Cardiorenal-Glycemic Status

CPT: 80061; 82043; 82565; 82570; 83036
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Specimen Requirements


Specimen

Urine, serum, and whole blood


Volume

1 mL urine, 1 mL serum, and 4 mL whole blood


Container

Urine bottle, gel barrier tube, lavender-top (EDTA) tube


Test Details


Use

According to the National Kidney Foundation, there are approximately 37 million adults in the U.S. who have chronic kidney disease (CKD), and about 90% are unaware of their condition. Diabetes is the leading cause of CKD in the United States. The significant impact of CKD on cardiovascular disease (CVD) risk has been increasingly recognized. Patients with CKD are far more likely to die, predominantly from CVD, than to progress to end-stage renal disease (ESRD). Currently, mainstays of treatment for diabetic kidney disease include control of hypertension, hyperglycemia and dyslipidemia. This panel has been established to aid in the identification and monitoring of hyperglycemia, dyslipidemia and CKD in patients with a history of diabetes and/or kidney disease.

Guidelines and expert panels advocate renal function testing patients with diabetes and/or hypertension at least annually with urinary albumin to creatinine ratio (uACR) and estimated glomerular filtration rate (eGFR). CKD is characterized by gradual loss of kidney function over time, defined as presence of either kidney damage (as indicated by the presence of albuminuria) or declining kidney function (as indicated by the level of GFR) for more than three months.1

Non-HDL-C is a calculation (total cholesterol minus HDL-C), and includes the sum of the VLDL-C, LDL-C, and IDL-C. While LDL-C has long been the primary focus of cholesterol reduction efforts, there are several other lipoproteins that also affect cardiovascular health. The advantage of non-HDL-C measurement is that it accounts for cholesterol in the other potentially atherogenic lipoprotein particles, which include VLDL-C, IDL-C, LDL-C, and lipoprotein(a). Recent guidelines suggest that non-HDL levels above 190 mg/dL enhances the risk for CVD.2

Hemoglobin A1c values are used to assess glucose control in diabetes, and in 2010, the American Diabetes Associations affirmed the decision of an international expert committee recommendation to use the A1c test to diagnose diabetes with a threshold ≥6.5%.

The Cardiorenal-glycemic Panel can be collected non-fasting.


Methodology

See individual test components.


Footnotes

1. KDIGO 2012 clinical practice guideline for the evaluation and management of chronic kidney disease. International Society of Nephrology, Kidney International Supplements. 2013 Jan;3(1):1-150.
2. Gruncy SM, Stone NJ, Bailey AL, et al. 2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA Guideline on the Management of Blood Cholesterol: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. J Am Coll Cardiol. 2019 Jun 25;73(24):e285-e350. Epub 2018 Nov 10.30423393

LOINC® Map

Order Code Order Code Name Order Loinc Result Code Result Code Name UofM Result LOINC
245292 Cardiorenal-Glycemic Status 001481 Hemoglobin A1c % 4548-4
245292 Cardiorenal-Glycemic Status 001370 Creatinine mg/dL 2160-0
245292 Cardiorenal-Glycemic Status 100798 Comment: N/A
245292 Cardiorenal-Glycemic Status 013672 Creatinine, Urine mg/dL 2161-8
245292 Cardiorenal-Glycemic Status 140097 Albumin, Urine ug/mL 14957-5
245292 Cardiorenal-Glycemic Status 140291 Alb/Creat Ratio mg/g creat 9318-7
245292 Cardiorenal-Glycemic Status 001065 Cholesterol, Total mg/dL 2093-3
245292 Cardiorenal-Glycemic Status 001172 Triglycerides mg/dL 2571-8
245292 Cardiorenal-Glycemic Status 011817 HDL Cholesterol mg/dL 2085-9
245292 Cardiorenal-Glycemic Status 011919 VLDL Cholesterol Cal mg/dL 13458-5
245292 Cardiorenal-Glycemic Status 012059 LDL Chol Calc (NIH) mg/dL 13457-7
245292 Cardiorenal-Glycemic Status 011831 Comment: 77202-0
245292 Cardiorenal-Glycemic Status 011976 Non-HDL Cholesterol mg/dL 43396-1
245292 Cardiorenal-Glycemic Status 100779 eGFR mL/min/1.73 98979-8

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