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HelpTest ID RFAMA Renal Function Panel, Serum
Necessary Information
Patient's age and sex are required.
Specimen Required
Collection Container/Tube:
Preferred: Serum gel
Acceptable: Red top
Submission Container/Tube: Plastic vial
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 the serum aliquoted into a plastic vial within 2 hours of collection.
Useful For
Aiding 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
Profile Information
| 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 |
Method Name
KS, NAS, CL: Potentiometry
HCO3: Photometric, Enzymatic
AGAP: Calculated result
BUN: Photometric, Urease
CRTS1: Colorimetric
CA: Photometric
GLURA: Photometric
ALB: Photometric, Bromcresol Green
PHOS: Photometric, Ammonium Molybdate
Reporting Name
Renal Function Panel, SSpecimen Type
SerumSpecimen Minimum Volume
0.5 mL
Specimen Stability Information
| Specimen Type | Temperature | Time |
|---|---|---|
| Serum | Refrigerated | 24 hours |
Reject Due To
| Gross hemolysis | Reject |
| Gross lipemia | OK |
Clinical Information
This 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. This 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.
Reference Values
SODIUM
<1 year: Not established
≥1 year: 135-145 mmol/L
POTASSIUM
<1 year: Not established
≥1 year: 3.6-5.2 mmol/L
CHLORIDE
<1 year: Not established
1-17 years: 102-112 mmol/L
≥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
≥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
≥10 years: 22-29 mmol/L
ANION GAP
<7 years: Not established
≥7 years: 7-15
BLOOD UREA NITROGEN (BUN)
Males
<12 months: Not established
1-17 years: 7-20 mg/dL
≥18 years: 8-24 mg/dL
Females
<12 months: Not established
1-17 years: 7-20 mg/dL
≥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
≥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
≥16 years: 0.59-1.04 mg/dL
ESTIMATED GLOMERULAR FILTRATION RATE (eGFR)
≥ 18 years old: ≥60 mL/min/BSA (body surface area)
Estimated GFR calculated using the 2021 CKD-EPI creatinine equation.
Note: eGFR results will not be calculated for patients younger than 18 years old.
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
≥1 year: 70-140 mg/dL
Total Protein
≥1 year: 6.3-7.9 g/dL
Reference values have not been established for patients who are younger than 12 months of age.
ALBUMIN
≥12 months: 3.5-5.0 g/dL
Reference values have not been established for patients who are younger than 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
≥18 years: 2.5-4.5 mg/dL
Reference values have not been established for patients that are younger 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
≥18 years: 2.5-4.5 mg/dL
Reference values have not been established for patients that are younger than 12 months of age.
Interpretation
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 results 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.
Cautions
No significant cautionary statements.
Clinical Reference
1. Oh MS: Evaluation of renal function, water, electrolytes, and acid-base balance. In: McPherson RA, Pincus MR, eds. Henry's Clinical Diagnosis and Management by Laboratory Methods. 22nd ed. Elsevier Saunders; 2011:chap 14
2. Renal Panel. Testing.com; Updated November 9, 2021. Accessed July 14, 2022. Available at www.testing.com/tests/renal-panel/
Method Description
Potassium, Sodium, Chloride:
An ion-selective electrode (ISE) makes use of the unique properties of ion-selective membrane to develop an electrical potential (electromotive force: EMF) for the measurements of ions in solution. Selective membrane is in contact with both the test solution and an internal filling solution. Due to the selectivity of the membrane, only the ions to be measured contribute to the EMF. The membrane EMF is determined by the difference in concentration of the test ion in the test solution and the internal filling solution. The EMF develops according to Nernst equation of a specific ion in solution.(Package insert: ISE indirect Na-K-Cl for Gen 2. Roche Diagnostics; 05/2024)
Bicarbonate:
