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Chromium (Cr)

Test Background

High concentrations of cobalt and chromium in blood or serum are associated with increased wear of artificial hip joints and may contribute to an indication for revision of the procedure. The MHRA has advised that a concentration of >134 nmol/L is an indication of excessive wear in a metal-on-metal hip implant. Chromium deficiency has been linked to impaired glucose metabolism; however this test cannot be used to determine chromium deficiency.

Clinical Indications

Predominantly used for assessing wear of artificial hip joints.
High concentrations of chromium are associated with increased wear of artificial hip joints and may contribute to an indication for revision of the procedure. Toxic sources of chromium include dyes, paints, and leather tanning processes.

Reference Range
Blood <15 nmol/L
Serum/Plasma <6 nmol/L
Urine <9 nmol/L

<2.9 nmol/mmol creatinine

 

Sample volume
0.5 mL
Turnaround time
2 weeks
Sample & Container Required
Whole Blood: EDTA Trace element tube (Royal blue cap), EDTA (lavender top) or heparin (green top) Serum: Trace element tube preferred (royal blue top), plain serum (red top) or SST (yellow top). Plasma: Li-Hep tube with or without gel separator. Urine: sterile universal or plain 24hr
Transport Storage
Stable at 2-8oC.
Sample can be sent by first class post.
Notes

Median whole blood chromium concentrations with well-functioning hips: (median concentration)

Metal-on plastic: Chromium 15 nmol/L

Unilateral metal-on-metal: Chromium 45 nmol/L

Bilateral metal-on-metal: Chromium 45 nmol/L

MHRA Action level of 7ppb is equivalent to 134 nmol/L Cr

Grossly haemolysed plasma or serum samples are unsuitable for this assay.

Record last updated
September 5, 2025

Sample Container

6ml Trace Metal Silica (Navy blue top with purple band on label)

Sample Container

4ml EDTA Vacutainers (Lavender top)

Sample Container

6ml Lithium Heparin (Green top)

Sample Container

6ml Plain Vacutainers (Red top)

Sample Container

5ml SST Vacutainers (Gold / Yellow top)

Sample Container

150ml Universal Container for Urine TB (Silver top)

Sample Container

24hr Urine Bottle (Plain label)

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Test Results

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See the following UKAS ref numbers:

  • Clinical Biochemistry Ref: 8673
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  • Infection & Immunity Sciences (Including Immunology, Virology, Microbiology and Histocompatibility and Immunogenetics ) Ref: 8659
  • Cellular Pathology (Including Histopathology, Cytology and Molecular Pathology) Ref: 9615

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INSTRUCTION SHEET FOR BLOOD SAMPLE COLLECTION 

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Our accreditations

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Find out more about our accreditations on the UKAS website.

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