Test ID: SULFU
Sulfate, Urine
Secondary ID 
A test code used for billing and in test definitions created prior to November 2011
NY State Approved Indicates the status of NY State approval and if the test is orderable for NY State clients.
Useful For Suggests clinical disorders or settings where the test may be helpful
Urinary sulfate can be used to assess the nutrition intake of animal protein.
It also can be a reflection of protein intake and can be assessed in patients with stone disease as related to stone supersaturation and prevention of stone disease.
Special Instructions and Forms Describes specimen collection and preparation information, test algorithms, and other information pertinent to test. Also includes pertinent information and consent forms to be used when requesting a particular test
Method Name A short description of the method used to perform the test
High-Performance Liquid Chromatography (HPLC)
Reporting Name A shorter/abbreviated version of the Published Name for a test; an abbreviated test name
Specimen Type Describes the specimen type needed for testing
Specimen Required Defines the optimal specimen. This field describes the type of specimen required to perform the test and the preferred volume to complete testing. The volume allows automated processing, fastest throughput and, when indicated, repeat or reflex testing.
Container/Tube: Plastic, 10-mL urine tube (Supply T068)
Specimen Volume: 5 mL
Collection Instructions:
1. Collect urine for 24 hours.
2. No preservative.
3. Specimen must be kept refrigerated during and after collection.
4. Specimen pH should be between 4.5 and 8 and will stay in this range if kept refrigerated. Specimens with pH >8 indicate bacterial contamination, and testing will be cancelled. Do not attempt to adjust pH as it will adversely affect results.
Additional Information:
1. 24-Hour volume is required.
2. See Urine Preservatives in Special Instructions for multiple collections.
Urine Preservative Collection Options
| Ambient | No |
| Refrigerated | Preferred |
| Frozen | Yes |
| 6N HCl | No |
| 50% Acetic Acid | No |
| Na2CO3 | Yes |
| Toluene | Yes |
| 6N HNO3 | No |
| Boric Acid | Yes |
| Thymol | Yes |
Specimen Minimum Volume Defines the amount of specimen required to perform an assay once, including instrument and container dead space. Submitting the minimum specimen volume makes it impossible to repeat the test or perform confirmatory or perform reflex testing. In some situations, a minimum specimen volume may result in a QNS (quantity not sufficient) result, requiring a second specimen to be collected.
Reject Due To Identifies specimen types and conditions that may cause the specimen to be rejected
| Hemolysis | NA |
| Lipemia | NA |
| Icterus | NA |
| Other | NA |
Specimen Stability Information Provides a description of the temperatures required to transport a specimen to the laboratory. Alternate acceptable temperature(s) are also included.
| Specimen Type | Temperature | Time |
|---|---|---|
| Urine | Refrigerated (preferred) | 7 days |
| Frozen | 7 days |
Clinical Information Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test
Urinary sulfate is a reflection of dietary protein intake, particularly meat, fish, and poultry, which are rich in sulfur-containing amino acids methionine and cysteine. Urinary sulfate can be used to assess dietary protein intake for nutritional purposes. A protein-rich diet has been associated with an increased risk for stone formation, possibly due, in part, to an increase in urinary calcium excretion caused by acid production from metabolism of sulfur-containing amino acids.(2,3) Indeed, urinary sulfate excretion is higher in patients who have kidney stones than in individuals who do not form stones. Thus, urinary sulfate excretion may provide an index for protein-induced calciuria.(2)
Sulfate is a major anion in the urine that has significant affinity for cations and modulates the availability of cations for reacting with other anions in the urine. It thus is an important factor of urinary supersaturation(4) for various crystals or stones such as calcium oxalate, hydroxyapatite, and brushite. For example, a high sulfate concentration may modulate the availability of calcium for reacting with oxalate and thus affect the propensity for calcium oxalate stone or crystal formation. Urinary sulfate also has a major impact on buffering or providing hydrogen ions and as such modulates the supersaturation of uric acid.
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.
7-47 mmol/specimen
Interpretation Provides information to assist in interpretation of the test results
Urinary sulfate is a reflection of dietary protein intake, particularly of meat, and thus can be used as an index of nutritional protein intake.
It also is used in the calculation of urinary supersaturation of various crystals or stones.
Cautions Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances
No significant cautionary statements
Clinical Reference Provides recommendations for further in-depth reading of a clinical nature
1. Houterman S, van Faassen A, Ocke MC, et al: Is urinary sulfate a biomarker for the intake of animal protein and meat? Cancer Lett 1997;114:295-296
2. Tschope W, Ritz E: Sulfur-containing amino acids are a major determinant of urinary calcium. Miner Electrolyte Metab 1985;11:137-139
3. Puche RC, Vacarro D, Sanchez A, et al: Increased fractional excretion of sulphate in stone formers. Br J Urol 1993;71:523-526
4. Parks JH, Coward M, Coe FL: Correspondence between stone composition and urine supersaturation in nephrolithiasis. Kidney Int 1997;51:894-900
Method Description Describes how the test is performed and provides a method-specific reference
HPLC with ion detection. (Bucholz AE, Verplough CI, Smith JL: A method for the simultaneous measurement of less than a part-per-million of chloride, nitrate, and sulfate in aqueous specimens by nonsuppressed ion chromatography. J Chromatogr Sci 1982;20:499-501)
Day(s) and Time(s) Test Performed Outlines the days and times the test is performed. This field reflects the day and time the sample must be in the testing laboratory to begin the testing process and includes any specimen preparation and processing time required before the test is performed. Some tests are listed as continuously performed, which means assays are performed several times during the day.
Monday through Friday; 8 a.m.-3 p.m.
Analytic Time Defines the amount of time it takes the laboratory to setup and perform the test. This is defined in number of days. The shortest interval of time expressed is "same day/1 day," which means the results may be available the same day that the sample is received in the testing laboratory. One day means results are available 1 day after the sample is received in the laboratory.
Maximum Laboratory Time Defines the maximum time from specimen receipt at Mayo Medical Laboratories until the release of the test result
Specimen Retention Time Outlines the length of time after testing that a specimen is kept in the laboratory before it is discarded
Performing Laboratory Location The location of the laboratory that performs the test
Test Classification Provides information regarding the medical device classification for laboratory test kits and reagents. Tests may be classified as cleared or approved by the US Food and Drug Administration (FDA) and used per manufacturer's instructions, or as products that do not undergo full FDA review and approval, and are then labeled as an Analyte Specific Reagent (ASR), Investigation Use Only (IUO) product, or a Research Use Only (RUO) product.
CPT Code Information Provides guidance in determining the appropriate Current Procedural Terminology (CPT) code(s) information for each test or profile. The listed CPT codes reflect Mayo Medical Laboratories interpretation of CPT coding requirements. It is the responsibility of each laboratory to determine correct CPT codes to use for billing.
84392
LOINC® Code Information Provides guidance in determining the Logical Observation Identifiers Names and Codes (LOINC) values for the result codes returned for this test or profile.
| Result ID | Reporting Name | LOINC Code |
|---|---|---|
| SLF_U | Sulfate, U | 39576-4 |
| TM89 | Collection Duration | 13362-9 |
| VL71 | Urine Volume | 3167-4 |
| SUL_C | Sulfate Concentration | 12920-5 |
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