Clinical Significance QuantiFERON®-TB Gold Plus, 4 Tubes, Draw Site Incubated - This test is a blood-based interferon-gamma release assay (IGRA) used as an aid in the diagnosis of Mycobacterium tuberculosis infection. It is an immune response-based, indirect test for M tuberculosis infection (including disease) and is intended for use in conjunction with risk assessment, radiography, and other medical and diagnostic evaluations. Additional testing is needed to determine if a person who has tested positive has latent tuberculosis (TB) infection or TB disease. This in vitro diagnostic test uses a peptide cocktail simulating ESAT-6, CFP-10, and TB7.7 proteins to stimulate cells in heparinized whole blood. Detection of interferon-γ (IFN-γ) by ELISA is used to identify in vitro responses to those peptide antigens that are associated with Mycobacterium tuberculosis infection. This test uses a 4-tube blood collection method, which requires incubation before submitting to the lab. For the single-tube QFT-Plus testing option, see test code #36970. Guidelines recommend testing for individuals who 1) have been exposed to a person with latent or active TB, including the general population and healthcare workers; 2) are from TB-endemic countries, which include most countries in Latin America, the Caribbean, Africa, Asia, and Eastern Europe, and Russia; 3) work in high-risk settings, such as correctional facilities, long-term care (LTC) facilities, nursing homes, and homeless shelters; or 4) have HIV or have an injection drug substance use disorder [1]. All of these individuals can be tested with either a traditional tuberculin skin test (TST) or an IGRA. However, the American Thoracic Society (ATS), the Infectious Disease Society of America (IDSA), and the Centers for Disease Control and Prevention (CDC) jointly prefer an IGRA test for individuals who have been vaccinated against bacillus Calmette-Guérin (BCG) or are not likely to return for the follow-up portion of the TST (and in both cases are at least 5 years old and likely to have TB infection and are at low or moderate risk of disease progression, or in whom it has been determined that TB testing is necessary [1]. The QuantiFERON-TB Gold test has specificity >99% in low-risk individuals and sensitivity of 92% in individuals with active disease [2]. In contrast to the TST, IGRA testing for TB requires only 1 patient visit (instead of 2). Also, IGRAs are not associated with the booster phenomenon, in which previously infected individuals generate a false-positive on a TST; and prior BCG vaccination does not generate a false-positive result. Note that for children aged 2 and above, either TST or IGRA can be used [3,4]. The CDC does not recommend dual testing with both a TST and an IGRA, unless the goal is to confirm a positive result, or when a high-risk individual’s test results are negative and there is clinical suspicion of TB. In this clinical situation, dual testing is used for confirmatory purposes [4]. For more information about TST versus IGRA testing, please visit the QuantiFERON®-TB Gold FAQs page. Note: Specimens collected for this test must be transferred to a 37 °C incubator as soon as possible (within 16 hours of collection). An alternative, single-tube test option (QuantiFERON®-TB Gold Plus, 1 Tube; test code 36970) allows the specimen to be stabilized for up to 48 hours before incubation. Preferred Specimen(s) 1 mL whole blood collected in each of the following tubes: QFT-Nil control (gray cap, white or gold ring) tube QFT-TB1 antigen (green cap, white or gold ring) tube QFT-TB2 antigen (yellow cap, white or gold ring) tube QFT-Mitogen control (purple cap, white or gold ring) tube Minimum Volume 0.8 mL in each tube Collection Instructions Note: Specimen collection locations >3350 feet above sea level should use the QuantiFERON® collection kit designed for "High Altitude" (tubes with a gold ring on tube top) For each patient, collect 1 mL of blood by venipuncture directly into each of the 4 QFT-PLUS blood collection tubes. These tubes should be at 17-25° C at the time of draw. If a "butterfly needle" is being used, a "purge" tube should be used to ensure that the tubing is filled with blood prior to the QFT-PLUS tubes being used. Immediately after filling the tubes, shake them 10 times just firmly enough to ensure the entire surface of the tube is coated with blood, to solubilize antigens on tube walls. Each of the four tubes must be transferred to a 37° C +/- 1° C incubator as soon as possible and within 16 hours of collection for 16-24 hours. If the blood is not incubated immediately after collection, re-mixing of the tubes by inverting 10 times must be performed immediately prior to incubation. The specimen rack should sit off the floor of the incubator and the tubes should be upright. Following incubation either: A. Centrifuge each of the 4 incubated collection tubes for 15 minutes at 2000-3000 RCF(G). Label with patient name, identification number, and date of collection. Deliver to Quest Diagnostics at 2-8° C. Samples will be stable for 28 days at 2-8° C (refrigerated). *OR* B. Immediately transport the 4 collection tubes to Quest Diagnostics between 4 and 27° C. Samples will be stable for 72 hours at 4-27° C (refrigerated or at room temperature). The Centers for Disease Control and Prevention (CDC) has provided guidance on clinical considerations for tuberculosis (TB) testing such as QuantiFERON®-TB Gold Plus in conjunction with COVID-19 mRNA vaccines. Please refer to the QuantiFERON®-TB Gold Plus FAQ link (https://education.questdiagnostics.com/faq/FAQ204) for more detailed information on the latest CDC guidelines regarding TB testing and COVID-19 vaccines. Transport Container QFT-Nil control (gray cap, white or gold ring) tube QFT-TB1 antigen (green cap, white or gold ring) tube QFT-TB2 antigen (yellow cap, white or gold ring) tube QFT-Mitogen control (purple cap, white or gold ring) tube Transport Temperature Refrigerated (cold packs) Specimen Stability Uncentrifuged specimens Room temperature: 72 hours after incubation Refrigerated: 72 hours after incubation Frozen: Unacceptable   Centrifuged specimens Room temperature: Unacceptable Refrigerated: 28 days Frozen: Unacceptable Reject Criteria Non-incubated specimens • Received frozen Includes The Centers for Disease Control and Prevention (CDC) has provided guidance on clinical considerations for tuberculosis (TB) testing such as QuantiFERON®-TB Gold Plus in conjunction with COVID-19 mRNA vaccines. Please refer to the QuantiFERON®-TB Gold Plus FAQ link under Test Resources for more detailed information on the latest CDC guidelines regarding TB testing and COVID-19 vaccines. Methodology Immunoassay (IA) Reference Range(s) Negative Alternative Name(s) TB Gold,QFT Gold Plus,QFT TB,QFT Plus,IGRA

