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Epic Test Code LAB377 Citrate Excretion, 24 Hour, Urine

Additional Codes

MML:CITR


Necessary Information


Patient's age and 24-hour volume (in milliliters) are required.



Specimen Required


Patient Preparation: Any drug that causes alkalemia or acidemia may be expected to alter citrate excretion and should be avoided, if possible. The patient must avoid laxative use for 24 hour collection period.

Supplies:

-Diazolidinyl Urea (Germall) 5.0 mL (T822)

-Sarstedt 5 mL Aliquot Tube (T914)

Container/Tube: Plastic tube

Specimen Volume: 4 mL

Collection Instructions:

1. Add 5 mL of diazolidinyl urea (Germall) as preservative at start of collection or refrigerate specimen during and after collection.

2. Collect urine for 24 hours.

3. Mix well before taking 4-mL aliquot.

Additional Information: See Urine Preservatives-Collection and Transportation for 24-Hour Urine Specimens for multiple collections.


Forms

If not ordering electronically, complete, print, and send a Renal Diagnostics Test Request (T830) with the specimen.

Useful For

Diagnosing risk factors for patients with calcium kidney stones

 

Monitoring results of therapy in patients with calcium stones or renal tubular acidosis

Method Name

Enzymatic

Reporting Name

Citrate Excretion, 24 Hr, U

Specimen Type

Urine

Specimen Minimum Volume

1 mL

Specimen Stability Information

Specimen Type Temperature Time Special Container
Urine Refrigerated (preferred) 14 days
  Frozen  14 days

Reject Due To

All specimens will be evaluated at Mayo Clinic Laboratories for test suitability.

Clinical Information

Urinary citrate is a major inhibitor of kidney stone formation due in part to binding of calcium in urine. Low urine citrate levels are considered a risk for kidney stone formation.

 

Several metabolic disorders are associated with low urine citrate. Any condition that lowers renal tubular pH or intracellular pH may decrease citrate (eg, metabolic acidosis, increased acid ingestion, hypokalemia, or hypomagnesemia).

 

Low urinary citrate promotes kidney stone formation and growth, and is subject to therapy by correcting acidosis, hypokalemia, or hypomagnesemia by altering diet or using drugs such as citrate and potassium.

Reference Values

0-19 years: not established

20 years: 150-1,191 mg/24 hours

21 years: 157-1,191 mg/24 hours

22 years: 164-1,191 mg/24 hours

23 years: 171-1,191 mg/24 hours

24 years: 178-1,191 mg/24 hours

25 years: 186-1,191 mg/24 hours

26 years: 193-1,191 mg/24 hours

27 years: 200-1,191 mg/24 hours

28 years: 207-1,191 mg/24 hours

29 years: 214-1,191 mg/24 hours

30 years: 221-1,191 mg/24 hours

31 years: 228-1,191 mg/24 hours

32 years: 235-1,191 mg/24 hours

33 years: 242-1,191 mg/24 hours

34 years: 250-1,191 mg/24 hours

35 years: 257-1,191 mg/24 hours

36 years: 264-1,191 mg/24 hours

37 years: 271-1,191 mg/24 hours

38 years: 278-1,191 mg/24 hours

39 years: 285-1,191 mg/24 hours

40 years: 292-1,191 mg/24 hours

41 years: 299-1,191 mg/24 hours

42 years: 306-1,191 mg/24 hours

43 years: 314-1,191 mg/24 hours

44 years: 321-1,191 mg/24 hours

45 years: 328-1,191 mg/24 hours

46 years: 335-1,191 mg/24 hours

47 years: 342-1,191 mg/24 hours

48 years: 349-1,191 mg/24 hours

49 years: 356-1,191 mg/24 hours

50 years: 363-1,191 mg/24 hours

51 years: 370-1,191 mg/24 hours

52 years: 378-1,191 mg/24 hours

53 years: 385-1,191 mg/24 hours

54 years: 392-1,191 mg/24 hours

55 years: 399-1,191 mg/24 hours

56 years: 406-1,191 mg/24 hours

57 years: 413-1,191 mg/24 hours

58 years: 420-1,191 mg/24 hours

59 years: 427-1,191 mg/24 hours

60 years: 434-1,191 mg/24 hours

>60 years: not established

Interpretation

Any value less than the mean for 24 hours represents a potential risk for kidney stone formation and growth. Patients with low urinary citrate and new or growing stone formation, may benefit from adjustments in therapy known to increase urinary citrate excretion. (See Clinical Information)

 

Very low levels (<150 mg/24 hours) suggest investigation is needed for the possible diagnosis of metabolic acidosis (eg, renal tubular acidosis).

Cautions

Drugs that lower systemic pH, potassium, and/or magnesium also lower urine citrate and are to be avoided in patients with a tendency to form calcium stones.

 

Conversely, drugs that raise systemic pH, potassium, and/or magnesium, may raise urine citrate and should be considered when treating patients or interpreting results.

Day(s) Performed

Monday through Saturday

Report Available

Same day/1 day

Specimen Retention Time

7 days

Performing Laboratory

Mayo Clinic Laboratories in Rochester

CPT Code Information

82507

 

NY State Approved

Yes

Urine Preservative Collection Options

Note: The addition of preservative must occur at the start of collection or application of temperature controls must occur during and after collection

Ambient

No

Refrigerate

OK

Frozen

OK

50% Acetic Acid

No

Boric Acid

OK

Diazolidinyl Urea

Preferred

6M Hydrochloric Acid

No

6M Nitric Acid

No

Sodium Carbonate

No

Thymol

OK

Toluene

No