Test Id : DOXA1
Oxalate Analysis, Hemodialysate
    
        Useful For
            
                
                
                    
                    Suggests clinical disorders or settings where the test may be helpful
                
            
    
    Determining the amount of oxalate removed during a dialysis session
Individualizing the dialysis prescription of hyperoxaluric patients
    
        Method Name
            
                
                
                    
                    A short description of the method used to perform the test
                
            
    
    Enzymatic
    
        NY State Available
            
                
                
                    
                    Indicates the status of NY State approval and if the test is orderable for NY State clients.
                
            
    
    
    
        Reporting Name
            
                
                
                    
                    Lists a shorter or abbreviated version of the Published Name for a test
                
            
    
    
    
        Aliases
            
                
                
                    
                    Lists additional common names for a test, as an aid in searching
                
            
    
    Dialysate Oxalate
Dialysis Oxalate
Hemodialysate Oxalate
Hemodialysis Oxalate
Oxalate Dialysate
Oxalate Dialysis
Oxalate Hemodialysate
Oxalate Hemodialysis
    
        Specimen Type
            
                
                
                    
                    Describes the specimen type validated for testing
                
            
    
        Dialysate Fluid
    
        Specimen Required
            
                
                
                    
                    Defines the optimal specimen required to perform the test and the preferred volume to complete testing
                
            
    
    Specimen Type: Dialysate fluid
Patient Preparation: Patient should avoid taking vitamin C supplements for 24 hours prior to dialysis
Supplies: Urine Tubes, 10 mL (T068)
Container/Tube: Plastic, 10-mL urine tube or a clean, plastic aliquot container with no metal cap or glued insert
Specimen Volume: 5 mL
Collection Instructions: Adjust the pH of the specimen to 2.5 to 3.0 with 6M Hydrochloric Acid
Additional Information: Nonacidified frozen hemodialysate delivered to the laboratory within 3 days from collection will be accepted and the following comment will be added to the result: In nonacidified hemodialysate stored frozen, oxalate values may increase spontaneously.
    
        Forms
    
    If not ordering electronically, complete, print, and send a Renal Diagnostics Test Request (T830) with the specimen.
    
        Specimen Minimum Volume
            
                
                
                    
                    Defines the amount of sample necessary to provide a clinically relevant result as determined by the testing laboratory. The minimum volume is sufficient for one attempt at testing.
                
            
    
    2 mL
    
        Reject Due To
            
                
                
                    
                    Identifies specimen types and conditions that may cause the specimen to be rejected
                
            
    
    | All specimens will be evaluated at Mayo Clinic Laboratories for test suitability. | 
    
        Specimen Stability Information
            
                
                
                    
                    Provides a description of the temperatures required to transport a specimen to the performing laboratory, alternate acceptable temperatures are also included
                
            
    
    | Specimen Type | Temperature | Time | Special Container | 
|---|---|---|---|
| Dialysate Fluid | Frozen | 14 days | 
    
        Useful For
            
                
                
                    
                    Suggests clinical disorders or settings where the test may be helpful
                
            
    
    Determining the amount of oxalate removed during a dialysis session
Individualizing the dialysis prescription of hyperoxaluric patients
    
        Clinical Information
            
                
                
                    
                    Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test
                
            
    
    Oxalate is a dicarboxylic acid, an end product of glyoxalate and glycerate metabolism that is excreted in the urine where it is a common component of kidney stones (up to 85%). Hyperoxaluria can be either genetic (eg, primary hyperoxaluria) or acquired/secondary (eg, enteric hyperoxaluria), and can lead to nephrocalcinosis and renal failure. Monitoring the adequacy of oxalate removal during hemodialysis can be useful in the management of patients with hyperoxaluria and renal failure, particularly following transplantation.
    
        Reference Values
            
                
                
                    
                    Describes reference intervals and additional information for interpretation of test results. May include intervals based on age and sex when appropriate. Intervals are Mayo-derived, unless otherwise designated. If an interpretive report is provided, the reference value field will state this.
                
            
    
    Not applicable
    
        Interpretation
            
                
                
                    
                    Provides information to assist in interpretation of the test results
                
            
    
    An exponential decrease in oxalate signal is expected through dialysis procedure.
Signals below 2 mcM at any point during dialysis suggest that the plasma has been effectively cleared, although there can be rebound after dialysis ceases.
Total oxalate removed during a dialysis session can be estimated by multiplying the concentration of oxalate in the dialysate by the oxalate flow rate for each time period that the oxalate is measured.
    
