Inductively Coupled Plasma-Mass Spectrometry
Urine Tests Requiring Preservatives, Refrigeration or Special Containers
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.