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Test ID DLAU D-Lactate, Urine


Specimen Required


Supplies: Urine Tubes, 10 mL (T068)

Container/Tube: Plastic urine tube

Specimen Volume: 0.50 mL

Collection Instructions:

1. Collect a timed or random urine specimen.

2. No preservative.

3. Immediately freeze specimen.


Secondary ID

8873

Useful For

Preferred test for diagnosing D-lactate acidosis, especially in patients with jejunoileal bypass and short-bowel syndrome

Method Name

Gas Chromatography Mass Spectrometry (GCMS) Stable Isotope Dilution Analysis

Reporting Name

D-Lactate, U

Specimen Type

Urine

Specimen Minimum Volume

0.15 mL

Specimen Stability Information

Specimen Type Temperature Time
Urine Frozen (preferred) 90 days
  Ambient  90 days
  Refrigerated  90 days

Clinical Information

D-lactate is produced by bacteria residing in the colon when carbohydrates are not completely absorbed in the small intestine. When large amounts of D-lactate are present, individuals can experience metabolic acidosis, altered mental status (from drowsiness to coma) and a variety of other neurologic symptoms, in particular dysarthria and ataxia. Although a temporal relationship has been described between elevations of plasma and urine D-lactate and the accompanying encephalopathy, the mechanism of neurologic manifestations has not been elucidated.

 

D-lactic acidosis is typically observed in patients with a malabsorptive disorder, such as short-bowel syndrome, or following jejunoileal bypass. In addition, healthy children presenting with gastroenteritis may also develop the clinical presentation of D-lactic acidosis.

 

Routine lactic acid determinations in blood will not reveal abnormalities because most lactic acid assays measure only L-lactate. Accordingly, D-lactate analysis must be specifically requested (eg, DLAC / D-Lactate, Plasma). However, as D-lactate is readily excreted in urine, this is the preferred specimen for D-lactate determinations.

Reference Values

0.0-0.25 mmol/L

Cautions

The test performed is for D-lactate. This is a product of bacterial overgrowth in the gastrointestinal tract. It should not be confused with L-lactate, which accumulates in some metabolic acidosis.

Day(s) Performed

Monday, Thursday

Report Available

3 to 6 days

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Test Classification

This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. It has not been cleared or approved by the US Food and Drug Administration.

CPT Code Information

83605

NY State Approved

Yes