Aids in diagnosis and management of conditions affecting kidney function
General health screening
Screening patients at risk of developing kidney disease
Management of patients with known kidney disease
Test Id | Reporting Name | Available Separately | Always Performed |
---|---|---|---|
KS | Potassium, S | Yes | Yes |
NAS | Sodium, S | Yes | Yes |
CL | Chloride, S | Yes | Yes |
HCO3 | Bicarbonate, S | Yes | Yes |
AGAP | Anion Gap | No | Yes |
BUN | Bld Urea Nitrog (BUN), S | Yes | Yes |
CRTS1 | Creatinine with eGFR, S | Yes | Yes |
CA | Calcium, Total, S | Yes | Yes |
GLURA | Glucose, Random, S | Yes | Yes |
ALB | Albumin, S | Yes | Yes |
PHOS | Phosphorus (Inorganic), S | Yes | Yes |
KS, NAS, CL: Potentiometric, Indirect Ion-Selective Electrode
HCO3: Photometric, Enzymatic
AGAP: Sodium-(Bicarbonate + Chloride)
BUN: Photometric, Urease
CRTS1: Enzymatic Colorimetric Assay
CA: Photometric, 5-nitro-5'-methyl-BAPTA
GLURA: Photometric/Hexokinase
ALB: Photometric, Bromcresol Green
PHOS: Photometric, Ammonium Molybdate
Renal function panel
Serum
Patient's age and sex are required.
Container/Tube:
Preferred: Serum gel
Acceptable: Red top
Specimen Volume: 0.6 mL
Collection Instructions:
1. Serum gel tubes should be centrifuged within 2 hours of collection.
2. Red-top tubes should be centrifuged and aliquoted within 2 hours of collection.
If not ordering electronically, complete, print, and send a Renal Diagnostics Test Request (T830) with the specimen.
0.5 mL
Gross hemolysis | Reject |
Gross lipemia | OK |
Specimen Type | Temperature | Time | Special Container |
---|---|---|---|
Serum | Refrigerated (preferred) | 24 hours |
Aids in diagnosis and management of conditions affecting kidney function
General health screening
Screening patients at risk of developing kidney disease
Management of patients with known kidney disease
A renal function panel could be ordered when a patient has risk factors for kidney dysfunction such as high blood pressure (hypertension), diabetes, cardiovascular disease, obesity, elevated cholesterol, or a family history of kidney disease. A renal function panel may also be ordered when someone has signs and symptoms of kidney disease, though early kidney disease often does not cause any noticeable symptoms. It may be initially detected through routine blood or urine testing.
SODIUM
<1 year: not established
> or =1 year: 135-145 mmol/L
POTASSIUM
<1 year: not established
> or =1 year: 3.6-5.2 mmol/L
CHLORIDE
<1 year: not established
1-17 years: 102-112 mmol/L
> or =18 years: 98-107 mmol/L
BICARBONATE
Males
<1 year: not established
1-2 years: 17-25 mmol/L
3 years: 18-26 mmol/L
4-5 years: 19-27 mmol/L
6-7 years: 20-28 mmol/L
8-17 years: 21-29 mmol/L
> or =18 years: 22-29 mmol/L
Females
<1 year: not established
1-3 years: 18-25 mmol/L
4-5 years: 19-26 mmol/L
6-7 years: 20-27 mmol/L
8-9 years: 21-28 mmol/L
> or =10 years: 22-29 mmol/L
ANION GAP
<7 years: not established
> or =7 years: 7-15
BLOOD UREA NITROGEN (BUN)
Males
<12 months: not established
1-17 years: 7-20 mg/dL
> or =18 years: 8-24 mg/dL
Females
<12 months: not established
1-17 years: 7-20 mg/dL
> or =18 years: 6-21 mg/dL
CREATININE
Males
0-11 months: 0.17-0.42 mg/dL
1-5 years: 0.19-0.49 mg/dL
6-10 years: 0.26-0.61 mg/dL
11-14 years: 0.35-0.86 mg/dL
> or =15 years: 0.74-1.35 mg/dL
Females
0-11 months: 0.17-0.42 mg/dL
1-5 years: 0.19-0.49 mg/dL
6-10 years: 0.26-0.61 mg/dL
11-15 years: 0.35-0.86 mg/dL
> or =16 years: 0.59-1.04 mg/dL
eGFR
>60 mL/min/BSA
Estimated GFR calculated using the 2009 CKD_EPI creatinine equation.
