Test Code COBRU Cobalt/Creatinine Ratio, Random, Urine
Reporting Name
Cobalt/Creat Ratio, Random, UPerforming Laboratory
Mayo Clinic Laboratories in RochesterUseful For
Detecting cobalt exposure in a random urine collection
Monitoring metallic prosthetic implant wear
This test is not useful for assessment of vitamin B12 activity.
Method Name
COBR: Inductively Coupled Plasma-Mass Spectrometry (ICP-MS)
CRETR: Enzymatic Colorimetric Assay
Ordering Guidance
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 Required
Supplies: Urine Tubes, 10 mL (T068)
Collection Container/Tube: Clean, plastic urine collection container
Submission Container/Tube: Plastic, 10-mL urine tube or clean, plastic aliquot container with no metal cap or glued insert
Specimen Volume: 3 mL
Collection Instructions:
1. Collect a random urine specimen.
2. See Metals Analysis Specimen Collection and Transport for complete instructions
Specimen Type
UrineSpecimen Minimum Volume
2 mL
Specimen Stability Information
Specimen Type | Temperature | Time | Special Container |
---|---|---|---|
Urine | Refrigerated (preferred) | 28 days | |
Frozen | 28 days | ||
Ambient | 14 days |
Reject Due To
All specimens will be evaluated at Mayo Clinic Laboratories for test suitability.Reference Values
COBALT:
0-17 years: Not established
>17 years: <1.7 mcg/g Cr
CREATININE:
≥18 years old: 16-326 mg/dL
Reference values have not been established for patients who are younger than 18 years of age.
Interpretation
Concentrations greater or equal to 2.0 mcg/g creatinine indicate excess exposure. There are no Occupational Safety and Health Administration blood or urine criteria for occupational exposure to cobalt.
Prosthesis wear is known to result in increased circulating concentration of metal ions. In a patient with a cobalt-based implant, modest increase (2-4 mcg/g creatinine) in urine cobalt concentration is likely to be associated with a prosthetic device in good condition. Excessive exposure is indicated when urine cobalt concentration is greater than 5 mcg/g creatinine, consistent with prosthesis wear. Urine concentrations greater than 20 mcg/g creatinine in a patient with a cobalt-based implant suggest significant prosthesis wear. Increased urine trace element concentrations in the absence of corroborating clinical information do not independently predict prosthesis wear or failure.
Day(s) Performed
Tuesday, Wednesday, Friday
Report Available
1 to 4 daysTest Classification
This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. It has not been cleared or approved by the US Food and Drug Administration.CPT Code Information
83018
82570
LOINC Code Information
Test ID | Test Order Name | Order LOINC Value |
---|---|---|
COBRU | Cobalt/Creat Ratio, Random, U | 13468-4 |
Result ID | Test Result Name | Result LOINC Value |
---|---|---|
607272 | Cobalt/Creat Ratio, U | 13468-4 |
CRETR | Creatinine, Random, U | 2161-8 |
Profile Information
Test ID | Reporting Name | Available Separately | Always Performed |
---|---|---|---|
COBR | Cobalt/Creat Ratio, U | No | Yes |
CRETR | Creatinine, Random, U | No | Yes |