Clinical Significance Queen Palm (t72) IgE - This test that quantifies an individual’s IgE response to Queen palm. It is an in vitro quantitative assay, which is intended to be used in conjunction with other clinical information to aid in the diagnosis of allergic diseases [1]. While allergen-specific serum IgE testing is considered comparable to skin testing in many instances, both the American Academy of Allergy, Asthma, and Immunology and the American College of Allergy, Asthma, and Immunology recognize that allergen-specific serum IgE testing may be preferred in some clinical situations. These include 1) the presence of widespread skin disease, 2) the recent use of antihistamines or other medications that can affect the results of allergy skin tests, 3) uncooperative patients, and 4) medical history suggesting that allergen skin testing would pose a significant risk for a serious allergic reaction [1]. A definitive clinical diagnosis of allergy should not be based on the results of any single diagnostic method, but should be made by a trained healthcare professional after all clinical and laboratory findings have been evaluated. Preferred Specimen(s) 0.3 mL serum Transport Container Serum Separator Tube (SST®) Transport Temperature Room temperature Specimen Stability Room temperature: 14 days Refrigerated: 14 days Frozen: 30 days

Clinical Significance QuestAssureD™ 25-Hydroxyvitamin D (D2, D3) - Measurement of serum 25-OH vitamin D concentrations provide a good index of circulating vitamin D activity in patients not suffering from renal disease. Lower than normal 25-OH vitamin D levels can result from a dietary deficiency, poor absorption of the vitamin or impaired metabolism of the sterol in the liver. A 25-OH vitamin D deficiency can lead to bone diseases such as rickets and osteomalacia. Above normal levels can lead to hypercalcemia. This assay employs liquid chromatography tandem mass spectrometry to independently measure and report the two common forms of 25-hydroxy vitamin D: 25-OH D3 - the endogenous form of the vitamin and 25-OH D2 - the analog form used to treat 25-OH Vitamin D3 deficiency. Preferred Specimen(s) 0.5 mL serum Minimum Volume 0.3 mL Collection Instructions Collect blood in a standard red-top serum Vacutainer® tube. Allow blood to clot at room temperature. Centrifuge and separate the serum from the cells immediately. Alternatively, collect blood in a Serum Separator Tube (SST®), allow to clot at room temperature. Centrifuge and remove from the gel within 48 hours. Transport Container Transport tube Transport Temperature Room temperature Specimen Stability Room temperature: 21 days Refrigerated: 21 days Frozen: 21 days Reject Criteria Gross hemolysis • Grossly lipemic • Heparinized or EDTA plasma • Serum not separated from Serum Separator Tube (SST®) gel or clot within 48 hours • Grossly icteric Includes Vitamin D, 25-OH, Total Vitamin D, 25-OH, D3 Vitamin D, 25-OH, D2 Patient Preparation Fasting preferred, but not required Methodology Chromatography/Mass Spectrometry Assay Category This test was developed and its analytical performance characteristics have been determined by Quest Diagnostics. It has not been cleared or approved by FDA. This assay has been validated pursuant to the CLIA regulations and is used for clinical purposes. Reference Range(s) Vitamin D, 25-OH, Total    30-100 ng/mL Vitamin D, 25-OH, D3    Not established Vitamin D, 25-OH, D2    Not established Alternative Name(s) Vitamin D2, 25-hydroxy,25-Hydroxyergocalciferol (25OHD2),Vitamin D3, 25-hydroxy,D2 Vitamin,25-Hydroxyvitamin D3,25-OH-D3,25-Hydroxycholecalciferol (25OHD3),25-OH-D2,D3 Vitamin,Vit D, LC/MS/MS,25-Hydroxyvitamin D2

