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Test Code RPNL Renal Function Panel

Specimen and Container/Tube

Specimen Type: Plasma

Preferred Specimen: Li-Heparin Mint Green Top

Other Acceptable specimens: Serum/Gold Top, Serum/Red Top

Specimen Handling and Transport Instructions

UCMC Onsite Instructions: 

Collect specimen per standard collection procedure and send to laboratory immediately. 

UCMC Offsite and UC MedLab Outreach Instructions: 

  • Samples should be centrifuged within 2 hours of collection.
  • Centrifuge specimens at >2500 x g for 10 minutes at room temperature.
  • Aliquot sample into plastic transport tube containing a minimum of 0.2 mL of specimen.
  • Make sure sample is tightly capped.
  • Samples must be sent room temperature at 15-25oC.

Rejection Criteria

  • Common specimen rejected situations include: incorrect specimen type, insufficient volume, missing or incomplete specimen identifiers, incorrect specimen transport, or specimens outside stability limits. 
  • Specimens that are clotted or grossly hemolyzed.
  • Specimens that were transported unspun/whole blood and draw time is greater than 6 hours.

Reference Values

 

Test

Age

Sex

Reference Range

Carbon Dioxide

All

All

23-30 mmol/L

Chloride

All

All

95-108 mmol/L

Potassium

All

All

3.5-5.0 mmol/L

Sodium

All

All

135-145 mmol/L

Anion Gap

All

All

6-15 mmol/L

Calcium

All

All

8.4-10.2 mg/dL

Glucose

All

All

60-109 mg/dL

 

 

Creatinine

 0 - <1 year ALL 0.17 - 0.42 mg/dL
1 - <5 years ALL 0.19 - 0.49 mg/dL
5 - <10 years ALL 0.26 - 0.61 mg/dL
10 - <15 years ALL 0.35 - 0.86 mg/dL
15 - <18 years Male 0.44 - 1.10 mg/dL
Female 0.44 - 1.04 mg/dL
>18 years ALL 0.50 - 1.40 mg/dL

Urea Nitrogen

All

All

7-20 mg/dL

Note: Reference range based on in-house studies, recommendations from Tietz Textbook of Clinical Chemistry, and Roche product literature. 

 

Test

Age

Sex

Reference Range

Interpretation

eGFR-ALL

>18 years

All

≥ 90

Normal

eGFR-ALL

>18 years

All

< 60

Chronic Kidney Disease

eGFR-ALL

>18 years

All

45-59

Stage 3a

eGFR-ALL

>18 years

All

30-44

Stage 3b

eGFR-ALL

>18 years

All

15-29

Stage 4

eGFR-ALL

>18 years

All

<15

Stage 5

Note: eGFR-ALL will replace the two prior equations, one for African Americans and one for all others.  This change is based on the recognition that race is a social not a biological construct.  

Critical Values

Analyte

Unit

Low

High

Age

Carbon Dioxide

mmol/L

<10

>40

All

Potassium

mmol/L

<2.8

>6.2

>14 days

Potassium

mmol/L

<2.8

>8.0

≤ 14 days

Sodium

mmol/L

<120

>160

All

Calcium

mg/dL

<6.0

>13.0

All

Glucose

mg/dL

<40

>500

>14 days

Glucose

mg/dL

<30

>300

≤ 14 days

CPT Codes

84132, 84295, 82435, 82374, 82310, 82947, 82565, 84540

LOINC Codes

2823-3, 2951-2, 2075-0, 2028-9, 17861-6, 2345-7, 2160-0, 3094-0

Volume

Preferred Volume: 0.5 mL

Minimum Volume: 0.2 mL

Specimen Stability

Storage Temperature

Stability

Room temperature

3 days

Refrigerated

8 hours

Frozen

N/A

Collection Instructions

Collect specimen per standard laboratory collection procedures. 

