Test Catalog

Test Id : KIDST

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Kidney Stone Analysis

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Overview

Test Catalog

Useful For
Suggests clinical disorders or settings where the test may be helpful

Managing patients with recurrent renal calculi (kidney stones)

Testing Algorithm
Delineates situations when tests are added to the initial order. This includes reflex and additional tests.

Upon arrival in the performing laboratory, all stone specimens and the containers in which they are received will be inspected. Prior to analysis, stones must be clean and dry.

Method Name
A short description of the method used to perform the test

Infrared Spectrum Analysis

NY State Available
Indicates the status of NY State approval and if the test is orderable for NY State clients.

Yes

Reporting Name
Lists a shorter or abbreviated version of the Published Name for a test

Kidney Stone Analysis

Aliases
Lists additional common names for a test, as an aid in searching

Calculi Stone Analysis

Calculus (Stone) Analysis

Prostatic Stones

Renal Calculi

Urinary Calculi

Testing Algorithm
Delineates situations when tests are added to the initial order. This includes reflex and additional tests.

Upon arrival in the performing laboratory, all stone specimens and the containers in which they are received will be inspected. Prior to analysis, stones must be clean and dry.

Specimen Type
Describes the specimen type validated for testing

Stone

Necessary Information

Specimen source is required.

ORDER QUESTIONS AND ANSWERS

Question ID Description Answers
SRC1 Source: Bladder
Passed Stone
Prostate
Urethra
Urinary Tract
Kidney
Left Kidney
Right Kidney
Renal
Left Renal
Right Renal
Ureter
Left Ureter
Right Ureter

Specimen Required
Defines the optimal specimen required to perform the test and the preferred volume to complete testing

Supplies: Stone Analysis Collection Kit (T550)

Sources: Bladder, kidney, prostatic, renal, or urinary

Specimen Volume: Entire dried calculi specimen

Collection Instructions:

1. Have patient collect specimen using the Patient Collection Instructions for Kidney Stones.

2. For detailed instructions on kidney stone preparation and packaging, see Kidney Stone Packaging Instructions.

3. Prepare stone by cleaning any blood or foreign material from the stone with deionized water.

4. Place stone on a clean filter or paper towel and let dry at ambient temperature for a minimum of 24 hours.

5. Do not place stone directly in a bag. If specimen is received in a bag, either transfer stone into a screw-capped, plastic container or place bag containing stone in a screw-capped, plastic container.

6. Indicate source of specimen on the outside of the container (eg, left kidney, bladder, right ureter).

7. Repeat steps 2 through 5 for each stone received.

Specimen Stability Information: Ambient (preferred) 2 years/Refrigerated 1 year/Frozen 1 year

Special Instructions
Library of PDFs including pertinent information and forms related to the test

Forms

If not ordering electronically, complete, print, and send 1 of the following forms with the specimen:

-General Request (T239)

-Renal Diagnostics Test Request (T830)

Specimen Minimum Volume
Defines the amount of sample necessary to provide a clinically relevant result as determined by the testing laboratory. The minimum volume is sufficient for one attempt at testing.

Entire stone

Reject Due To
Identifies specimen types and conditions that may cause the specimen to be rejected

  All specimens will be evaluated at Mayo Clinic Laboratories for test suitability.

Specimen Stability Information
Provides a description of the temperatures required to transport a specimen to the performing laboratory, alternate acceptable temperatures are also included

Specimen Type Temperature Time Special Container
Stone Ambient (preferred)
Frozen 365 days
Refrigerated 365 days

Useful For
Suggests clinical disorders or settings where the test may be helpful

Managing patients with recurrent renal calculi (kidney stones)

Testing Algorithm
Delineates situations when tests are added to the initial order. This includes reflex and additional tests.

Upon arrival in the performing laboratory, all stone specimens and the containers in which they are received will be inspected. Prior to analysis, stones must be clean and dry.

Clinical Information
Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test

The composition of urinary stones may vary from a simple crystal to a complex mixture containing several different species of crystals. The composition of the nidus (center) may be entirely different from that of the peripheral layers.

 

Eighty percent of patients with kidney stones have a history of recurrent stone formation. Knowledge of stone composition can be useful to guide therapy of patients with recurrent stone formation.

 

Treatment of urinary calculi is complex.(1) In an overly simplified format, the following patterns are often treated as follows:

-Hyperuricuria and predominately uric acid stones: Alkalinize urine to increase uric acid solubility

-Hypercalciuria and predominately hydroxyapatite stones: Acidify urine to increase calcium solubility

However, treatment also depends on urine pH and urine phosphate, sulfate, oxalate, and citrate concentrations.

-Hyperoxaluria and calcium oxalate stones: Increase daily fluid intake and consider reduction of daily calcium

However, daily requirements for calcium to maintain good bone formation complicate the treatment.

-Magnesium ammonium phosphate stones (struvite): Investigate and treat urinary tract infection.

Reference Values
Describes reference intervals and additional information for interpretation of test results. May include intervals based on age and sex when appropriate. Intervals are Mayo-derived, unless otherwise designated. If an interpretive report is provided, the reference value field will state this.

The presence of a kidney stone is abnormal. A quantitative report will be provided after analysis.

Interpretation
Provides information to assist in interpretation of the test results

The interpretation of stone analysis results is complex and beyond the scope of this text. For more information see the second Clinical Reference.

 

Calcium oxalate stones:

-Production of calcium oxalate stones consisting of oxalate dihydrate indicates that the stone is newly formed, and current urine constituents can be used to assess the importance of supersaturation.