Clinical Significance QuestAssureD™ for Infants, 25-Hydroxyvitamin D - While measurements of 25(OH)D provide a good index of circulating Vitamin D activity in patients not suffering from renal disease, for infants less than 3 years of age it is important to remove circulating levels of the inactive c3-epimer of Vitamin D from the sample so that total Vitamin D levels are not falsely elevated. Falsely elevated results could erroneously make the child appear to be within normal limits and result in potential under-treatment. Levels of c3-epimer in older children and adults are usually negligible and do not cause falsely elevated Vitamin D results. This assay employs advanced liquid chromatography - tandem mass spectrometry, which enables the chromatographic separation of the c3-epimer from 25-OH Vitamin D, thereby allowing accurate measurement in the presence of c3-epimer. While this assay will produce accurate Vitamin D results on patients of any age, it is specifically indicated for infants less than 3 years of age. Preferred Specimen(s) 0.5 mL serum Minimum Volume 0.2 mL Collection Instructions Collect blood in a standard red-top serum Vacutainer® tube. Allow blood to clot at room temperature. Centrifuge and separate the serum from the cells immediately. Alternatively, collect blood in a Serum Separator Tube (SST®) at room temperature, centrifuge and remove from the gel within 48 hours. Transport Container Transport tube Transport Temperature Room temperature Specimen Stability Room temperature: 7 days Refrigerated: 7 days Frozen: 28 days Reject Criteria Gross hemolysis • Grossly lipemic • Plasma • Serum not separated from Serum Separator Tube (SST®) • Serum not separated from gel or clot within 48 hours • Grossly icteric Includes Vitamin D, 25-OH, Total Vitamin D, 25-OH, D3 Vitamin D, 25-OH, D2 Patient Preparation Fasting specimens are preferred but not required Methodology Chromatography/Mass Spectrometry Assay Category This test was developed and its analytical performance characteristics have been determined by Quest Diagnostics. It has not been cleared or approved by FDA. This assay has been validated pursuant to the CLIA regulations and is used for clinical purposes. Reference Range(s) Vitamin D, 25-OH, Total    30-100 ng/mL Vitamin D, 25-OH, D3    Not established Vitamin D, 25-OH, D2    Not established Alternative Name(s) VIT D, Infants

Preferred Specimen(s) 0.3 mL serum Minimum Volume 0.15 mL/allergen Transport Container Serum separator tube (SST) Transport Temperature Room temperature Specimen Stability Room temperature: 14 days Refrigerated: 14 days Frozen: 30 days

Clinical Significance Rabbit Epithelia (e82) IgE - This allergen-specific IgE antibody test quantifies an individual’s IgE response to rabbit epithelia. It is an in vitro quantitative assay that is intended to be used in conjunction with other clinical information to aid in the diagnosis of allergic diseases [1]. While allergen-specific serum IgE testing is considered comparable to skin testing in many instances, both the American Academy of Allergy, Asthma, and Immunology and the American College of Allergy, Asthma, and Immunology recognize that allergen-specific serum IgE testing may be preferred in some clinical situations. These include 1) the presence of widespread skin disease, 2) the recent use of antihistamines or other medications that can affect the results of allergy skin tests, 3) uncooperative patients, and 4) medical history suggesting that allergen skin testing would pose a significant risk for a serious allergic reaction [1]. A definitive clinical diagnosis of allergy should not be based on the results of any single diagnostic method, but should be made by a trained healthcare provider after all clinical and laboratory findings have been evaluated. Preferred Specimen(s) 0.3 mL serum Transport Container Serum Separator Tube (SST®) Transport Temperature Room temperature Specimen Stability Room temperature: 14 days Refrigerated: 14 days Frozen: 30 days

Preferred Specimen(s) 0.3 mL serum Transport Container Serum Separator Tube (SST®) Transport Temperature Room temperature Specimen Stability Room temperature: 14 days Refrigerated: 14 days Frozen: 30 days Methodology Immunoassay (IA) Assay Category This test was developed and its analytical performance characteristics have been determined by Quest Diagnostics. It has not been cleared or approved by the U.S. Food and Drug Administration. This assay has been validated pursuant to the CLIA regulations and is used for clinical purposes.

