Epic Test Code TIUCR Titanium/Creatinine Ratio, Random, Urine
Shipping Instructions
Ship specimen on ice
Specimen Required
Patient Preparation: High concentrations of gadolinium and iodine are known to interfere with most metal tests. If either gadolinium- or iodine-containing contrast media has been administered, the specimen should not be collected for at least 96 hours.
Supplies: Urine Tubes, 10 mL (T068)
Collection Container/Tube: Clean, plastic urine collection container
Submission Container/Tube: Plastic, 10-mL urine tube or a clean, plastic aliquot container with no metal cap or glued insert
Specimen Volume: 7 mL
Collection Instructions:
1. Collect a random urine specimen.
2. See Metals Analysis Specimen Collection and Transport for complete instructions.
Useful For
Monitoring exposure and elimination of titanium
Profile Information
Test ID | Reporting Name | Available Separately | Always Performed |
---|---|---|---|
TICU | Titanium/Creat Ratio, U | No | Yes |
CRTFR | Creatinine, Random, U | No | Yes |
Special Instructions
Method Name
TICU: Triple-Quadrupole Inductively Coupled Plasma-Mass Spectrometry (ICP-MS/MS)
CRTFR: Enzymatic Colorimetric Assay
Reporting Name
Titanium/Creat Ratio, Random, USpecimen Type
UrineSpecimen Minimum Volume
2 mL
Specimen Stability Information
Specimen Type | Temperature | Time | Special Container |
---|---|---|---|
Urine | Frozen | 28 days |
Reject Due To
All specimens will be evaluated at Mayo Clinic Laboratories for test suitability.Clinical Information
Titanium is the ninth most abundant element in the earth's crust. Its light weight and high strength are useful in alloys for diverse applications. There is no evidence to date that titanium is an essential element. Due in part to titanium's oxide formation propensity, the element is considered to be nontoxic. Soils, drinking water, and air all contain trace amounts of titanium. The food processing industry uses large quantities of titanium as a food additive; processed foods contain higher levels than are found in most produce and organic food products. The average daily oral intake through food consumption is 0.1 to 1 mg/day, which accounts for more than 99% of exposure. Gastrointestinal absorption of titanium is low (approximately 3%), and most of the ingested titanium is rapidly excreted in the urine and stool. The total body burden of titanium is usually in the range of 9 to 15 mg, a significant portion of which is contained in the lungs. Titanium dust entering the respiratory tract is nonirritating and is almost completely nonfibrogenic in humans.
Titanium-containing alloys are used in some artificial joints, prosthetic devices, and implants. Titanium dioxide allows osseointegration between an artificial medical implant and bone. Despite their wide use, exposure to these materials has not been linked to toxicity. In one study, patients monitored up to 36 months following joint replacement with titanium-containing joints showed a statistically significant increase in detectable titanium. While titanium concentrations are not a measure of toxicity, they can be useful in determining whether implant breakdown is occurring.
Reference Values
TITANIUM
0-17 years: Not established
≥18 years: <0.4 mcg/g creatinine
CREATININE
≥18 years old: 16-326 mg/dL
Reference values have not been established for patients who are less than 18 years of age.
Interpretation
Elevated concentrations of urinary titanium have been reported after documented exposures.
Cautions
Titanium is a trace metal commonly used in alloys and readily present in the environment. Thus, contamination of the collection site and of the specimen must be avoided. Failure to use metal-free collection procedures and devices may cause falsely increased results. See Specimen Required for collection and processing information.
Day(s) Performed
Wednesday
Report Available
1 to 7 daysSpecimen Retention Time
14 daysPerforming Laboratory
Mayo Clinic Laboratories in RochesterCPT Code Information
82570
83018