Catecholamines, Fractionated, Random Urine

CATS, epinephrine, norepinephrine, dopamine

Test Codes

EPIC: LAB1231929, Beaker: CatRanUr, Quest: 5244

Department

Send Outs

Instructions

It is preferable for the patient to be off medications for a minimum of 18-24 hours prior to collection. However, common antihypertensives (diuretics, ACE inhibitors, calcium channel blockers, alpha and beta blockers) cause minimal or no interference. Patient should avoid alcohol, coffee, tea, tobacco and strenuous exercise for 8-12 hours prior to collection.

Specimen Collection Criteria

Collect: Random urine in a screw-capped container (preferred) or other sterile collection container. (Minimum: 5.0 mL)

Physician Office/Draw Specimen Preparation

Add 1-2 drops 6N HCl to a 10 mL urine aliquot within 4 hours of collection. Mix well, ensure pH is between 1-3, and send urine refrigerated in a plastic screw-capped urine cup. Maintain frozen (-20°C/-4°F or below) prior to transport.

Preparation for Courier Transport

Transport: Urine, frozen (-20°C/-4°F or below). (Minimum: 0.75 mL)

Rejection Criteria

Specimens not collected and processed as indicated.

In-Lab Processing

Add 1-2 drops 6N HCl to a 10 mL urine aliquot within 4 hours of collection. Mix well, ensure pH is between 1-3, and send urine refrigerated in a plastic screw-capped urine cup. Maintain specimen refrigerated (2-8°C or 36-46°F) prior to transport.

Transport: Urine, frozen (-20°C/-4°F or below). (Minimum: 0.75 mL)

NOTE: Catecholamines are not stable above pH 7. The pH of such specimens must be adjusted by the addition of 6N HCL prior to transport.

Storage

Specimen Stability for Testing:

With preservative:
Room Temperature (20-26°C or 68-78.8°F): Unacceptable
Refrigerated (2-8°C or 36-46°F): 30 days
Frozen (-20°C/-4°F or below): 60 days

Without preservative:
Room Temperature (20-26°C or 68-78.8°F): Unacceptable
Refrigerated (2-8°C or 36-46°F): 7 days
Frozen (-20°C/-4°F or below): 60 days

Specimen Storage in Department Prior to Disposal:

Specimen retention time is determined by the policy of the reference laboratory. Contact the Send Outs Laboratory with any questions.

Laboratory

Sent to Quest Diagnostics, Wood Dale, IL.

Performed

Monday, Wednesday, Friday.
Results available within 3-5 days.

Reference Range

By report.

Test Methodology

Liquid Chromatography/Mass Spectrometry (LC/MS).

Clinical Utility

Catecholamines, Fractionated, Random Urine - This panel may aid in evaluating catecholamine-producing pheochromocytomas and paragangliomas (PPGLs). However, measurements of plasma free or urinary fractionated metanephrines (i.e., the O-methylated catecholamine metabolites) are preferred for the initial biochemical evaluation of PPGLs because of their overall high diagnostic sensitivity [1]. To adjust for the concentration differences in random urine specimens, results are expressed as catecholamine to creatinine ratios.

Most PPGLs secrete catecholamines and can cause catecholamine excess, resulting in hypertension, arrhythmia, and hyperglycemia. Left untreated, PPGLs often lead to life-threatening cardiovascular complications. The estimated prevalence of PPGLs is 0.05% to 0.1% in adults with hypertension and 1.7% in children with hypertension [2]. Recognizing the possibility of a PPGL and performing appropriate biochemical testing are crucial for the diagnosis [1]. Plasma or urine catecholamine levels may be used, in addition to metanephrine levels, to provide additional information during the initial biochemical evaluation of PPGLs (e.g., when detecting dopamine-secreting paragangliomas) [2].

Intermittent or insignificant secretion of catecholamines by some PPGLs may not increase catecholamine measurements. Physiological stress and certain medications (e.g., acetaminophen, labetalol, and sotalol) may increase catecholamine measurements [1].

The results of this test should be interpreted in the context of pertinent clinical and family history and physical examination findings.

Reference

1. Lenders JW, et al. J Clin Endocrinol Metab. 2014;99(6):1915-1942.
2. National Comprehensive Cancer Network. NCCN clinical practice guidelines in oncology (NCCN Guidelines®).
    Neuroendocrine and Adrenal Tumors. V1.2022. Accessed June 28, 2022. http://www.nccn.org

CPT Codes

82384, 82570.

Contacts

Last Updated

11/19/2025