Evaluation of hypo- or hyperphosphatemic states
Evaluation of patients with nephrolithiasis
Molybdic Acid
Phosphate
PO4
Urine
Supplies: Sarstedt 5 mL Aliquot Tube (T914)
Container/Tube: Plastic, 5-mL tube
Specimen Volume: 4 mL
Collection Instructions:
1. Collect a random urine specimen.
2. No preservative.
1 mL
All specimens will be evaluated at Mayo Clinic Laboratories for test suitability. |
Specimen Type | Temperature | Time | Special Container |
---|---|---|---|
Urine | Refrigerated (preferred) | 14 days | |
Frozen | 30 days | ||
Ambient | 7 days |
Evaluation of hypo- or hyperphosphatemic states
Evaluation of patients with nephrolithiasis
Approximately 80% of filtered phosphorus is reabsorbed by renal proximal tubule cells. The regulation of urinary phosphorus excretion is principally dependent on regulation of proximal tubule phosphorus reabsorption. A variety of factors influence renal tubular phosphate reabsorption and consequent urine excretion. Factors that increase urinary phosphorus excretion include high phosphorus diet, parathyroid hormone, extracellular volume expansion, low dietary potassium intake, and proximal tubule defects (eg, Fanconi syndrome, X-linked hypophosphatemic rickets, tumor-induced osteomalacia). Factors that decrease, or are associated with decreases in, urinary phosphorus excretion include low dietary phosphorus intake, insulin, high dietary potassium intake, and decreased intestinal absorption of phosphorus (eg, phosphate-binding antacids, vitamin D deficiency, malabsorption states).
A renal leak of phosphate has also been implicated as contributing to kidney stone formation in some patients.
A timed 24-hour urine collection is the preferred specimen for measuring and interpreting this urinary analyte. Random collections normalized to urinary creatinine may be of some clinical use in patients who cannot collect a 24-hour specimen, typically small children.
No established reference values
Random urine phosphorus may be interpreted in conjunction with serum phosphorus, using both values to calculate fractional excretion of chloride.
The calculation for fractional excretion (FE) of phosphorus is
FE(P)= ([P(urine) X Creat(serum)]/[P(serum) X Creat(urine)])X100
Interpretation of urinary phosphorous excretion is dependent upon the clinical situation and should be interpreted in conjunction with the serum phosphorous concentration.
No significant cautionary statements.
1. Delaney MP, Lamb EJ: Kidney disease. In: Rifai N, Horvath AR, Wittwer CT, eds. Tietz Textbook of Clinical Chemistry and Molecular Diagnostics. 6th ed. Elsevier; 2018:1280-1283
2. Matos V, van Melle G, Boulat O et al: Urinary phosphate/creatinine, calcium/creatinine, and magnesium/creatinine ratios in a healthy pediatric population. J Pediatr. 1997;131:252-257
3. Agarwal R, Knochel JP: Hypophosphatemia and hyperphosphatemia. In: Brenner BM, ed. The Kidney. 6th ed. WB Saunders Company; 2000:1071-1125
Inorganic phosphorus reacts with ammonium molydbdate in an acidic solution to form ammonium phosphomolybdate. The ammonium phosphomolybdate is quantified in the ultraviolet range (340 nm).(Package insert: Roche Phosphorus. Roche Diagnostics; V9.0 12/2019)
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.
84105
Test Id | Test Order Name | Order LOINC Value |
---|---|---|
RPHOC | Phosphorus, Random, U | 2778-9 |
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.
|
---|---|---|
RPHOC | Phosphorus, Random, U | 2778-9 |