Clinical Significance Rape Seed (rf316) IgE - This test is an allergen-specific IgE antibody test that quantifies an individual’s IgE response to rapeseed. It is an in vitro quantitative assay, which is intended to be used in conjunction with other clinical information to aid in the diagnosis of food allergy [1]. While allergen-specific serum IgE testing is considered comparable to skin testing in many instances, both the American Academy of Allergy, Asthma, and Immunology and the American College of Allergy, Asthma, and Immunology recognize that allergen-specific serum IgE testing may be preferred in some clinical situations. These include 1) the presence of widespread skin disease, 2) the recent use of antihistamines or other medications that can affect the results of allergy skin tests, 3) uncooperative patients, and 4) medical history suggesting that allergen skin testing would pose a significant risk for a serious allergic reaction [1]. Food-specific IgE tests are extremely sensitive. However, a positive test result only indicates that a patient is IgE sensitized to the food of concern. Many IgE-sensitized patients do not develop any symptoms when this food is ingested. A diagnosis of food allergy should only be made by a trained medical provider, after conducting a thorough clinical evaluation [2,3]. While food-specific IgE test results may contribute to that evaluation, they cannot replace it. In this regard, detection of food-specific IgE in serum provides evidence of IgE sensitization, but a history of clinical reactivity to the food of concern, is required to make a diagnosis of IgE-mediated food allergy. Moreover, several forms of food hypersensitivity are not associated with the presence of food-specific IgE in serum. Preferred Specimen(s) 0.3 mL serum Transport Container Serum separator tube (SST) Transport Temperature Room temperature Specimen Stability Room temperature: 14 days Refrigerated: 14 days Frozen: 30 days

Clinical Significance Rape Weed (w203) IgE - This test quantifies an individual’s IgE response to the pollen rape weed. It is an in vitro quantitative assay, which is intended to be used in conjunction with other clinical information to aid in the diagnosis of allergic diseases [1]. While allergen-specific serum IgE testing is considered comparable to skin testing in many instances, both the American Academy of Allergy, Asthma, and Immunology and the American College of Allergy, Asthma, and Immunology recognize that allergen-specific serum IgE testing may be preferred in some clinical situations. These include 1) the presence of widespread skin disease, 2) the recent use of antihistamines or other medications that can affect the results of allergy skin tests, 3) uncooperative patients, and 4) medical history suggesting that allergen skin testing would pose a significant risk for a serious allergic reaction [1]. A definitive clinical diagnosis of allergy should not be based on the results of any single diagnostic method, but should be made by a trained healthcare professional after all clinical and laboratory findings have been evaluated. Preferred Specimen(s) 0.3 mL serum Minimum Volume 0.15 mL/allergen Transport Container Serum Separator Tube (SST®) Transport Temperature Room temperature Specimen Stability Room temperature: 14 days Refrigerated: 14 days Frozen: 30 days

Preferred Specimen(s) 0.3 mL serum Transport Container Serum Separator Tube (SST®) Transport Temperature Room temperature Specimen Stability Room temperature: 14 days Refrigerated: 14 days Frozen: 30 days

Preferred Specimen(s) 0.3 mL serum Minimum Volume 0.15 mL/allergen Transport Container Serum Separator Tube (SST®) Transport Temperature Room temperature Specimen Stability Room temperature: 14 days Refrigerated: 14 days Frozen: 30 days

Preferred Specimen(s) 0.3 mL serum Transport Container Serum Separator Tube (SST®) Transport Temperature Room temperature Specimen Stability Room temperature: 14 days Refrigerated: 14 days Frozen: 30 days

Preferred Specimen(s) 0.3 mL serum Transport Container Serum Separator Tube (SST®) Transport Temperature Room temperature Specimen Stability Room temperature: 14 days Refrigerated: 14 days Frozen: 30 days

Clinical Significance Rat Urine Proteins (e74) IgE - This allergen-specific IgE antibody test quantifies an individual’s IgE response to rat urine proteins. It is an in vitro quantitative assay that is intended to be used in conjunction with other clinical information to aid in the diagnosis of allergic diseases [1]. While allergen-specific serum IgE testing is considered comparable to skin testing in many instances, both the American Academy of Allergy, Asthma, and Immunology and the American College of Allergy, Asthma, and Immunology recognize that allergen-specific serum IgE testing may be preferred in some clinical situations. These include 1) the presence of widespread skin disease, 2) the recent use of antihistamines or other medications that can affect the results of allergy skin tests, 3) uncooperative patients, and 4) medical history suggesting that allergen skin testing would pose a significant risk for a serious allergic reaction [1]. A definitive clinical diagnosis of allergy should not be based on the results of any single diagnostic method, but should be made by a trained healthcare provider after all clinical and laboratory findings have been evaluated. Preferred Specimen(s) 0.3 mL serum Transport Container Serum Separator Tube (SST®) Transport Temperature Room temperature Specimen Stability Room temperature: 14 days Refrigerated: 14 days Frozen: 30 days