-Production of calcium oxalate stones consisting of oxalate monohydrate indicates an old (>2 months since formed) stone, and current urine composition may not be meaningful.

 

Magnesium ammonium phosphate stones (struvite):

-Production of magnesium ammonium phosphate stones (struvite) indicates that the cause of stone formation was infection.

-Treatment of the infection is the only way to inhibit further stone formation.

 

Ephedrine/guaifenesin stones:

-Certain herbal and over-the-counter preparations (eg, Mah Jung) contain high levels of ephedrine and guaifenesin. Excessive consumption of these products can lead to the formation of ephedrine/guaifenesin stones.

Cautions
Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances

No significant cautionary statements

Clinical Reference
Recommendations for in-depth reading of a clinical nature

1. Mandel NS, Mandel IC, Kolbach-Mandel AM: Accurate stone analysis: the impact on disease and treatment. Urolithiasis. 2017 Feb;45(1):3-9. doi: 10.1007/s00240-016-0943-0

2. Smith LH: In: Schrier RW, Gottscholk CW, eds. Diseases of the Kidney. 4th ed. Little, Brown and Company; 1987:chap 25

3. Lieske JC, Segura JW: Evaluation and medical management of kidney stones. In: Potts JM, ed: Essential Urology: A Guide to Clinical Practice. Humana Press; 2004:117-152

4. Lieske JC: Pathophysiology and evaluation of obstructive uropathy. In: Smith AD, Gopal Badlani B, Bagley D, et al. Smith's Textbook of Endourology. 2nd ed. BC Decker Inc; 2007:101-106

Method Description
Describes how the test is performed and provides a method-specific reference

Representative specimens are taken from all identifiable layers of the calculus (stone). Each specimen is crushed into a fine powder. An infrared spectrum of each specimen is recorded, and the resulting spectrum compared against reference spectra of all known calculus components. This procedure allows for accurate analyses of complex crystal mixtures as well as the hydration state of each crystal type.(Hesse A, Bach D: Stone analysis by infrared spectroscopy. In: Rose GA, ed: Urinary Stones: Critical and Laboratory Aspects. University Park Press; 1982; Gambaro G. Croppi E, Coe F, Consensus Conference Group, et al. Metabolic diagnosis and medical prevention of calcium nephrolithiasis and its systemic manifestations: a consensus statement. J Nephrol. 2016 Dec;29(6):715-734)

PDF Report
Indicates whether the report includes an additional document with charts, images or other enriched information

No

Day(s) Performed
Outlines the days the test is performed. This field reflects the day that the sample must be in the testing laboratory to begin the testing process and includes any specimen preparation and processing time before the test is performed. Some tests are listed as continuously performed, which means that assays are performed multiple times during the day.

Monday through Saturday

Report Available
The interval of time (receipt of sample at Mayo Clinic Laboratories to results available) taking into account standard setup days and weekends. The first day is the time that it typically takes for a result to be available. The last day is the time it might take, accounting for any necessary repeated testing.

4 to 6 days

Specimen Retention Time
Outlines the length of time after testing that a specimen is kept in the laboratory before it is discarded

7 days

Performing Laboratory Location
Indicates the location of the laboratory that performs the test

Rochester

Fees
Several factors determine the fee charged to perform a test. Contact your U.S. or International Regional Manager for information about establishing a fee schedule or to learn more about resources to optimize test selection.

  • Authorized users can sign in to Test Prices for detailed fee information.
  • Clients without access to Test Prices can contact Customer Service 24 hours a day, seven days a week.
  • Prospective clients should contact their account representative. For assistance, contact Customer Service.

Test Classification
Provides information regarding the medical device classification for laboratory test kits and reagents. Tests may be classified as cleared or approved by the US Food and Drug Administration (FDA) and used per manufacturer instructions, or as products that do not undergo full FDA review and approval, and are then labeled as an Analyte Specific Reagent (ASR) product.

This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. It has not been cleared or approved by the US Food and Drug Administration.

CPT Code Information
Provides guidance in determining the appropriate Current Procedural Terminology (CPT) code(s) information for each test or profile. The listed CPT codes reflect Mayo Clinic Laboratories interpretation of CPT coding requirements. It is the responsibility of each laboratory to determine correct CPT codes to use for billing.

CPT codes are provided by the performing laboratory.

82365

LOINC® Information
Provides guidance in determining the Logical Observation Identifiers Names and Codes (LOINC) values for the order and results codes of this test. LOINC values are provided by the performing laboratory.

Test Id Test Order Name Order LOINC Value
KIDST Kidney Stone Analysis 74446-6
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.
SRC1 Source: 31208-2
605761 Kidney Stone Analysis 40787-4
605762 Stone Interpretation 56119-1
618163 Result Comment 77202-0

Test Setup Resources

Setup Files
Test setup information contains test file definition details to support order and result interfacing between Mayo Clinic Laboratories and your Laboratory Information System.

Excel | Pdf

Sample Reports
Normal and Abnormal sample reports are provided as references for report appearance.

Normal Reports | Abnormal Reports

SI Sample Reports
International System (SI) of Unit reports are provided for a limited number of tests. These reports are intended for international account use and are only available through MayoLINK accounts that have been defined to receive them.

SI Normal Reports | SI Abnormal Reports

Test Update Resources

Change Type Effective Date
Test Status - Test Resumed 2024-10-09
Test Status - Test Delay 2024-08-21
File Definition - Result ID 2023-04-04