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Test Code ZNUCR Zinc/Creatinine Ratio, Random, Urine


Ordering Guidance


The use of blood testing is recommended for children younger than 10 years. Order ZN_S / Zinc, Serum.



Specimen Required


Patient Preparation: High concentrations of barium are known to interfere with most metal tests. If barium-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 with no metal cap or glued insert

Submission Container/Tube: Plastic 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.


Secondary ID

615259

Useful For

Identifying the cause of abnormal serum zinc concentrations using a random urine specimen

Profile Information

Test ID Reporting Name Available Separately Always Performed
ZNCU Zinc/Creat Ratio, U No Yes
CRETR Creatinine, Random, U No Yes

Method Name

ZNCU: Triple-Quadrupole Inductively-Coupled Plasma Mass Spectrometry (ICP-MS/MS)

CRETR: Enzymatic Colorimetric Assay

Reporting Name

Zinc/Creat Ratio, Random, U

Specimen Type

Urine

Specimen 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.

Clinical Information

Zinc is an essential element; it is a critical cofactor for carbonic anhydrase, alkaline phosphatase, RNA and DNA polymerases, alcohol dehydrogenase, and many other physiologically important proteins. Zinc is a key element required for active wound healing.

 

Zinc depletion occurs because it is either not absorbed from the diet (excess copper or iron interfere with absorption) or lost after absorption. Dietary deficiency may be due to absence (parenteral nutrition) or because the zinc in the diet is bound to fiber and not available for absorption. Once absorbed, the most common route of loss is via exudates from open wounds, such as third-degree burns, or gastrointestinal loss as in colitis. Hepatic cirrhosis also causes excess loss of zinc by enhancing renal excretion. The peptidase, kinase, and phosphorylase enzymes are most sensitive to zinc depletion.

 

Zinc excess is not of major clinical concern. The popular American habit of taking megavitamins (containing huge doses of zinc) produces no direct toxicity problems. Much of this zinc passes through the gastrointestinal tract and is excreted in the feces. The excess fraction that is absorbed is excreted in the urine. The only known effect of excessive zinc ingestion relates to the fact that zinc interferes with copper absorption, which can lead to hypocupremia.

Reference Values

ZINC/CREATININE:

0-17 years: Not established

≥18 years: 89-910 mcg/g creatinine

 

CREATITINE:

≥18 years old: 16-326 mg/dL

Reference values have not been established for patients who are younger than 18 years.

Interpretation

Fecal excretion of zinc is the dominant route of elimination. Renal excretion is a minor, secondary elimination pathway. Normal daily excretion of zinc in the urine is in the range of 89 to 910 mcg/g creatinine.

 

High urine zinc associated with low serum zinc may be caused by hepatic cirrhosis, neoplastic disease, or increased catabolism.

 

High urine zinc with normal or elevated serum zinc indicates a large dietary source, usually in the form of high-dose vitamins.

 

Low urine zinc with low serum zinc may be caused by dietary deficiency or loss through exudation common in burn patients and those with gastrointestinal losses.

CPT Code Information

84630

82570

LOINC Code Information

Test ID Test Order Name Order LOINC Value
ZNUCR Zinc/Creat Ratio, Random, U 13473-4

 

Result ID Test Result Name Result LOINC Value
615260 Zinc/Creat Ratio, U 13473-4
CRETR Creatinine, Random, U 2161-8