 

Test Components

  • Carbon Dioxide
  • Chloride
  • Potassium
  • Sodium
  • Anion Gap (IGAP) is a calculation of Sodium (Na+ ) minus ((Cl-) plus the Bicarbonate (CO2))
  • Calcium
  • Glucose
  • Creatinine
  • Glomerular Filtration Rate (eGFR)  (See CR for calculation)
  • Urea Nitrogen

Clinical Indications

  • The bicarbonate content of serum or plasma is a significant indicator of electrolyte dispersion and anion deficit.
  • Chloride measurements are used in the diagnosis and treatment of electrolyte and metabolic disorders such as cystic fibrosis and diabetic acidosis.
  • Potassium, as one of the principal intracellular cations in the body, is a major contributor to tissue osmotic pressure and is the prime determinant of the cell resting membrane potential.
  • Sodium measurements are used in the diagnosis and treatment of aldosteronism (excessive secretion of the hormone aldosterone), diabetes insipidus (chronic excretion of large amounts of dilute urine, accompanied by extreme thirst), adrenal hypertension, Addison’s disease (caused by destruction of the adrenal glands), dehydration, inappropriate antidiuretic hormone secretion, or other diseases involving electrolyte imbalance.
  • Calcium is used for the diagnosis and monitoring of hypocalcemia (calcium deficiency) and hypercalcemia (excess calcium) in serum.
  • Glucose is used to monitor hyperglycemia or hyperglycemia. Most frequent cause of hyperglycemia is diabetes mellitus resulting from a deficiency in insulin secretion or action. A number of seconday factors also contribute to elevated blood glucose levels. These include pancreatitis, thyroid dysfunction, renal failure and liver disease. Hypoglycemia is less frequently observed. A variety of conditions may cause low blood glucose levels such as insulinoma, hypopituitarism or insluin induced hypoglycemia.
  • The assay of creatinine in serum or plasma is the most commonly used test to assess renal function.
  • The determination of urea (BUN) is the most widely used test for the evaluation of kidney function. The test is frequently used in conjunction with the determination of creatinine for the differential diagnosis of prerenal hyperuremia (cardiac decompensation, water depletion, increased protein catabolism), renal hyperuremia (glomerulonephritis, chronic nephritis, polycystic kidney, nephrosclerosis, tubular necrosis) and postrenal hyperuremia (obstructions of the urinary tract).

Methodology

  • Ion Specific Electrode Method (ISE) (Roche Diagnostics)
  • Enzymatic Method (Roche Diagnostics)
  • Spectrophotometric (with 5-nitro-5'-methyl-BAPTA) (Roche Diagnostics)
  • Enzymatic Method with hexokinase (Roche Diagnostics)
  • Enzmatic Method, Jaffe alkaline picrate method (Roche Diagnostics)
  • Spectrophotometric, Kinetic (Roche Diagnostics)

Additional Information

  • Results should always be assessed in conjunction with patient's medical history, clinical examination and other findings.
  • Release of potassium from as few as 0.5 % of the erythrocytes (from specimen collection) can increase the plasma level by 0.5 mmol/L.
  • For Additional Information please see individual test. Chloride, Potassium, Sodium, Bicarbonate, Calcium, Glucose, Creatinine, Urea Nitrogen
  • Each of these test components may be ordered individually. A test or panel may be ordered only when all components are medically necessary to diagnose or treat an individual patient. If all components are not medically necessary, a less inclusive panel and/or an individual test as appropriate to treat the individual patient should be ordered.

Turnaround Time

Turnaround times are relative to the time the specimen is received in the test laboratory. 

 

STAT Turnaround Time: 1 hour

Routine Turnaround Time: 4 hours

Testing Schedule: 24/7

Synonyms/Keyword Search

CO2, HCO3, Bicarbonate, Na, Sodium, K, Potassium, Cl, Chloride, IGAP, Anion Gap, Calcium, Total, Sugar, CREA, Creatinine, eGFR, GFREA, GFRE, CR, UREA, BUN

Last Review Date

8/19/2024