Catecholamines (Urine)

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Auckland Te Toka Tumai

Test Guide

Catecholamines (Urine)

Testing Laboratory

Auckland Te Toka Tumai | Auckland Hospital

Department

Chemical Pathology

Delphic Registration Code (Alpha Code)

CATS (Adults)
KCAT (0661) (patients <16 years old)

Test Code (Numeric Code)

0612

Laboratory Handling

Transport

Once the sample is collected, send immediately to the laboratory.
Please mark request form with a "Paediatric catecholamine - Urgent" sticker.

Registration

Casual urines must be registered urgently and given to Automation staff for acidifying WITHIN 2 HOURS of collection.

Laboratory

LabPLUS High Performance Liquid Chromatography

Sample Stability

Catecholamines are not stable.
Casual specimens must be acidified to a pH of 3 - 4 with 2 hours of collection.
24 hour urine collection must be in acid bottle (20mL 6mol/L HCl).

Associated Tests

Metanephrines (Urine)

Synonyms

Catecholamines (Urine), Adrenaline, Noradrenaline, Dopamine, Cats

Turnaround Time

1 week

Performed Weekly.
Special arrangements can be made following discussions with Chemical Pathologist if urgent testing is required.
Urine HVA will be prioritised for urgent testing due to faster turnaround time.

Specimen Type

24hr Urine
Urine

Specimen Requirements

Tube/Container Type:

Preferred

Acidified 24hr Urine Container

Acceptable

BD Urine Tube (no additive)

Preferred Sample Volume (ml)

Minimum Sample Volume (ml)

Paediatric Specimen Requirements

Tube/Container Type:

Preferred

Acidified 24hr Urine Container
BD Urine Tube (no additive)
Specimen Container

Preferred Sample Volume (ml)

Minimum Sample Volume (ml)

Additional Specimen Information

Casual urine must be acidified within 2 hours of collection.

Urine catecholamine requests in adults are not usually performed. For requests on patients 16 years and older urine metanephrines will be performed instead. Please refer to the urine metanephrines test guide entry for sample requirements.

ADULT: 20mL 6mol/L HCl .
Urine catecholamine requests in adults are not usually performed unless by special arrangement with a Chemical Pathologist. For requests on patients 16 years and older urine metanephrines will be performed instead. Please refer to the urine metanephrines test guide entry for sample requirements.

CHILDREN
Random samples from children are acceptable if there is difficulty collecting a 24 h specimen. In this case, concentrations will be related to creatinine output.
Casual paediatric specimens must be acidified within 2 hours of collection. Minimum sample 2 mL.

For casual collects on children at ACH the following protocol is used:
1. Once the sample is collected, send immediately to the laboratory. Please mark request form with a "Paediatric catecholamine - Urgent" sticker so that samples are treated with HCl as soon as possible.
2. HVA and metanephrine levels will also be measured automatically on all samples from children 15 years of age and under.
3. Ward staff are to ensure samples are handed to a laboratory staff member, and not just placed in the specimen reception tray.

Diagnostic Use

When confirming the diagnosis of phaeochromocytoma, the first-line tests are:

Urine metanephrines in a 24 hour urine collection (adults) or a spot urine (children).
Plasma metanephrines (5mL EDTA blood).

Urine and plasma metanephrines have equal diagnostic accuracy (sensitivity and specificity) and are better than other tests.

Urine catecholamines may be helpful if urine and plasma metanephrines are borderline. Plasma catecholamines are difficult to measure and to interpret as they fluctuate widely depending on posture, anxiety etc. They are very rarely required, and only done as part of a clonidine suppression test.

Catecholamines, Medication and Diet

No special dietary precautions are necessary, because the HPLC method used at Labplus does not have any problems with food interferences.
The following drugs may cause false positive results:

Clozapine has been reported to cause hypertension, with symptoms similar to phaeochromocytoma, and raised urine noradrenaline and normetadrenaline levels (up to 3 x normal) (4)
Labetalol interferes with the adrenaline peak seen during analysis, which may lead to a falsely increased adrenaline result.
L-dopa will cause an increased dopamine
Tricyclic antidepressants and phenoxybenzamine are likely to cause increases in noradrenaline and/or adrenaline. SSRIs do not have this effect.
Alpha-blockers , beta-blockers , calcium channel blockers , phenothiazines and theophylline may cause small (up to 2x) increases in noradrenaline and/or adrenaline.

Please list all medications on the request form. Some other medications produce peaks on the HPLC tracing but they can be distinguished from the catecholamines. If we see some unusual peaks, it is helpful if we can relate them to the patient’s medication.

Dopamine and neuroblastoma

Dopamine and its metabolite HVA are increased in neuroblastoma. An isolated increase in urinary dopamine excretion is a fairly common non-specific finding in both children and adults, and is probably not clinically significant if there is no clinical suspicion of neuroblastoma. Most of the dopamine found in normal urine is produced by the kidneys rather than elsewhere in the body. Phaeochromocytomas which secrete only dopamine are very rare. Huge increases in urinary dopamine are seen in patients who are taking L-dopa.

