Metanephrines - Urine

 Extra-regional sites: see Metanephrines - Urine, Extra-regional

80 mL aliquot of acidified 24 hour urine collection

Newborn to Adult:
Refer to charts in Specimen Handling and Additional Information sections.

REFRIGERATE during collection.
Urine specimen collection container must have preservative
pouch(es) added prior to collection.

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.

ADULT Collection Type	Weight of Sulfamic acid in pouch for ADULT Collections
24 hr. collections on patients > 4 yrs.	7 g pouch in each 4 liter container collection
Adult Timed collections	7 g pouch in each 4 liter container collection
Adult random collections	0.5 g pouch for every 100 mL collected (orange capped urine container = 100 mL)

Collection Type for NEWBORN up to 4 YRS	Weight of Sulfamic acid pouch for NEWBORN up to 4 YRS
24 hr. collections on newborn up to 4 yrs.	Use acidification chart in Additional Information section
random collections on newborn up to 4 yrs.	Refer patient to ACH

Testing includes Normetanephrine, Metanephrine, 3 Methoxytyramine

The following drugs cause physiological interference with the levels of
either urine metanephrines, catecholamines, VMA or HVA:
Physiological decreases: clonidine, guanethine, guanfacine, methylDOPA,
Oubain, reserpine, tosylate bretylium, imipramine, moclobemide.
Physiological increases: Atenolol, dopamine, isoproterenol, nifedipine,
nitroglycerin, prochlorperazine, rauwolfia, levodopa, disulfiram,
MAO inhibitors.

For Acidification of Pediatric 24 hour Urines:

Age	Number of 0.5 g pouches of Sulfamic acid to add when Acidifying During Collection
Up to 1 month	Not suitable for 0.5 g pouch Refer patient to ACH
1 up to 2 months	2
2 up to 4 months	3
4 up to 12 months	4
12 months up to 4 yrs	5