Red Blood Cell Count Any other names for this test? This test is also an erythrocyte count and a red cell count. What is a red blood cell count? A red blood cell (RBC) count checks the number of red blood cells that are present in your blood. Red blood cells supply oxygen from the lungs to all parts of the body. Your cells demand oxygen to develop, reproduce, and stay healthy. Hemoglobin, present in red blood cells, transports oxygen throughout the body. What is a red blood cell count lab test? A red blood cell count test measures the number of red blood cells in the blood. The quantity and efficiency of red blood cells determine how much oxygen is transported to the tissues in your body. An RBC count is typically performed as part of a full blood cell (FBC) test. An abnormally high or low RBC count is frequently the first indicator of an illness. Therefore, the test can enable you to receive treatment even before you show symptoms. What is the purpose of a red blood cell count test? The purpose of this test is to identify red blood cell disorders like anemia, a condition in which the body does not make healthy red blood cells. This test is often part of a complete blood count (CBC) test, a collection of tests that examine many different aspects of your blood. Why do I require a red blood cell count test? The complete blood count (CBC), which is frequently included in a regular checkup, may have this test as part of the procedure. The doctor may also order this test if you exhibit signs of low or high red blood cell count.  Low red blood cell count symptoms   Fatigue/ tiredness Loss of breath Lightheadedness and weakness often occur while changing positions too quickly. Fast heartbeat light or pale skin Headaches   High red blood cell count symptoms   Fatigue Breathing problems Sleeping problems Joint pain Pain in your palms or soles of your feet Itchy skin often occurs after taking a shower or bath. Schedule a red blood cell count test right away, if you have any of the above symptoms.   How should I prepare for a red blood cell count test? You do not need to prepare anything special for this test. However, tell your healthcare provider about any medicine or dietary supplement you are taking. These factors might affect the test results.   How does a red blood cell count test work?  A red blood cell count is a basic blood test. From a vein in your hand, your healthcare provider will draw blood for testing.  Here is the guide for how this test is done.   Your healthcare professional will first use an antibacterial to clean the puncture site. Afterward, he will wrap the hand's upper portion in an elastic band to force blood into the vein. He will now insert a little needle into the vein. Blood drawn into the needle will be put in a test container for testing. The blood test procedure has now finished. The blood testing procedure is now complete. A member of your medical team will take off the elastic band. Is there any risk attached to a red blood cell count test? Blood tests have a slight risk to them. You might feel a pinch of pain or a bruise around the area where the needle went. These symptoms, however, go away in two to three days. What does the result mean? The RBC ranges are measured in cells per microliter (L). The normal ranges of a red blood cell count test vary by gender and age. These ranges are: Females: 4.2–5.4 million cells/L Males: 4.7–6.1 million cells/L Children: 4.1–5.5 million cells/L Newborn: 4.8–7.1 million cells/L   These reference ranges may vary from laboratory to laboratory. What does a low level of red blood cell count mean? You have anemia if your RBC count results are below average. It can be due to a decrease in RBC production or the damage or loss of RBCs. Low red blood cells can lead to the following illnesses:   Anemia Kidney failure Leukemia is a type of blood cancer. Malnutrition is a problem when the body does not get the vitamins, calories, and minerals it needs. Multiple myeloma is a bone marrow cancer. Chronic conditions   Pregnancy can also be a sign of low red blood cell count. What does a high red blood cell count mean? Erythrocytosis is a condition that arises when your RBC count results are higher than usual. It makes your blood thicker than usual and raises your risk of blood clots. The problems that can affect you if your test results are high   Heart problems Lung illness Smoking Kidney cancer Dehydration Polycythemia vera, a bone marrow disease Is there anything else that I should do in addition to a red blood cell count test? This test is often part of a complete blood count test. A CBC test has several other tests included in it. These tests are given below.   Red blood cell test White blood cells Hemoglobin Hematocrit Platelets   Anything else I should know about a red blood cell count test? You might require more tests to help with the diagnosis if the results showed that your red blood cell counts are low or high. These consist of Reticulocyte count: A test to count the reticulocytes in the blood is called a reticulocyte count. Red blood cells that are still growing are known as reticulocytes. Also known as immature red blood cells. The iron test:  It is the test that measures the iron in the blood. Red blood cells must have iron to be produced. Vitamin B test: A vitamin B test is used to determine the blood's concentration of one or more B vitamins. Making red blood cells requires vitamin B.