CALCIUM
<1 year: 8.7-11.0 mg/dL
1-17 years: 9.3-10.6 mg/dL
18-59 years: 8.6-10.0 mg/dL
60-90 years: 8.8-10.2 mg/dL
>90 years: 8.2-9.6 mg/dL
GLUCOSE
0-11 months: not established
> or =1 year: 70-140 mg/dL
Total Protein
> or =1 year: 6.3-7.9 g/dL
Reference values have not been established for patients who are <12 months of age.
ALBUMIN
> or =12 months: 3.5-5.0 g/dL
Reference values have not been established for patients who are <12 months of age.
PHOSPHORUS
Males
1-4 years: 4.3-5.4 mg/dL
5-13 years: 3.7-5.4 mg/dL
14-15 years: 3.5-5.3 mg/dL
16-17 years: 3.1-4.7 mg/dL
> or =18 years: 2.5-4.5 mg/dL
Reference values have not been established for patients that are less than 12 months of age.
Females
1-7 years: 4.3-5.4 mg/dL
8-13 years: 4.0-5.2 mg/dL
14-15 years: 3.5-4.9 mg/dL
16-17 years: 3.1-4.7 mg/dL
> or =18 years: 2.5-4.5 mg/dL
Reference values have not been established for patients that are less than 12 months of age.
Renal function panel results are not diagnostic but rather indicate that there may be a problem with the kidneys and that further testing is required to make a diagnosis and determine the cause. Results of the panel are usually considered together, rather than separately. Individual test result can be abnormal due to causes other than kidney disease, but taken together with risks and signs and symptoms, they may give an indication of whether kidney disease is present.
No significant cautionary statements.
1. Oh MS: Evaluation of renal function, water, electrolytes, and acid-base balance. In Henry's Clinical Diagnosis and Management by Laboratory Methods. 22nd edition. Edited by RA McPherson, MR Pincus. Philadelphia, PA: Elsevier Saunders; 2011:chap 14
2. AACC: Lab Tests Online: Access 03/22/2017. Available at https://labtestsonline.org/understanding/analytes/bmp
KS, NAS, CL:
Ion-selective electrode (ISE) (indirect potentiometry). The ISE module performs indirect measurement of electromotive force (EMF). The ISE module measures the EMF difference between an ISE and a reference electrode. The EMF of the ISE is dependent on the ion concentration of the sample. The EMF of the reference electrode is constant. An electronic calculation circuit converts EMF of the sample to the ion concentration of the sample.(Package insert: Roche Diagnostics ISE reagent; Indianapolis, IN, 2006)
Bicarbonate (HCO3):
This is a photometric rate reaction. Bicarbonate (HCO3-) reacts with phosphoenolpyruvate (PEP) in the presence of phosphoenolpyruvate carboxylase (PEPC) to produce oxaloacetate and phosphate. The oxaloacetate produced is coupled with NADH in the presence of malate dehydrogenase (MDH) to produce malate and NAD. The consumption of NADH causes a decrease in absorbance and is monitored in the UV range of 320 nm to 400 nm. The rate of change is directly proportional to the concentration of bicarbonate.(Package insert: Roche Bicarbonate reagent, Indianapolis, IN, July 2000)
AGAP:
This is a calculated result. The following equation is used to calculate the anion gap (A gap):
A gap = Na - (Cl + HCO3)
BUN:
This is a kinetic ultraviolet assay where urease cleaves urea to form ammonia and CO2. The ammonia formed then reacts with a-ketoglutarate and NADH in the presence of urease/glutamate dehydrogenase (GLDH) to yield glutamate and NAD. The decrease in absorbance, due to the consumption of NADH, is measured kinetically and is proportional to the amount of urea in the sample.(Package insert: Roche Urea/BUN reagent; Indianapolis, IN, Sept 2000)
CRTS1:
This enzymatic method is based on the conversion of creatinine with the aid of creatininase, creatinase, and sarcosine oxidase to glycine, formaldehyde, and hydrogen peroxide. Catalyzed by peroxidase, the liberated hydrogen peroxide reacts with 4-aminophenazone and hydroxy(tosyloxy)iodobenzene (HTIB) to form a quinone imine chromogen. The color intensity of the quinone imine chromogen formed is directly proportional to the creatinine concentration in the reaction mixture.(Package insert: Roche Diagnostics, Indianapolis IN, 12/2016)
CA:
Calcium ions react with 5-nitro-5'-methyl-BAPTA (NM-BAPTA) under alkaline conditions to form a complex. This complex reacts in the second step with EDTA. The change in absorbance is directly proportional to the calcium concentration and is measured photometrically.(Package insert: Roche Calcium Gen.2 reagent, Roche Diagnostic Corp, Indianapolis, IN, 2012 July)
GLURA:
Glucose in the serum, in the presence of hexokinase, is converted to glucose-6-phosphate (G-6-P). Glucose-6-phosphate dehydrogenase (G-6-PDH), in the presence of NADP, oxides G-6-P to gluconate-6-phosphate and NADPH. The rate of NADPH formation is directly proportional to glucose concentration in the serum and is measured photometrically.(Package insert: Roche Glucose Reagent. Indianapolis, IN, January 2000)
ALB:
The dye, bromcresol green (BCG), is added to serum in an acid buffer. The color intensity of the blue-green albumin-BCG complex is directly proportional to the albumin concentration and is determined photometrically.(Package insert: Roche Albumin reagent; Roche Diagnostic Corp., Indianapolis, IN, July 1999)
PHOS:
The method is based on the reaction of phosphate with ammonium molybdate to form ammonium phosphomolybdate (without reduction). The addition of an accelerator gives rise to a more rapid rate of reaction. Sample blanking yields more precise results.(Package insert: Roche Phosphorus reagent, Roche Diagnostics Corp, Indianapolis, IN, 1999)
Monday through Sunday
This test has been cleared, approved, or is exempt by the US Food and Drug Administration and is used per manufacturer's instructions. Performance characteristics were verified by Mayo Clinic in a manner consistent with CLIA requirements.
KS: 84132
NAS: 84295
CL: 82435
HCO3: 82374
BUN: 84520
CRTS1: 82565
CA: 82310
GLURA: 82947
ALB: 82040
PHOS: 84100
Test Id | Test Order Name | Order LOINC Value |
---|---|---|
RFAMA | Renal Function Panel, S | 24362-6 |
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.
|
---|---|---|
AGAP | Anion Gap | 33037-3 |
ALB | Albumin, S | 1751-7 |
BUN | Bld Urea Nitrog (BUN), S | 3094-0 |
CL | Chloride, S | 2075-0 |
GLURA | Glucose, Random, S | 2345-7 |
HCO3 | Bicarbonate, S | 1963-8 |
PHOS | Phosphorus (Inorganic), S | 2777-1 |
CA | Calcium, Total, S | 17861-6 |
NAS | Sodium, S | 2951-2 |
KS | Potassium, S | 2823-3 |
CRTSA | Creatinine, S | 2160-0 |
EGNB | eGFR Non-Black/African American | 88294-4 |
EGBL | eGFR-Black/African American | 88293-6 |
EGFR1 | Estimated GFR (eGFR) | 2160-0 |