        Cautions
            
                
                
                    
                    Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances
                
            
    
    
            
            
    
        Clinical Reference
            
                
                
                    
                    Recommendations for in-depth reading of a clinical nature
                
            
    
    1. Perinpam M, Enders FT, Mara KC, et al: Plasma oxalate in relation to eGFR in patients with primary hyperoxaluria, enteric hyperoxaluria and urinary stone disease. Clin Biochem 2017;50(18):1014-1019
2. Tang X, Voskoboev NV, Wannarka SL, et al: Oxalate quantification in hemodialysate to assess dialysis adequacy for primary hyperoxaluria. Am J Nephrol 2014;39(5):376-382
3. Marangella M, Petrarulo M, Mandolfo S, et al: Plasma profiles and dialysis kinetics of oxalate in patients receiving hemodialysis. Nephron 1992;60(1):74-80
4. Marangella M, Vitale C, Petrarulo M, et al: Bony content of oxalate in patients with primary hyperoxaluria or oxalosis-unrelated renal failure. Kidney Int 1995;48(1):182-187
    
        Method Description
            
                
                
                    
                    Describes how the test is performed and provides a method-specific reference
                
            
    
    This is an enzymatic method based on the reduction of oxalate by oxalate oxidase. The reaction releases hydrogen peroxide, which in the presence of peroxidase reacts with a dye to give a colored end point that is measured using a BioTek EPOCH plate spectrophotometer at 590 nm.(Package insert: Trinity Biotech, Oxalate Kit, Jamestown, NY, V. 07/2016)
    
        PDF Report
            
                
                
                    
                    Indicates whether the report includes an additional document with charts, images or other enriched information
                
            
    
    
    
        Day(s) Performed
            
                
                
                    
                    Outlines the days the test is performed. This field reflects the day that the sample must be in the testing laboratory to begin the testing process and includes any specimen preparation and processing time before the test is performed. Some tests are listed as continuously performed, which means that assays are performed multiple times during the day.
                
            
    
    Monday through Friday
    
        Report Available
            
                
                
                    
                    The interval of time (receipt of sample at Mayo Clinic Laboratories to results available) taking into account standard setup days and weekends. The first day is the time that it typically takes for a result to be available. The last day is the time it might take, accounting for any necessary repeated testing.
                
            
    
    
    
        Specimen Retention Time
            
                
                
                    
                    Outlines the length of time after testing that a specimen is kept in the laboratory before it is discarded
                
            
    
    
    
        Performing Laboratory Location
            
                
                
                    
                    Indicates the location of the laboratory that performs the test
                
            
    
    
    
        Fees :
            
                
                
                    
                    Several factors determine the fee charged to perform a test. Contact your U.S. or International Regional Manager for information about establishing a fee schedule or to learn more about resources to optimize test selection.
                
            
    
    - Authorized users can sign in to Test Prices for detailed fee information.
- Clients without access to Test Prices can contact Customer Service 24 hours a day, seven days a week.
- Prospective clients should contact their account representative. For assistance, contact Customer Service.
    
        Test Classification
            
                
                
                    
                    Provides information regarding the medical device classification for laboratory test kits and reagents. Tests may be classified as cleared or approved by the US Food and Drug Administration (FDA) and used per manufacturer instructions, or as products that do not undergo full FDA review and approval, and are then labeled as an Analyte Specific Reagent (ASR) product.
                
            
    
    This test has been modified from the manufacturer's instructions. Its performance characteristics were determined by Mayo Clinic in a manner consistent with CLIA requirements. This test has not been cleared or approved by the US Food and Drug Administration.
    
        CPT Code Information
            
                
                
                    
                    Provides guidance in determining the appropriate Current Procedural Terminology (CPT) code(s) information for each test or profile. The listed CPT codes reflect Mayo Clinic Laboratories interpretation of CPT coding requirements. It is the responsibility of each laboratory to determine correct CPT codes to use for billing.
CPT codes are provided by the performing laboratory.
                
            
    
    CPT codes are provided by the performing laboratory.
83945
    
        LOINC® Information
            
                
                
                    
                    Provides guidance in determining the Logical Observation Identifiers Names and Codes (LOINC) values for the order and results codes of this test. LOINC values are provided by the performing laboratory.
                
            
    
    | Test Id | Test Order Name | Order LOINC Value | 
|---|---|---|
| DOXA1 | Oxalate, Dialysate Fluid | 47715-8 | 
| Result Id | Test Result Name | Result LOINC Value 
                                        
                                        Applies only to results expressed in units of measure originally reported by the performing laboratory. These values do not apply to results that are converted to other units of measure.
                                     | 
|---|---|---|
| DOXA1 | Oxalate, Dialysate Fluid | 47715-8 |