Preferred Specimen(s) 0.3 mL serum Transport Temperature Room temperature Specimen Stability Room temperature: 14 days Refrigerated: 14 days Frozen: 30 days Methodology Immunoassay (IA) Assay Category This test was developed and its analytical performance characteristics have been determined by Quest Diagnostics. It has not been cleared or approved by the U.S. Food and Drug Administration. This assay has been validated pursuant to the CLIA regulations and is used for clinical purposes. Alternative Name(s) ImmunoCAP®,Juniperus virginiana,Red Cedar Juniper,Eastern Red Cedar

Clinical Significance Red Kidney Bean (f287) IgE - This test is an allergen-specific IgE antibody test that quantifies an individual’s IgE response to red kidney bean. It is an in vitro quantitative assay, which is intended to be used in conjunction with other clinical information to aid in the diagnosis of food allergy [1]. While allergen-specific serum IgE testing is considered comparable to skin testing in many instances, both the American Academy of Allergy, Asthma, and Immunology and the American College of Allergy, Asthma, and Immunology recognize that allergen-specific serum IgE testing may be preferred in some clinical situations. These include 1) the presence of widespread skin disease, 2) the recent use of antihistamines or other medications that can affect the results of allergy skin tests, 3) uncooperative patients, and 4) medical history suggesting that allergen skin testing would pose a significant risk for a serious allergic reaction [1]. Food-specific IgE tests are extremely sensitive. However, a positive test result only indicates that a patient is IgE sensitized to the food of concern. Many IgE-sensitized patients do not develop any symptoms when this food is ingested. A diagnosis of food allergy should only be made by a trained medical provider, after conducting a thorough clinical evaluation [2,3]. While food-specific IgE test results may contribute to that evaluation, they cannot replace it. In this regard, detection of food-specific IgE in serum provides evidence of IgE sensitization, but a history of clinical reactivity to the food of concern, is required to make a diagnosis of IgE-mediated food allergy. Moreover, several forms of food hypersensitivity are not associated with the presence of food-specific IgE in serum. Preferred Specimen(s) 0.3 mL serum Transport Container Serum Separator Tube (SST®) Transport Temperature Room temperature Specimen Stability Room temperature: 14 days Refrigerated: 14 days Frozen: 30 days

Preferred Specimen(s) 0.3 mL serum Minimum Volume 0.15 mL/allergen Transport Container Serum Separator Tube (SST®) Transport Temperature Room temperature Specimen Stability Room temperature: 14 days Refrigerated: 14 days Frozen: 30 days

