Ascend Clinical Reference Ranges (November 2018) Chemistry

Transcription

1 24 Hour Urine Creatinine mg/24 hr (Male) (Female) Kinetic Alkaline Picrate (Jaffe Reaction) for Creatinine 24 hour Urine Creatinine Clearence (Creatinine ml/min/1.73m^ (Male) Kinetic Alkaline Picrate (Jaffe Reaction) for Clearance) (Female) Creatinine 24 Hour Urine Urea Nitrogen g/24 hr 7-16 Urease/GLDH A/G Ratio Ratio > 0.9; high ratio is usually clinically insignificant Albumin g/dl Bromocresol Green (BCG) Alkaline Phosphatase IU/L p-nitrophenyl Phosphate; IFCC ALT (SGPT) IU/L 7-52 UV/NADH; IFCC Aluminum µg/l 1-20 Inductively Coupled Plasma Mass Agilent 7800 Spectrometry (ICP-MS) Anion Gap meq/l 3-14 AST (SGOT) IU/L UV/NADH; IFCC Bilirubin, Direct mg/dl Diazonium Salt, DPD Bilirubin, Total mg/dl Diazonium Salt, DPD BUN (Blood Urea Nitrogen) mg/dl 7-25 Urease/GLDH Calcium mg/dl Arsenazo III Calcium, Adjusted Total (with Albumin) mg/dl Calcium Phosphorus Product (CA*PO4) mg^2/dl^2 <55.0 Calcium Phosphorus Product, Adjusted mg^2/dl^2 <55.0 (CA*PO4, Adjusted) Calcium, Ionized mmol/l Ion Selective Electrode (ISE), Direct Nova 8 (Undiluted) Chloride meq/l Ion Selective Electrode (ISE), Indirect (Diluted) Cholesterol mg/dl Normal: Enzymatic Cholesterol/HDL Ratio Ratio Optimal: < 200 Borderline: Higher Risk: > 239 Optimal: < 3.3 Higher Risk: > 6.2 CO2 (Bicarbonate or Carbon Dioxide) meq/l Enzymatic (Phosphoenolpyruvate Carboxylase) C-Reactive Protein (CRP) mg/l Immunoturbidimetric Creatine Kinase (CPK) IU/L UV/NADPH; IFCC (Creatine Phosphate/NADPH) Ranges subject to change without notice. Please refer to patient's laboratory report. Page 1 of 6

2 Creatinine mg/dl See Table Below Kinetic Alkaline Picrate (Jaffe Reaction) Ferritin Folate ng/ml ng/ml Male: Female: >5.38 Indeterminate: ng/ml Deficient: ng/ml Chemiluminescence Chemiluminescence Siemens Atellica IM-1600 Siemens Atellica IM-1600 Gamma Glutamyl Transferase (GGT) IU/L 9-64 Glutamyl-carboxy-p-nitroanilide; IFCC Globulin g/dl Glucose mg/dl Hexokinase-UV/NAD HDL mg/dl Male: mg/dl; Female: mg/dl Direct - No Pretreatment, Enzymatic Desirable: > 59 (Accelerator Selective Detergent) Higher Risk: < 40 Hemoglobin A1C (Glycohemoglobin) High-Performance Liquid Chromatography Bio-Rad D-100 (HPLC) Iron µg/dl TPTZ (Tripyridyltriazine) Kt/V Jindal N/A The HD Adequacy Work Group feels this formula should not be used to measure delivered dose of Hemodialysis. - Jindal Formula Kt/V Natural Log N/A The K/DOQI recommendations are: - Daugirdas II Formula Prescribed dose of hemodialysis - Kt/V of 1.3 Delivered dose of hemodialysis - Kt/V > 1.2 Kt/V Equilibrated N/A See Kt/V Standard for recommendations - Leypoldt Formula Kt/V Standard N/A The K/DOQI recommendations are: - Leypoldt Formula Minimum Kt/V Standard of 2.0 per week Ranges subject to change without notice. Please refer to patient's laboratory report. Page 2 of 6

3 LDH, Plasma IU/L Lactate-Pyruvate (NAD); IFCC LDL, Calc mg/dl Optimal: < 100 Above Optimal: Borderline High: High: Very High: > Friedewald Formula Magnesium mg/dl Colorimetric (Xylidyl Blue) npna g/kg/day Providers should strive to achieve an npna of greater than - Modified Bergstrom Formula or equal to 0.9 g/kg/day. npna valid only if protein loss <15 g/day. Phosphorus mg/dl UV; Phosphomolybdate Complex Potassium (K) meq/l Ion Selective Electrode (ISE), Crown-Ether Membrane Prealbumin mg/dl Immunoturbidimetric Protein, Total g/dl Biuret; Blanked Protein, Total, 24 hr Urine w/ Creatinine mg/g Creatinine 0-84 Protein, Total, Random Urine w/ Creatinine mg/dl Urine Protein, Random: 5-25 (Male) Pyrogallol Red Urine Protein, Random: 5-24 (Female) mg/g Creatinine Urine Protein, Random with Creatinine: PSA, Total ng/ml Chemiluminescence Siemens Advia Centaur XPT PTH, Intact pg/ml Suggested (KDIGO) ESRD maintenance range is two to nine times the upper normal limit (80.1 pg/ml) for the laboratory. Chemiluminescence Siemens Atellica IM-1600 Recirculation Study Recirculation results should average zero (-5 to +5) in patients with unimpaired accesses. Recirculation exceeding 10 should prompt investigation of its cause. If access recirculation values exceed 20, correct placement of needles should be confirmed before conducting further studies. Elevated levels of access recirculation should be investigated using angiography (fistulography) to determine whether stenotic lesions are impairing access blood flow. Residual Urea Clearance (KrU) ml/min N/A Sodium (NA) meq/l Ion Selective Electrode (ISE), Crown-Ether Membrane T3, Free pg/ml Chemiluminescence Siemens Atellica IM-1600 T3, Total ng/dl Chemiluminescence Siemens Atellica IM-1600 Ranges subject to change without notice. Please refer to patient's laboratory report. Page 3 of 6

