Cadmium, 24 Hour, Urine
Clinical Information Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test
The toxicity of cadmium resembles the other heavy metals (arsenic, mercury, and lead) in that it attacks the kidney; renal dysfunction with proteinuria with slow onset (over a period of years) is the typical presentation. Measurable changes in proximal tubule function, such as decreased clearance of para-aminohippuric acid also occur over a period of years, and precede overt renal failure.
Breathing the fumes of cadmium vapors leads to nasal epithelial deterioration and pulmonary congestion resembling chronic emphysema.
The most common source of chronic exposure comes from spray painting of organic-based paints without use of a protective breathing apparatus; auto repair mechanics represent a susceptible group for cadmium toxicity. Another common source of cadmium exposure is tobacco smoke, which has been implicated as the primary source of the metal leading to reproductive toxicity in both males and females.
The concentration of cadmium in the kidneys and in the urine is elevated in some patients exposed to cadmium.
See also CDOM / Cadmium for Occupational Monitoring, Urine. If employees are being monitored in the workplace, the Occupational Safety and Health Administration requires that laboratory reports express the cadmium excretion rate per gram of creatinine rather than per 24 hours. This alternative test is available to accommodate that requirement. Mayo Medical Laboratories is certified to provide this test.
Detecting exposure to cadmium, a toxic heavy metal
Cautions Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances
Collection of urine specimens through a catheter frequently results in elevated values because rubber contains trace amounts of cadmium that are extracted as urine passes through the catheter.
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.
Reference Values Describes reference intervals and additional information for interpretation of test results. May include intervals based on age and sex when appropriate. Intervals are Mayo-derived, unless otherwise designated. If an interpretive report is provided, the reference value field will state this.
0-15 years: not established
> or =16 years: 0.0-1.3 mcg/specimen
Clinical References Provides recommendations for further in-depth reading of a clinical nature
1. deBurbure C, Buchet J-P, Leroyer A, et al: Renal and Neurologic Effects of Cadmium, Lead, Mercury, and Arsenic in Children: Evidence of Early Effects and Multiple Interactions at Environmental Exposure Levels. Environ Health Perspect 2006;114:584-590
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(GerESIV) Int J Hyg Environ Health 2009;212:637-647
3. Occupational Safety and Health Administration, US Department of Labor: Cadmium Exposure Evaluation. Updated 9/2/2008. Available from URL: osha.gov/SLTC/cadmium/evaluation.html