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Test Code ROXUR Oxalate, Random, Urine


Ordering Guidance


A timed 24-hour urine collection is the preferred specimen for measuring and interpreting this urinary analyte. Order OXU / Oxalate, 24 Hour, Urine.

 

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 under 16 years old.



Specimen Required


Patient Preparation: Avoid taking large doses (>2 g orally/24 hours) of vitamin C prior to specimen collection.

Supplies: Urine Tubes, 10 mL tube (T068)

Container/Tube: 10-mL plastic tube or a clean, plastic container with no metal cap

Specimen Volume: 7 mL

Collection Instructions:

1. Collect a random urine specimen.

2. No preservative.

3. Specimen pH should be between 4.5 and 8 and will stay in this range if kept refrigerated. Specimens with pH above 8 may indicate bacterial contamination, and testing will be cancelled. Do not attempt to adjust pH as it will adversely affect results.


Useful For

Monitoring therapy for kidney stones using random urine specimens

 

Identifying increased urinary oxalate as a risk factor for stone formation

 

Diagnosis of primary or secondary hyperoxaluria

Profile Information

Test ID Reporting Name Available Separately Always Performed
OXCO1 Oxalate, Random, U (mmol/L) No Yes
OXCO3 Oxalate, Random, U (mg/L) No Yes
CRETR Creatinine, Random, U No Yes
RAT11 Oxalate/Creatinine Ratio No Yes

Method Name

OXCO1: Enzymatic Using Oxalate Oxidase

CRETR: Enzymatic Colorimetric Assay

OXCO3, RAT11: Calculation

Reporting Name

Oxalate, Random, U

Specimen Type

Urine

Specimen Minimum Volume

6 mL

Specimen Stability Information

Specimen Type Temperature Time Special Container
Urine Refrigerated (preferred) 14 days
  Frozen  14 days
  Ambient  72 hours

Reject Due To

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

Clinical Information

Oxalate is an end product of glyoxalate and glycerate metabolism. Humans have no enzyme capable of degrading oxalate, therefore 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 to kidney 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

No established reference values

Interpretation

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 below 0.35 mmol/mL at birth, to below 0.15 mmol/mL at 1 year of age, to below 0.10 mmol/mL at 10 years of age, and below 0.05 mmol/mL at 20 years of age (see table below).(1)

 

Table. 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

Ingestion of ascorbic acid (>2 g/day) may falsely elevate the measured urinary oxalate excretion.

 

Do not collect in metal-capped containers.

Method Description

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 600 nm.(Kasidas GP, Rose GA. Continuous-flow assay for urinary oxalate using immobilized oxalate oxidase. Ann Clin Biochem, 1985;22:412-419; package insert: Oxalate kit. Trinity Biotech; V 11/2017)

Day(s) Performed

Monday through Saturday

Report Available

3 to 5 days

Specimen Retention Time

7 days

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Test Classification

This test has been modified from the manufacturer's instructions. Its performance characteristics were determined by Mayo Clinic in a manner consistent with CLIA requirements. This test has not been cleared or approved by the US Food and Drug Administration.

CPT Code Information

83945

82570

LOINC Code Information

Test ID Test Order Name Order LOINC Value
ROXUR Oxalate, Random, U 15086-2

 

Result ID Test Result Name Result LOINC Value
CRETR Creatinine, Random, U 2161-8
OXCO1 Oxalate, Random, U (mmol/L) 15086-2
OXCO3 Oxalate, Random, U (mg/L) 2700-3
RAT11 Oxalate/Creatinine Ratio 13483-3

Forms

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

Disease States

  • Hyperoxaluria