Urine metanephrines are performed 2-3 times per week. Urine catecholamines are performed once a week (i.e. turnaround time of up to 2 weeks depending on arrival). As these are highly specialised analyses, we would like to avoid testing at night or weekends, so please aim to provide/send early specimens to us wherever possible.
LabPlus uses advanced technology (tandem mass spectrometry) to perform urine HVA tests; which results in significantly faster turnaround time. If urgent testing is required, Urine HVA will be done. Prior approval by a chemical pathologist is required for the laboratory to perform urgent testing.
Urine catecholamines are not offered as an urgent service. However, if asked the on-call chemical pathologist can consider this as an unusual request on a case by case basis, depending on clinical suspicion and the HVA result.
Urine metanephrines carry excellent diagnostic utility for neuroblastic tumours. Their use is being increasingly adopted by laboratories across Australasia. Urine metanephrines (including methoxytyramine), catecholamines and HVA are performed on every paediatric request to maximise sensitivity, regardless of whether the clinical indication is for neuroblastoma or phaeochromocytoma.
A review of local data consisting of 20 new neuroblastoma cases indicated that the sensitivity of urine HVA and methoxytyramine was approximately 90% while dopamine alone was 76%. No new cases of neuroblastoma had an isolated urine dopamine/creatinine ratio increase. The specificity of urine methoxytyramine, dopamine and HVA are approximately 90% for new cases.
If clinically indicated, variations to this agreement, such as plasma metanephrines/methoxytyramine, can be available by arrangement by contacting the on-call chemical pathologist.

24h versus spot urine specimens are preferred over spot urines. A 24 hour urine specimen is more likely to detect brief peaks in catecholamine secretion than a random specimen. 24 hour urinary creatinine excretion is used as a guide to the completeness of a urine collection.

Reference Intervals

24-hour urines

Reference intervals:

Age	Adrenaline (nmol/d)	Noradrenaline (nmol/d)
10-19 years	≤ 110	≤ 470
19 years or older	≤ 100	≤ 760

Age	Dopamine (umol/d)
10-15 years	≤ 2.9
15 years or older	≤ 4.0

Age	Adrenaline / Creatinine (nmol/mmol)	Noradrenaline / Creatinine (nmol/mmol)	Dopamine / Creatinine (umol/mmol)
10-15 years	≤ 8	≤ 51	≤ 0.38
15 years or older	≤ 9.5	≤ 69	≤ 0.46

Random urines

Reference intervals:

Age	Adrenaline / Creatinine (nmol/mmol)	Noradrenaline / Creatinine (nmol/mmol)
< 1 year	≤ 69	≤ 278
1-4 years	≤ 65	≤ 196
4-10 years	≤ 50	≤ 179
10-15 years	≤ 14	≤ 74

Age	Dopamine / Creatinine (umol/mmol)
< 3 months	≤ 2.0
3 months – 1 year	≤ 1.7
1-2 years	≤ 1.3
2-5 years	≤ 0.9
5-10 years	≤ 0.7
10-15 years	≤ 0.4

Age	Adrenaline / Creatinine (nmol/mmol)	Noradrenaline / Creatinine (nmol/mmol)
< 1 year	≤ 69	≤ 278
1-4 years	≤ 65	≤ 196
4-10 years	≤ 50	≤ 179
10-15 years	≤ 14	≤ 74

Test Method

High performance liquid chromatography with electrochemical detection (HPLC-ECD)

Limitations / Interference

The most common drugs that cause interference are labetolol, L-dopa and sinemet. Other drugs such as some psychotropics, e.g. MAOI's, can also affect results.

Uncertainty of Measurement

Adrenaline 12% (this Assay), Noradrenaline 10%. Dopamine 12%

Last updated: 25/08/2026

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Testing Laboratory

Department

Delphic Registration Code (Alpha Code)

Test Code (Numeric Code)

Laboratory Handling

Transport

Registration

Laboratory

Sample Stability

Associated Tests

Synonyms

Turnaround Time

Specimen Type

Specimen Requirements

Tube/Container Type:

Preferred

Acceptable

Preferred Sample Volume (ml)

Minimum Sample Volume (ml)

Paediatric Specimen Requirements

Tube/Container Type:

Preferred

Preferred Sample Volume (ml)

Minimum Sample Volume (ml)

Additional Specimen Information

Aliquot Instructions

Sample Type

Minimum Volume (ml)

Transport to Lab

Diagnostic Use

Reference Intervals

24-hour urines

Random urines

Test Method

Limitations / Interference

Uncertainty of Measurement

Contact Information

Enquiry Form

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Catecholamines (Urine)

Overview

Testing Laboratory

Department

Delphic Registration Code (Alpha Code)

Test Code (Numeric Code)

Laboratory Handling

Transport

Registration

Laboratory

Sample Stability

Associated Tests

Synonyms

Turnaround Time

Specimen

Specimen Type

Specimen Requirements

Tube/Container Type:

Preferred

Acceptable

Preferred Sample Volume (ml)

Minimum Sample Volume (ml)

Paediatric Specimen Requirements

Tube/Container Type:

Preferred

Preferred Sample Volume (ml)

Minimum Sample Volume (ml)

Additional Specimen Information

Referral

Aliquot Instructions

Sample Type

Minimum Volume (ml)

Transport to Lab

Clinical Information/Test Method

Diagnostic Use

Reference Intervals

24-hour urines

Random urines

Test Method

Limitations / Interference

Uncertainty of Measurement

Additional Information

Contact Information

Contact Information

Enquiry Form

Search tests