4 T4, Free (FT4) ng/dl Hypothyroid: < 0.89 Hyperthyroid: > 1.76 Chemiluminescence Siemens Atellica IM-1600 T4, Total (Thyroxine) ug/dl Chemiluminescence Siemens Atellica IM-1600 Thyroid Stimulating Hormone (TSH), µiu/ml Chemiluminescence Siemens Atellica IM-1600 Ultrasensitive TIBC, Calculated ug/dl Transferrin mg/dl Immunoturbidimetric Transferrin Saturation Triglycerides mg/dl Optimal: < 150 Borderline High: Enzymatic (Glycerol Phosphate Oxidase); Colorimetric (without Glycerol Blank with Serum Blank) High: URR (Urea Reduction Rate), Uric Acid mg/dl Very High: > 499 The K/DOQI recommendations are: Prescribed dose of hemodialysis - URR > or = to 70 Delivered dose of hemodialysis - URR > or = to (Male) (Female) Uricase Urine Creatinine (Random) mg/dl N/A Kinetic Alkaline Picrate (Jaffe Reaction) Urine Protein (Random) mg/dl see 24-hour urine Total Protein Pyrogallol Red Urine Protein, Random with Creatinine mg/g Creatinine see 24-hour urine Total Protein Pyrogallol Red for Urine Protein Urine Urea Nitrogen (Random) mg/dl N/A Urease/GLDH Vitamin B12 pg/ml Deficient: Chemiluminescence Siemens Atellica IM-1600 Vitamin D 25-OH (Vitamin D, 25-Hydroxy) ng/ml See Table Below Chemiluminescence Siemens Atellica IM-1600 VLDL Cholesterol mg/dl Optimal: < 30 Borderline High: High: Very High: > 99 Zinc µg/l Inductively Coupled Plasma Mass Spectrometry (ICP-MS) Agilent 7800 Ranges subject to change without notice. Please refer to patient's laboratory report. Page 4 of 6

5 Hematology Basophils Eosinophils (Male) (Female) (Male) (Female) Fluid Cell Count WBC/µL <50 and Manual Differential Hematocrit (HCT) Hemoglobin (HGB) g/dl (Male) (Female) (Male) Direct Current Sheath Flow Cyanide-free Sodium Lauryl Sulfate (SLS) (Female) Hemoglobin Immature Granulocytes (IG) HGB x 3 Lymphocytes g/dl (Male) (Female) (Male) MCH MCHC MCV pg g/dl fl (Female) (Male) (Female) (Male) (Female) (Male) Monocytes Neutrophils (Female) (Male) (Female) (Male) Platelets RBC K/µL M/uL (Female) (Male) (Female) (Male), Direct Current Sheath Flow Direct Current Sheath Flow RDW Reticulocytes (Female) (Male) (Female) (Male) (Female) Reticulocyte HE pg WBC K/µL (Male) (Female) Ranges subject to change without notice. Please refer to patient's laboratory report. Page 5 of 6

6 Coagulation Prothrombin Time (PT) seconds Optical Clot Detection Sysmex CS-2500/CA-1500 INR Ratio Therapeutic Ranges Low Dose Anticoagulant: High Dose Anticoagulant: Sysmex CS-2500/CA-1500 Hep B Surface Ab Quant miu/ml >=10: Antibodies present (Probable Immunity) Chemiluminescent Sandwich Immunoassay Siemens Atellica IM-1600 <10: Antibodies not present (No Immunity) Immunology / Serology Hep B Surface Ag N/A Negative Chemiluminescent Sandwich Immunoassay Siemens Atellica IM-1600/Siemens Advia Centaur XPT Hep B Core Ab, IgM N/A Negative Chemiluminescent Sandwich Immunoassay Siemens Atellica IM-1600 Hep B Core Ab, Total N/A Negative Chemiluminescent Sandwich Immunoassay Siemens Atellica IM-1600 Hep C Virus Ab N/A Non-Reactive Chemiluminescent Sandwich Immunoassay Siemens Atellica IM-1600 HIV12 Ab and p24 Ag N/A Non-Reactive Chemiluminescent Sandwich Immunoassay Siemens Advia Centaur XPT Therapeutic Drugs (TDMs) Digoxin ng/ml Enzyme Immunoassay Phenytoin, Total (Dilantin) µg/ml Enzyme Immunoassay Vancomycin, Peak µg/ml Enzymatic Mediated Immuno Technique (EMIT) Vancomycin, Random µg/ml Peak: Trough: Enzymatic Mediated Immuno Technique (EMIT) Vancomycin, Trough µg/ml Enzymatic Mediated Immuno Technique (EMIT) KDOQI Guidelines for Chronic Kidney Disease: GFR (Glomerular Filtration Rate) ml/min/1.73 m2 Stage 1: >89 Formula based on four parameter MDRD Stage 2: (Modification of Diet in Renal Disease) equation using an IDMS (Isotope Dilution Stage 3: Stage 4: Mass Spectometry) - Traceable Calibration for Creatinine Stage 5: <15 Ranges subject to change without notice. Please refer to patient's laboratory report. Page 6 of 6