CAP Pro Course - Chemistry - Liver and Renal Testing

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Author: DeRhonda Crawford, MT(ASCP)
Reviewer: Laurie Bjerklie, MA, MLS(ASCP)CM

Continuing Education Credits

Objectives

  • Discuss the clinical significance of liver function assays.
  • Identify methodologies used for certain liver function assays.
  • Discuss the clinical significance of renal function assays.
  • Describe the relationships between serum creatinine, glomerular filtration rate, and estimated glomerular filtration rate.
  • Recognize preanalytical variables that may affect liver and renal function assay results and describe measures to ensure accuracy.

Course Outline

  • Discuss the clinical significance of liver function assays.
      • Liver Enzymes
      • Other Relevant Liver Assays
      • Clinical Significance of Liver Tests
      • A young child had some routine laboratory tests performed. The ALP result was increased and the GGT result was normal. What is most likely the cause o...
      • A newborn baby had a total and direct bilirubin ordered by their doctor. The laboratory performing the testing did not report the indirect bilirubin. ...
      • The doctor ordered a liver function panel to evaluate his patient's liver. Of the tests listed, which one should normally be included in a liver funct...
      • A new mother asks her doctor why her newborn boy's skin appears jaundiced. Of the tests listed below, which would be the most helpful in diagnosing th...
  • Identify methodologies used for certain liver function assays.
      • Measurement of Enzyme Activity
      • Direct Spectrophotometric Method for Determination of Total Bilirubin
      • Diluting Specimens for Enzyme Testing
      • A doctor treating a 5-year-old child is requesting a bilirubin test be run. The doctor calls the laboratory requesting the sample be run by a non-dire...
      • The result for ALP is outside the upper limit of the analytic measurement range (AMR). The AMR for ALP is 0 - 1000 IU/L. The undiluted result is 3500 ...
      • The AMR for GGT is 10-2000 IU/L. The maximum dilution for GGT is X2 with a maximum reportable range of 4000 IU/L. The final diluted result read 4500 I...
      • What does "analytic measurement range" refer to?
  • Discuss the clinical significance of renal function assays.
      • Blood and Urine Renal Function Assays
      • Urine Protein and Renal Function
      • Microalbumin
      • Clinical Significance of Renal Function Assays
      • The kidneys filter the blood and remove waste products and other unwanted substances from the blood. What is another process the kidneys provide for t...
      • What is one non-protein substance listed that can be measured in the blood and urine that evaluate renal filtering and waste removal functions of the ...
      • A patient diagnosed with renal disease has the following laboratory values:Urine CRE (UCRE) = 300 mg/dLUrine total protein (UTP) = 20 mg/dLWhat would ...
      • Urine albumin (UALB) and urine creatinine (UCRE) are run on a randomly collected urine sample and an albumin-to-creatinine ratio (ACR) is calculated f...
      • What are the two significant non-protein substances measured to evaluate renal function?
  • Describe the relationships between serum creatinine, glomerular filtration rate, and estimated glomerular filtration rate.
      • Relationship Between Creatinine, GFR, and eGFR
      • Limitations on Using the MDRD Equation for Estimating GFR
      • If a 60-year-old woman is diagnosed with kidney damage, what would you expect her creatinine and GFR to read as part of a general chemistry panel?
      • When collecting a 24-hour urine for creatinine clearance, a serum/plasma creatinine level must also be collected. What is the time frame in which the ...
      • What is the recommended age for a laboratory to start reporting an estimated glomerular filtration rate (eGFR) calculation with a person's routine che...
  • Recognize preanalytical variables that may affect liver and renal function assay results and describe measures to ensure accuracy.
      • Preanalytical Errors Affecting Measurement of Liver and Renal Analytes
      • Preanalytical Factors That May Affect Plasma Ammonia Test Results
      • What is a preanalytical step for phlebotomists and laboratory technicians to follow when collecting and processing samples for ammonia?
      • The laboratory's SOP requires blood samples for serum or plasma testing to be spun down after collection. What is the recommended time frame for centr...
      • The laboratory called the phlebotomy station located on the 5th floor to have a liver function test recollected due to hemolysis. From the liver funct...
  • References
      • References

Additional Information

Level of Instruction: Intermediate
Intended Audience: This program is designed as an educational and training tool for MLS, MT, and MLT personnel, phlebotomists, medical laboratory science students and interns, pathology residents, and practicing pathologists.
Author: DeRhonda Crawford, MT(ASCP) is the chemistry supervisor at Gwinnett Medical Center in Lawrenceville, Georgia and the technical supervisor for the Gwinnett Medical Center in Duluth, Georgia. She holds a BS in Medical Technology from the Medical College of Georgia.
Reviewer Information: Laurie Bjerklie, M.A., MLS(ASCP)CM is currently a Content Developer for MediaLab and LabCE. She earned a B.S. in Medical Laboratory Science from the University of North Dakota and an M.A. in Curriculum and Instruction from Saint Xavier University. She has over 14 years of experience in higher education and has held faculty positions in both MLT and MLS programs. She most recently served as the Program Manager of Medical Laboratory Science at Saint Louis University.

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