Test Code ALKP Alkaline Phosphatase, Total and Isoenzymes, Serum
Necessary Information
Patient's age and sex are required.
Specimen Required
Patient Preparation: Fasting (8 hours) required
Supplies: Sarstedt Aliquot Tube, 5 mL (T914)
Collection Container/Tube:
Preferred: Serum gel
Acceptable: Red top
Submission Container/Tube: Plastic vial
Specimen Volume: 1 mL
Collection Instructions:
1. Within 2 hours of collection, centrifuge the specimen.
2. For red top tubes, immediately aliquot into a plastic vial.
3. For serum gel tubes, serum may sit on gel refrigerated but must be aliquoted within 7 days.
Useful For
Aid in the diagnosis and treatment of liver, bone, intestinal, and parathyroid diseases
Determining the tissue source of increased alkaline phosphatase (ALP) activity in serum
Differentiating between liver and bone sources of elevated ALP
Profile Information
Test ID | Reporting Name | Available Separately | Always Performed |
---|---|---|---|
ALP | Alkaline Phosphatase, S | Yes | Yes |
ALPI | Alkaline Phosphatase Isoenzymes, S | No | Yes |
Method Name
ALP: Colorimetric
ALPI: Electrophoresis
Reporting Name
Alkaline Phosphatase, Tot and Iso,SSpecimen Type
SerumSpecimen Minimum Volume
1 mL
Specimen Stability Information
Specimen Type | Temperature | Time |
---|---|---|
Serum | Frozen (preferred) | 14 days |
Ambient | 7 days | |
Refrigerated | 7 days |
Reference Values
ALKALINE PHOSPHATASE
Males
0-14 days: 83-248 U/L
15 days-<1 year: 122-469 U/L
1-<10 years: 142-335 U/L
10-<13 years: 129-417 U/L
13-<15 years: 116-468 U/L
15-<17 years: 82-331 U/L
17-<19 years: 55-149 U/L
≥19 years: 40-129 U/L
Females
0-14 days: 83-248 U/L
15 days-<1 year: 122-469 U/L
1-<10 years: 142-335 U/L
10-<13 years: 129-417 U/L
13-<15 years: 57-254 U/L
15-<17 years: 50-117 U/L
≥17 years: 35-104 U/L
ALKALINE PHOSPHATASE ISOENZYMES
Ages:
≤17 years: Refence values have not been established for patients less than 18 years of age.
≥18 years:
Liver %: 30.2-74.7
Liver U/L: 15.8-71.9
Bone %: 23.8-68.3
Bone U/L: 12.0-56.7
Intestine %: ≤22.5
Intestine U/L: ≤12.6
Interpretation
Liver alkaline phosphatase (ALP) isoenzyme is most frequently elevated when total ALP is elevated. Increased liver ALP is associated with a wide group of conditions including acute hepatitis, cirrhosis, fatty liver, drug induced liver disease, obstruction of biliary flow, bile duct stricture, primary biliary cirrhosis, and metastatic carcinoma of the liver.
Bone ALP is elevated due to increased osteoblastic activity. Abnormally elevated bone ALP may be indicative of bone tumors, Paget’s disease, or renal rickets.
Intestinal ALP is detectable in approximately 20% of samples tested. Intestinal ALP is most frequently noted postprandially in patients with blood group O or B.
Clinical Reference
1. Rifai N, Horvath AR, Wittwer CT, eds. Tietz Textbook of Clinical Chemistry and Molecular Diagnostics 6th ed. Elsevier; 2018
2. Lowe D, Sanvictores T, John S. Alkaline phosphatase. In: StatPearls [Internet]. StatPearls Publishing; 2021. Updated August 11, 2021. Accessed November 10, 2021. Available at www.ncbi.nlm.nih.gov/books/NBK459201
3. Teitelbaum JE, Laskowski A, Barrows FP. Benign transient hyperphosphatasemia in infants and children: a prospective cohort. J Pediatr Endocrinol Metab. 2011;24(5-6):351-353
4. Jassam NJ, Horner J, Marzo-Ortega H, Sinclair M, Barth JH. Transient rise in alkaline phosphatase activity in adults. BMJ Case Rep. 2009;2009:bcr09.2009.2250
5. Verma J, Gorard DA. Persistently elevated alkaline phosphatase. BMJ Case Rep. 2012;24;2012:bcr2012006768
6. Sharma U, Pal D, Prasad R. Alkaline phosphatase: an overview. Indian J Clin Biochem. 2014;29(3):269-278
Day(s) Performed
Tuesday through Saturday
Report Available
3 to 5 daysPerforming Laboratory

Test Classification
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.CPT Code Information
84075
84080
LOINC Code Information
Test ID | Test Order Name | Order LOINC Value |
---|---|---|
ALKP | Alkaline Phosphatase, Tot and Iso,S | 24332-9 |
Result ID | Test Result Name | Result LOINC Value |
---|---|---|
ALP | Alkaline Phosphatase, S | 6768-6 |
622367 | Alkaline Phosphatase Isoenzymes, S | 12805-8 |
622369 | Liver Percent | 15015-1 |
622368 | Liver | 1779-8 |
622371 | Bone Percent | 15013-6 |
622370 | Bone | 1777-2 |
622373 | Intestine Percent | 15014-4 |
622372 | Intestine | 1778-0 |