Bicarbonate reacts with phosphoenolpyruvate (PEP) in the presence of PEPC to produce oxaloacetate and phosphate. That reaction is coupled with one involving the transfer of a hydrogen ion from reduced nicotinamide adenine dinucleotide (NADH) analog to oxaloacetate using malate dehydrogenase. The resultant consumption of NADH analog causes a decrease in absorbance, which is proportional to the concentration of bicarbonate in the sample being analyzed.(Package insert: Bicarbonate reagent. Roche Diagnostics; 02/2023)
Anion Gap:
This is a calculated result. The following equation is used to calculate the anion gap (A gap):
A gap = Na - (Cl + HCO3-)
Blood Urea Nitrogen (BUN):
Kinetic test with urease and glutamate dehydrogenase. Urea is hydrolyzed by urease to form ammonium and carbonate. In the second reaction 2-oxoglutarate reacts with ammonium in the presence of glutamate dehydrogenase and the coenzyme reduced nicotinamide adenine dinucleotide (NADH) to produce L-glutamate. In this reaction two moles of NADH are oxidized to NAD[+] for each mole of urea hydrolyzed. The rate of decrease in NADH concentrations is directly proportional to the urea concentration in the specimen and is measured photometrically.(Package insert: Urea/BUN reagent. Roche Diagnostics; 07/2024)
Creatinine:
This enzymatic method is based on the conversion of creatinine with the aid of creatininase, creatinase, and sarcosine oxidase to form glycine, formaldehyde, and hydrogen peroxide. Catalyzed by peroxidase the liberated hydrogen peroxide reacts with 4-aminophenazone and HTIB (2,4,6-triiodo03-hydroxybenzoic acid) 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: Creatinine plus. Roche Diagnostics; 07/2024)
Estimated Glomerular Filtration Rate:
Estimated glomerular filtration rate (eGFR) is calculated using the 2021 Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation:
Females:
If creatinine ≤0.7 mg/dL: 142 x (Scr/0.7)(-0.241) x 0.9938age x 1.012
If creatinine >0.7 mg/dL: 142 x (Scr/0.7)(-1.200) x 0.9938age x 1.012
Males:
If creatinine ≤0.9 mg/dL: 142 x (Scr/0.9)(-0.302) x 0.9938age
If creatinine >0.9 mg/dL: 142 x (Scr/0.9)(-1.200) x 0.9938age
Values are reported for calculated GFR estimates between 15 to 90 mL/min/1.73 m(4). Estimated GFR values outside of this range are reported as "<15 mL/min/1.73 m(2)" or ">90 mL/min/1.73 m(4)" and not as an exact number.
Calcium:
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: CA2 reagent. Roche Diagnostics; 08/2023)
Glucose:
Hexokinase catalyzes the phosphorylation of glucose to glucose-6-phosphate by ATP. Glucose-6-phosphate dehydrogenase oxidizes glucose-6-phosphate in the presence of nicotinamide adenine dinucleotide phosphate (NADP) to gluconate-6-phosphate. No other carbohydrate is oxidized. The rate of NADPH formation during the reaction is directly proportional to the glucose concentration and is measured photometrically.(Package insert: Glucose HK Gen.3. Roche Diagnostics; 07/2024)
Albumin:
At a pH value of 4.1, albumin displays a sufficiently cationic character to be able to bind with bromcresol green (BCG), an anionic dye, to form a blue-green complex. The color intensity of the blue-green color is directly proportional to the albumin concentration in the sample and is measured photometrically.(Package insert: Albumin reagent. Roche Diagnostics; V 8.0, 06/2024)
Phosphorus (Inorganic):
Inorganic phosphate forms an ammonium phosphomolybdate complex with ammonium molybdate in the presence of sulfuric acid. The concentration of phosphomolybdate formed is directly proportional to the inorganic phosphate concentration and is measured photometrically.(Package insert: Phosphate (Inorganic). Roche Diagnostics; 10/2023)
Day(s) Performed
Monday through Sunday
Report Available
Same day/1 to 2 daysTest Classification
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.CPT Code Information
KS: 84132
NAS: 84295
CL: 82435
HCO3: 82374
BUN: 84520
CRTS1: 82565
CA: 82310
GLURA: 82947
ALB: 82040
PHOS: 84100
NY State Approved
YesForms
If not ordering electronically, complete, print, and send 1 of the following forms with the specimen:
-Kidney Transplant Test Request
-Renal Diagnostics Test Request (T830)