Test Utilization, Toxicology

Vitamin D 1,25 Testing

Numerous 1,25-Dihydroxyvitamin D (1,25(OH)2D) requests are received daily (1200 in 2015). This is not the standard test for Vitamin D status.  1,25-Dihydroxyvitamin D testing should be reserved for patients with renal disease, sarcoid, tuberculosis, lymphoma and rickets, as well as, long term use of protease inhibitors, glucocorticoids, or anticonvulsants. Vitamin D 25 (25 OH D) level is sufficient in most cases. The number of requests and review of the ordering providers raises a concern that a number of these requests were ordered inappropriately.

In an effort to decrease the number of potential improperly ordered tests and consequently decrease unnecessary costs to patients, insurance companies, and the laboratory, please review your individual ordering practices.

In the near future, this test name will be changed to “Renal 1,25 Dihydroxyvitamin D” to better reflect its appropriate utilization.

Any questions concerning Vitamin D testing may be directed to Dr. David Alter in the Pathology Department.

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