Test ID: ROXU
Oxalate, Pediatric, Random, 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
Monitoring therapy for kidney stones
Identifying increased urinary oxalate as a risk factor for stone formation
Diagnosis of primary or secondary hyperoxaluria
A timed 24-hour urine collection is the preferred specimen for measuring and interpreting this urinary analyte. Random collections normalized to urinary creatinine may be of some clinical use in patients who cannot collect a 24-hour specimen, typically small children. Therefore, this random test is offered for children <16 years old.
Method Name A short description of the method used to perform the test
Enzymatic Using Oxalate Oxidase
Reporting Name A shorter/abbreviated version of the Published Name for a test; an abbreviated test name
Aliases Lists additional common names for a test, as an aid in searching
Oxalate
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: 7 mL
Collection Instructions:
1. Collect a random urine specimen.
2. No preservative.
Additional Information:
1. A timed 24-hour urine collection is the preferred specimen for measuring and interpreting this urinary analyte. Random collections normalized to urinary creatinine may be of some clinical use in patients who cannot collect a 24-hour specimen, typically small children. Therefore, this random test is offered for children <16 years old.
2. Avoid taking large doses (>2 g orally/24 hours) of vitamin C prior to specimen collection.
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
Oxalate is an end product of glyoxalate and glycerate metabolism. Humans have no enzyme capable of degrading oxalate, so it must be eliminated by the kidney.
In tubular fluid, oxalate can combine with calcium to form calcium oxalate stones. In addition, high concentrations of oxalate may be toxic for renal cells.
Increased urinary oxalate excretion results from inherited enzyme deficiencies (primary hyperoxaluria), gastrointestinal disorders associated with fat malabsorption (secondary hyperoxaluria), or increased oral intake of oxalate-rich foods or vitamin C.
Since increased urinary oxalate excretion promotes calcium oxalate stone formation, various strategies are employed to lower oxalate excretion.
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.
No established reference values
Interpretation Provides information to assist in interpretation of the test results
An elevated urine oxalate (>0.46 mmol/day) may suggest disease states such as secondary hyperoxaluria (fat malabsorption), primary hyperoxaluria (alanine glyoxalate transferase enzyme deficiency, glyceric dehydrogenase deficiency), idiopathic hyperoxaluria, or excess dietary oxalate or vitamin C intake.
In stone-forming patients high urinary oxalate values, sometimes even in the upper limit of the normal range, are treated to reduce the risk of stone formation.
The urinary oxalate creatinine ratio varies widely in young children from <0.35 mmol/mL at birth to <0.15 mmol/mL at 1 year to <0.10 mmol/mL at 10 years and <0.05 mmol/mL at 20 years of age (see table below).(1)
| Oxalate/Creatinine (mg/mg) | |
| Age (year) | 95th Percentile |
| 0-0.5 | <0.175 |
| 0.5-1 | <0.139 |
| 1-2 | <0.103 |
| 2-3 | <0.08 |
| 3-5 | <0.064 |
| 5-7 | <0.056 |
| 7-17 | <0.048 |
Cautions Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances
Ingestion of ascorbic acid (>2 g/day) may falsely elevate the measured urinary oxalate excretion.
Do not collect in metal-capped containers.
Clinical Reference Provides recommendations for further in-depth reading of a clinical nature
1. Matos V, Van Melle G, Werner D et al: Urinary oxalate and urate to creatinine ratios in a healthy pediatric population. Am J Kidney Dis 1999;34:e1
2. Wilson DM, Liedtke RR: Modified enzyme-based colorimetric assay of urinary and plasma oxalate with improved sensitivity and no ascorbate interference: reference values and sample handling procedures. Clin Chem 1991;37:1229-1235
Method Description Describes how the test is performed and provides a method-specific reference
The assay utilizes oxalate oxidase, which oxidizes oxalate to carbon dioxide and peroxide. In the presence of peroxidase, the peroxide oxidatively couples 3-methyl-2-benzothiazolinone and 3-dimethylaminobenzoic acid to form indamine dye, which is measured spectrophotometrically at 580 nm.(Kasidas GP, Rose GA: Continuous-flow assay for urinary oxalate using immobilized oxalate oxidase. Ann Clin Biochem 1985;22:412-419 [A modification of the method])
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 Saturday; 1 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.
83945
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 |
|---|---|---|
| OXCON | Oxalate, Pediatric, Random, U | 15086-2 |
| OXCO2 | Oxalate Concentration | 2700-3 |
| CREA8 | Creatinine Concentration | 2161-8 |
| RATO7 | Oxalate/Creatinine Ratio | 13483-3 |
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