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Biochemistry

Urine pH

Reference Range

No reference range is reported for urine pH. Although urine pH normally ranges between 6.5 to 8.5 in healthy individuals, it varies with food consumption. Urine with a pH >6.0 is suggestive of alkali contamination or the presence of urea splitting bacteria. In a patient with metabolic acidosis, a urine pH >5.5 suggests a failure of urinary acidification which may indicate renal tubular acidosis.

Turnaround Time:
1 working day

Urine Protein:Creatinine ratio (Random urine)

Reference Range

<15 mg/mmol Creatinine = Normal
15 – 49 mg/mmol Creatinine = Trace Proteinuria. Consider ACEI or ARB in diabetes.
50 – 99 mg/mmol Creatinine = Significant proteinuria. Repeat using early am sample. Consider ACEI or ARB in hypertension.
100 – 300 mg/mmol Creatinine = High proteinuria. If new finding, seek nephrology advice regardless of eGFR.
>300 mg/mmol Creatinine = “Nephrotic range” proteinuria. If new finding, seek nephrology advice regardless of eGFR.

Proteinuria is a risk factor for cardiovascular disease and for decline in GFR in CKD

UK CKD Guidelines suggest if PCR is >100 mg/mmol patient should be referred to Nephrologists irrespective of GFR.

Source of Reference Range: NICE guideline CG73 (2008) and UK eCKD guidelines 2009.)

Turnaround Time: 1 Day

Glucose (CSF)

Reference Range

Adults: 2.2 - 3.9 mmol/L

Results should be interpreted in relation to concurrent plasma values (the CSF glucose concentration should be 60% of the plasma glucose concentration).

Turnaround Time: 1 day

Related Tests Total Protein (CSF)

Glucose (Plasma)

Reference Range

There is no associated reference range for plasma glucose as the concentration should be assessed in conjunction with the fasting and diabetes status. Diabetes mellitus can be diagnosed based on random and fasting glucose. Various cut offs are quoted in the literature however the most commonly used are based on the WHO recommendations (2006) which states with symptoms of diabetes symptoms one requires:

• A random venous plasma glucose concentration ≥ 11.1 mmol/l or
• A fasting plasma glucose concentration ≥ 7.0 mmol/l (whole blood ≥ 6.1 mmol/l) or
• Two hour plasma glucose concentration ≥ 11.1 mmol/l two hours after 75g anhydrous glucose in an oral glucose tolerance test (OGTT).

Gestational diabetes should be diagnosed if the woman has either:

• A fasting plasma glucose level of 5.6mmol/l or above or
• A 2-hour plasma glucose level of 7.8mmol/l or above.

Turnaround Time: 1 day

Beta Human Choronic Gonadotrophin (B-HCG)

Reference Range

Pregnancy ranges:

Negative <5 IU/L

Equivocal ≥5 - <25 IU/L

Positive ≥25 IU/L

Turnaround Time: 1 day

Bicarbonate

Reference Range

Adult 22-29 mmol/L

Turnaround Time: 24 Hours

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University Hospitals Birmingham medical laboratories at Queen Elizabeth Hospital, Heartlands Hospital, Good Hope Hospital and Solihull Hospital are UKAS (United Kingdom Accreditation Service) accredited to the ISO 15189:2012 standard. For a list of accredited tests and other information please visit the UKAS website using the following link: https://www.ukas.com/find-an-organisation/

Molecular Pathology is a UKAS accredited medical laboratory No. 8759
Biochemistry is a UKAS accredited medical laboratory No. 8910
Haematology and Transfusion is a UKAS accredited medical laboratory No. 8784
Clinical Microbiology is a UKAS accredited medical laboratory No. 8760
Cellular Pathology is a UKAS accredited medical laboratory No. 10141
Musculoskeletal laboratory is a UKAS accredited medical laboratory No. 9897
Heartlands, Good Hope and Solihull Hospital pathology laboratories are a UKAS accredited medical laboratory No.8217.

Tests not appearing on the UKAS Schedule of Accreditation currently remain outside of our scope of accreditation. However, these tests have been validated to the same high standard as accredited tests and are performed by the same trained and competent staff.

For further test information, please visit the test database: http://qehbpathology.uk/test-database

For further information contact Louise Fallon, Quality Manager, 0121 371 5962