Alberta Precision Laboratories

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Organization:

Alberta Precision Laboratories

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Test Name/Synonym:

Metanephrines, Urine, 24 Hour and Metanephrines, Urine, Random - Calgary Zone (CLS)

LABID (Connect Care):

24 Hour: LAB409
Random: LAB4663

Primary Container:

Random: Sterile container
24 Hour: 24 HR URINE CONTAINER – ACID

Specimen Collection Requirements:

80 mL aliquot of 24 hour urine collection preserved with Sulfamic Acid.

If Sulfamic acid is not available, HCl is also an acceptable preservative. See HCl for Urine Preservation. If test is ordered at the same time as Oxalate, collect with HCl instead of Sulfamic acid. See Oxalate. Direct patient to obtain container with 25 mL of 6N HCl from Beddington or Riverbend PSC or Alberta Children’s Hospital, Foothills Medical Centre and South Health Campus Outpatient labs. HCl is not available at any other PSC.

Specimen may be dropped off at any PSC after collection is complete.

24 hour urine specimen collection container must have preservative pouch(es) added BEFORE collection.

Collection type	Patient Age	Amount of Sulfamic acid preservative
24 hour	Up to 1 month	Not suitable for 0.5 g pouch Refer the patient to ACH
	1 up to 2 months	2 x 0.5 g pouches
	2 up to 4 months	3 x 0.5 g pouches
	4 up to 12 months	4 x 0.5 g pouches
	12 months up to 4 years	5 x 0.5 g pouches
	Greater than or equal to 4 years	7 g pouch in each 4 liter container collection
Random	Less than 18 years ONLY	No preservative.

Refrigerate during collection.

Processing:

24 Hour Collections:

Acidify specimen in original collection container.
Record 24 hour volume and collection (start and end) dates and time in space provided on requisition.
Mix well and pour off acidified aliquot.
Sample pH should be less than 3.0.

Random Collections: (ONLY for patients less than 18 years old)

Transport to DSC on ice.
DSC Accession: freeze specimen upon arrival at DSC.

Testing Schedule:

Weekly

Reference Interval:

Random Urine Reference Intervals (normalized to urine creatinine):

Age (years)	Metanephrines Reference Intervals (umol/mmol)			Normetanephrine Reference Intervals (umol/day)
	Male	Female	U/X	Male	Female	U/X
0 up to 3	0 – 0.24			0 – 0.58
3 up to 10	0 – 0.19			0 – 0.44
10 up to 13	0 – 0.12			0 – 0.26
13 up to 18	0 – 0.09			0 – 0.18
18 or greater	Not accepted			Not accepted

24 Hour Urine Reference Intervals:

Age (years)	Metanephrines Reference Intervals (umol/day)			Normetanephrine Reference Intervals (umol/day)
Age (years)	Male	Female	U/X	Male	Female	U/X
0 up to 3	Not available			Not available
3 up to 10	0 – 0.5	0 – 0.7	0 – 0.7	0 – 0.9	0 – 0.8	0 – 0.9
10 up to 13	0 – 1.0	0 – 0.6	0 – 1.0	0 – 2.3	0 – 1.5	0 – 2.3
13 up to 18	0 – 1.1	0 – 0.9	0 – 1.1	0 – 2.5	0 – 1.6	0 – 2.5
18 up to 30	0 – 1.3	0 – 0.9	0 – 1.3	0 – 3.3
30 up to 40				0 – 2.7
40 up to 50				0 – 3.0
50 up to 60				0 – 4.3
60 up to 70				0 – 4.2
70 or greater				0 – 3.3

Testing Area:

Toxicology

Performing Site:

Diagnostic and Scientific Centre

Additional Test Information:

Testing includes Normetanephrine and Metanephrine, 3-Methoxytyramine is available on special request.

False positive increases in urine and plasma metanephrines and catecholamines have been associated with the following drugs or classes of drugs: anti-depressants, anti-psychotics, some beta blockers, dihydropyridine calcium channel blockers, some anxiolytics, anti-Parkinson’s drugs, decongestants, phenoxybenzamine.

Interpretation of results while on one of these agents should be interpreted with caution and put into clinical context.

24 Hour Urine HVA and VMA have historically been used in the screening of pheochromocytoma and have been replaced by the 24 hour Urine Metanephrine screen, a more specific assay.

Last Updated On:

Monday, May 15, 2023