Renal Function Panel Test Any other names for this test? Renal panel test, Kidney panel test, Kidney function panel test What is a renal function panel test? A renal function panel test helps to determine the conditions of your kidneys. This panel test is a blood test that identifies, diagnoses, and observes kidney disorders. A renal panel test monitors the current levels of substances, such as electrolytes, proteins, minerals, and glucose in your blood. High or low levels of these substances may indicate kidney problems.  Your kidneys consist of organs similar to bean-shaped. They are present below the rib cages on both sides of the back. Healthy kidneys can filter or purify about 170 liters of blood a day. The function of kidneys is to:   Eliminate excess water from the blood through urine. Release waste material, such as urea, uric acid, or toxins. Balance the essential chemical substances, such as sodium, potassium, calcium, phosphorus, bicarbonate, chloride, and magnesium. Help to control the pH levels. When you experience kidney problems, this may lead to the deposition of waste material in your blood. High body fluid levels may damage your body or lead to severe conditions. What is the purpose of this test? A renal function panel test is a series of tests that measures different substances to see the current health of the kidney. These tests often include Glucose - It is a significant source of energy for your body. Glucose is a type of blood sugar. Its high level may lead to diabetes. Phosphorus - This mineral helps to provide energy, muscle, bone, and nerve function. It also maintains the acid-base level in your body. Calcium - An essential mineral for the development of bones and teeth. A high value of calcium deposits in your bones, but your blood needs it too. Calcium helps regulate the nerves, heart, and muscles. It also uses blood clotting.  Electrolyte tests An electrolyte panel test helps to measure electrically charged minerals in your body, including Sodium - Sodium maintains the body's function, specifically for nerves and muscles. It comes from the food you eat. Your kidneys are responsible for maintaining the sodium levels in your body. Potassium - It transfers signals from the nerve to the muscles. It plays a vital role in the metabolism of cells. It also comes from the food you eat. Chloride - It balances the acid-base level in the body. A chloride regulates the amount of fluid throughout the body. Bicarbonate - It controls the pH level of your body and shows the amount of carbon dioxide in your blood. Protein tests Albumin - This is a protein in your blood made by your liver. It carries enzymes, nutrients, and other substances in your bloodstream. It also helps to resist fluid from leaking from the blood vessels. Total protein - This test measures other proteins (globulins) besides albumin. Creatinine - It is a waste product produced by creatinine. It develops during the regular activity of the muscles. A creatinine test indicates the function of the kidney. Blood urea nitrogen - This component specifies the quantities of urea nitrogen in the blood. Blood urea nitrogen is a waste material your kidneys remove from your blood. A renal function panel test may also include Anion gap - Anion gap provides a value originating from the electrolyte panel test. It helps to differentiate between measured and unmeasured charged particles (ions or electrolytes) in the liquid part of your blood. Estimated glomerular filtration rate - This test determines an estimation of the actual glomerular filtration rate. An eGFR test describes the number of blood filters by glomeruli in the kidneys per minute) that comes from creatinine in your blood. BUN to Creatinine ratio - A BUN/Creatinine ratio consists of BUN and creatinine tests. A healthcare provider divides the BUN value with the creatinine to see your kidney conditions. When do I need a renal function panel test? A renal function panel test is a routine test for those with a high risk for kidney problems. Your healthcare provider may recommend this test if you have symptoms of kidney disease. Symptoms of kidney disease   Weakness Muscles contraction or cramps Frequency or reduction in urine Difficulty in passing the urine Swelling in eyes or legs Bloody or foamy urine Dry skin Weight loss Loss of appetite Sleep disorder Difficulty thinking properly Breath difficulty Accumulation of water in the body Your provider may recommend a renal panel test to observe your kidney conditions if you ever had an abnormal renal function panel test. You may need this test to check your response to the therapy if you have a treatment for kidney disease. What is the method for this test? Your provider will ask for a blood sample for a renal function panel test. The step-by-step procedure for this test is listed below   Sit in front of your provider and remove your part of the cloth from one arm. Your provider will insert a small needle into the vein in your arm. A small amount of blood will collect in a test tube. Your blood sample will keep at the laboratory for examination. Daily activities can start after the test. This test generally takes five minutes. You can go to the laboratory after booking an online order for this test. How do I need to prepare for this test? A renal function panel test does not require specific preparation. Your provider may ask if you use medicines, vitamins, and supplements. You may need to fast if your provider asks for additional blood tests. You may provide specific instructions by seeing your medical history. What are the risks of this test? A renal function panel test does not have high risks. You may experience slight pain when your provider injects a needle into your veins. Some risks may include    Low bleeding Bruising Infection lightheaded feeling What do the renal panel test results mean? The test results may vary on age, gender, medical history, and other factors. The renal function test results may differ slightly among laboratories. It is because each lab may use different methods for examination.  High amounts of phosphorus, urea, creatinine, glucose and anion gap may show kidney disease. Low blood calcium and albumin levels and an imbalance of electrolyte levels indicate severe kidney problems. The recommended range for adults for different substances is: Glucose - 4.1-5.6 mmol/L (millimoles per liter) Phosphorus - 0.81-1.45 mmol/L Calcium - 2.15-2.57 mmol/L Potassium - 3.5-5.1 mmol/L Sodium - 136-145 mmol/L Chloride - 98-107 mmol/L Bicarbonate - 23-29 mmol/L Albumin - 35-52 g/L Creatinine (Male) - 55-96 µmol/L Creatinine (Female) - 40-66 µmol/L BUN - 2.1-7.1 mmol/L You can see the other measurements if the provider requests for in the renal function panel test. You can review your test results with a professional healthcare provider here.  What additional tests may I need to conduct along with the renal panel test? Your provider may also order additional tests, such as kidney imaging or a kidney biopsy, if you may have a chance of developing kidney disease by blood and urine test. A healthcare provider may also ask for individual tests if they see abnormal levels in any of the substances. These tests may include   Electrolyte panel test Glucose test Protein and total protein test Calcium test BUN or BUN/Creatinine ratio test Sodium Potassium eGFR Creatinine

"Preferred Specimen(s) 4 mL serum Minimum Volume 2.5 mL Transport Container Serum separator tube (SST) Transport Temperature Room temperature Includes IgE allergy testing for: Alternaria alternata (a mold) (m6) Aspergillus fumigatus (m3) Aureobasidium pullulans (m12) Bermuda grass (g2) Blomia tropicalis (d201) Cat dander (e1) Cladosporium herbarum (m2) Cockroach (i6) Dermatophagoides farinae (d2) Dermatophagoides pteronyssinus (d1) Dog dander (e2) Elm (t8) Eucalyptus (t18) Johnson grass (g10) Mouse Urine Proteins (e72) Oak (t7) Penicillium notatum (m1) Red top grass (Bent grass) (g9) Rough pigweed (w14) Sheep sorrel (w18) Wall pellitory (w19)   Immunoglobulin E Methodology Immunoassay (IA)

