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Metanephrines - Urine

Source Urine

 
Mnemonic UMETA and U24H (urine creatinine is included in the U24H order)

 
Specimen Requirements

80 mL aliquot of 24 hour urine collection preserved with Sulfamic acid. Refer to charts in Specimen Handling and Additional Information sections.
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.

HCl collections:
Direct patient to obtain container with 25 mL of 6N HCl from Beddington or Riverbend PSC or RRL Outpatient labs. HCl is not available at any other PSC. Specimen may be dropped off at any PSC after collection is complete.

Refrigerate during collection.
24 hour urine specimen collection container must have preservative pouch(es) added prior to collection.

 

Specimen Handling

 Patient Type

Collection type

Weight of Sulfamic acid in pouch

 Newborn to 4 years

24 hour

See Pediatric 24 Hour Urine Acidification chart below

 4 - 150 years

24 hour
Timed

7 g pouch in each 4 liter container collection

 Less than 16 years ONLY

 Random

No preservative.  Transport to DSC on ice. 
DSC Accession: freeze specimen upon arrival at DSC.


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.


Pediatric 24 Hour Urine Acidification:

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 to 2 months

2

2 to 4 months

3

4 to 12 months

4

 12 months to 4 years 

5

 

 


 

Additional Information

Testing includes Normetanephrine and Metanephrine

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24 Hour Urine HVA and VMA have historically been used in the screening of pheochromocytoma and have been replaced by the 24 hour Urine Metanephrine screen, a more specific assay. 

Testing Location Analytical Toxicology
Testing Frequency Weekly

 
Alternate Name(s) Hypertension Screen, Normetanephrine, Pheochromocytoma Screen

 
Reference Interval 24 hour urine levels less than 2.4 umol/d Metanephrine and less than 5.3 umol/d Normetanephrine may be seen in hypertensive patients.

Age

Sex

Normetanephrine (umol/d)

Random Normetanephrine (umol/mol Ur Creat)

Metanephrine (umol/d)

Random Metanephrine (umol/mol Ur Creat)

Less than 3 years  

Not Available

75-584

Not Available

47-240

3-8 years

M

0.2-0.9

57-443

0.2-0.5

37-191

F

0.2-0.8

0.1-0.7

9-12 years

M

0.5-2.3

33-255

0.3-1.0

24-120

F

0.3-1.5

0.2-0.6

13-17 years

M

0.5-2.5

23-176

0.4-1.1

17-88

F

0.3-1.6

0.2-0.9

18-150 years

M

0.2-1.3

 

F

0.2-0.9

18-29 years

M/F

0.6-2.1

 

30-39 years

M/F

0.6-2.3

     

40-49 years

M/F

0.6-2.5

     
50-59 years

M/F

0.7-2.6

 

60-69 years

M/F

0.8-2.8

     
70-150 years

M/F

0.8-3.1