Browsing Tag

Nephrology

Compliance & Safety, General Information, Immunochemistry, Main lab

Serum Kappa/Lambda Free Light Chain Assay Update

Effective September 28th, 2020, a new generation of the serum kappa/lambda free light chain assay has been implemented.

With the implementation of the new generation of the assay there is an approximately 20% negative bias for kappa free light chains in serum containing >20 mg/dL kappa free light chain.  This may affect the trending for patient who are serially monitored by this assay. Continue Reading

General Information, Immunochemistry, Test Utilization

Protein Electrophoresis Orderable Changes

As of August 26, 2020, the following tests will be obsoleted or made as lab orderables only.  This was implemented to streamline protein electrophoresis orders and ensure that patients receive the recommended testing for the assessment of plasma cell proliferative diseases.

In addition to streamlining protein electrophoresis orders, order questions have been implemented to the available tests to access the reason for ordering to ensure that the proper reflex testing is applied.

For more information, see the lab test directory under the available tests for a protein electrophoresis orders tip sheet entitled “Orders- Protein Orderable ChangesContinue Reading

General Information, Toxicology

Test Update: Cystatin C

Effective Wednesday, December 18, 2019, Cystatin C will change from a sendout reference test performed by Mayo Clinic Laboratories to an in-house test performed by Spectrum Health Regional Laboratory. This test will be performed in the Toxicology Laboratory and will include a new reference range (please see link in Test Information below).

Questions may be directed to Toxicology via the “contact us” link above.

TEST INFORMATION

Cystatin C – Epic Code #LAB3226, Interface #11631, CPT #82610

General Information, Immunochemistry, Main lab, Test Utilization

Protein Electrophoresis Testing Update

In December, serum and urine protein electrophoresis testing will be simplified and standardized.  The only testing available will be:

Protein electrophoresis, serum, IFE if indicated 

Protein electrophoresis, random urine, do IFE if indicated 

Protein electrophoresis, 24 hour urine, do IFE if indicated 

In addition, on December 5, 2019, a new panel will be added which reflects expert recommendations for first line testing for monoclonal gammopathy, including plasma cell myeloma and most cases of amyloidosis, called “Monoclonal Gammopathy Screen

Protein electrophoresis, serum, IFE if indicated 

Kappa and lambda free light chains  Continue Reading

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 the Pathology Department.