"Preferred Specimen(s) 4 mL serum Minimum Volume 2.5 mL Transport Temperature Room temperature Includes IgE allergy testing for: Alternaria alternata (a mold) (m6) Aspergillus fumigatus (m3) Bermuda grass (g2) Cat dander (e1) Cladosporium herbarum (m2) Cockroach (i6)  Common ragweed (short) (w1) Cottonwood (t14) Dermatophagoides farinae (d2) Dermatophagoides pteronyssinus (d1) Dog dander (e5) Elm (t8) Maple (box elder) (t1) Mountain cedar (Juniperus sabinoides) (t6) Mouse Urine Proteins (e72) Mulberry (t70) Nettle (Urtica dioica) (w20) Oak (t7) Penicillium notatum (m1) Russian thistle (prickly saltwort) (w11) Sheep sorrel (Rumex acetosella) (w18) Timothy grass (Phleum pratense) (g6) White ash (Fraxinus americana) (t15)   Immunoglobulin E Methodology Immunoassay (IA) Alternative Name(s) ImmunoCAP®

"Preferred Specimen(s) 4 mL serum Minimum Volume 2.5 mL Transport Temperature Room temperature Includes IgE allergy testing for: Alder (t2) Alternaria alternata (a mold) (m6) Aspergillus fumigatus (m3) Bermuda grass (g2) Cat dander (e1) Cladosporium herbarum (m2) Cocroach (i6) Common ragweed (short) (w1) Cottonwood (t14) Dermatophagoides farinae (d2) Dermatophagoides pteronyssinus (d1) Dog dander (e2) Elm (t8) Johnson grass (g10) Mountain cedar (t6) Mouse Urine Proteins (e72) Mugwort (sagebrush) (w6) Mulberry (t70) Oak (t7) Olive (t9) Penicillium notatum (m1) Rough pigweed (w14) Russian Thistle (prickly saltwort) (w11) Timothy grass (g6) Walnut tree (t10)   Immunoglobulin E Methodology Immunoassay (IA) Reference Range(s) See Laboratory Report Alternative Name(s) ImmunoCAP®

"Preferred Specimen(s) 4 mL serum Minimum Volume 2.5 mL Transport Temperature Room temperature Includes IgE allergy testing for: Alternaria alternata (a mold) (m6) Aspergillus fumigatus (m3) Bahia grass (g17) Bermuda grass (g2) Birch (t3) Cat dander (e1) Cladosporium herbarum (m2) Cockroach (i6) Common ragweed (short) (w1) Dermatophagoides farinae (d2) Dermatophagoides pteronyssinus (d1) Dog dander (e2) Elm (t8) Maple (box elder) (t1) Mountain cedar (t6) Mouse Urine Proteins (e72) Nettle (w20) Oak (t7) Pecan/Hickory (t22) Penicillium notatum (m1) Rough pigweed (W14) Sheep sorrel (w18) Timothy grass (g6)   Immunoglobulin E Methodology Immunoassay (IA) Alternative Name(s) ImmunoCAP®

"Preferred Specimen(s) 4 mL serum Minimum Volume 2.5 mL Transport Temperature Room temperature Specimen Stability Room temperature: 14 days Refrigerated: 14 days Frozen: 30 days Includes IgE allergy testing for: Alternaria alternata (a mold) (m6) Asperigillus fumigatus (m3) Bahia grass (Paspalum notatum) (g17) Bermuda grass (Cynodon dactylon) (g2) Blomia tropicalis (d201) Cat dander (e1) Cladosporium herbarum (m2) Cockroach (i6) Common ragweed (short; Ambrosia elatior) (w1) Dermatophagoides farinae (d2) Dermatophagoides pteronyssinus (d1) Dog dander (e5) Elm (Ulmus americana) (t8) Maple (box elder; Acer negindo) (t1) Mountain cedar (Juniperus sabinoides) (t6) Mouse Urine Proteins (e72) Nettle (Urtica dioica) (w20) Oak (Quercus alba) (t7) Penicillium notatum (m1) Rough pigweed (Amaranthus retroflexus) (w14) Sheep sorrel (Rumex acetosella) (w18) Timothy grass (Phleum pratense) (g6)   Immunoglobulin E Methodology Immunoassay (IA) Alternative Name(s) ImmunoCAP®