Test Code RTRP2 Tubular Reabsorption of Phosphorus, Random Urine and Serum
Specimen Required
Both serum and urine are required.
Specimen Type: Serum
Patient Preparation: Fasting
Collection Container/Tube:
Preferred: Serum gel
Acceptable: Red top
Submission Container/Tube: Plastic vial
Specimen Volume: 0.5 mL
Collection Instructions:
1. Centrifuge and aliquot serum into a plastic vial.
2. Label specimen as serum.
Specimen Type: Urine
Container/Tube: Plastic, 5-mL tube
Specimen Volume: 4 mL
Collection Instructions:
1. Collect a random urine specimen.
2. No preservative.
3. Label specimen as urine.
Useful For
Assessing renal reabsorption of phosphorus in a variety of pathological conditions associated with hypophosphatemia including hypophosphatemic rickets, tumor-induced osteomalacia, and tumoral calcinosis
Adjusting phosphate replacement therapy in severe deficiency states monitoring the renal tubular recovery from acquired Fanconi syndrome
Profile Information
Test ID | Reporting Name | Available Separately | Always Performed |
---|---|---|---|
PHOS | Phosphorus (Inorganic), S | Yes | Yes |
Method Name
RTRP: Calculation
CRETR, ACREA: Enzymatic Colorimetric Assay
PHOS: Photometric, Ammonium Molybdate
Reporting Name
Tubular Phosp Reabsorption, RandomSpecimen Type
SerumUrine
Specimen Minimum Volume
Urine: 1 mL; Serum: See Specimen Required
Specimen Stability Information
Specimen Type | Temperature | Time | Special Container |
---|---|---|---|
Serum | Frozen (preferred) | 7 days | |
Refrigerated | 7 days | ||
Urine | Refrigerated (preferred) | 30 days | |
Frozen | 14 days | ||
Ambient | 7 days |
Reference Values
TUBULAR REABSORPTION OF PHOSPHORUS
>80%
(Although, tubular reabsorption of phosphorus levels must be interpreted in light of the prevailing plasma phosphorus and glomerular filtration rate.)
TUBULAR MAXIMUM PHOSPHORUS REABSORPTION/GLOMERULAR FILTRATION RATE (TmP/GFR)
2.6-4.4 mg/dL (0.80-1.35 mmol/L)
PHOSPHORUS (INORGANIC)
Males
1-4 years: 4.3-5.4 mg/dL
5-13 years: 3.7-5.4 mg/dL
14-15 years: 3.5-5.3 mg/dL
16-17 years: 3.1-4.7 mg/dL
≥18 years: 2.5-4.5 mg/dL
Reference values have not been established for patients that are <12 months of age.
Females
1-7 years: 4.3-5.4 mg/dL
8-13 years: 4.0-5.2 mg/dL
14-15 years: 3.5-4.9 mg/dL
16-17 years: 3.1-4.7 mg/dL
≥18 years: 2.5-4.5 mg/dL
Reference values have not been established for patients that are <12 months of age.
PHOSPHORUS, Random Urine
No established reference values
Random urine phosphorus may be interpreted in conjunction with serum phosphorus, using both values to calculate fractional excretion of phosphorus.
The calculation for fractional excretion (FE) of phosphorus (P) is
FE(P)= ([P(urine)XCreat(serum)]/[P(serum)XCreat(urine)]) X 100
CREATININE Serum
Males(1)
0-11 months: 0.17-0.42 mg/dL
1-5 years: 0.19-0.49 mg/dL
6-10 years: 0.26-0.61 mg/dL
11-14 years: 0.35-0.86 mg/dL
≥15 years: 0.74-1.35 mg/dL
Females(1)
0-11 months: 0.17-0.42 mg/dL
1-5 years: 0.19-0.49 mg/dL
6-10 years: 0.26-0.61 mg/dL
11-15 years: 0.35-0.86 mg/dL
> or=16 years: 0.59-1.04 mg/dL
CREATININE, Random Urine
16-326 mg/dL
Reference values have not been established for patients who are less than 18 years of age.
Interpretation
Interpretation of tubular reabsorption of phosphate (TRP) and the maximum rate of TRP to the glomerular filtration rate (TmP/GMR) is dependent upon the clinical situation and should be interpreted in conjunction with the serum phosphorous concentration.
TmP/GFR is independent of dietary phosphorus intake, tissue release of phosphorus, and GFR.
Clinical Reference
1. Kulasingam V, Jung BP, Blaustig IM, et al: Pediatric reference intervals for 28 chemistries and immunoassays on the Roche cobas 6000 analyzer--a CALIPER pilot study. Clin Biochem. 2010;43:1045-1050
2. Suki WN, Lederer ED, Rouse D: Renal transport of calcium, magnesium, and phosphate. In: Brenner B, ed: The kidney. 6th ed. WB Saunders Company; 2000:chap 12
3. Bijvoet OL: Relation of plasma phosphate concentration to renal tubular reabsorption of phosphate. Clin Sci. 1969;37:23-36
4. Walton RJ, Bijvoet OL: Nomogram for derivation of renal threshold phosphate Concentration. Lancet. 1975;2:309-310
5. Payne RB: Renal tubular reabsorption of phosphate (TmP/GFR): indications and interpretation. Ann Clin Biochem. 1998;35:201-206
6. Delaney MP, Lamb EJ: Kidney disease. In: Rifai N, Horvath AR, Wittwer CT, eds. Textbook of Clinical Chemistry. 6th ed. Elsevier; 2018:1256-1323
Performing Laboratory
Mayo Clinic Laboratories in RochesterTest 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
82565
82570
84100
84105
LOINC Code Information
Test ID | Test Order Name | Order LOINC Value |
---|---|---|
RTRP2 | Tubular Phosp Reabsorption, Random | In Process |
Result ID | Test Result Name | Result LOINC Value |
---|---|---|
PHOS | Phosphorus (Inorganic), S | 2777-1 |
Day(s) Performed
Monday through Sunday
Report Available
Same day/1 dayForms
If not ordering electronically, complete, print, and send a Renal Diagnostics Test Request (T830) with the specimen.