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Appendix I: Reference Intervals Appendix I: Reference Intervals AMIN Y. BARAKAT The following reference intervals are guidelines usually needed in the diagnosis and management of renal disease. Values may vary according to the methodology used. Laboratory values are given in conventional and international units. A few references have been used in the formu­ lation of this table (1-5); values from other sources have been referenced separately. The prefixes for units are the standard ones approved by the Conference Generale des Poids et Mesures, 1964, the International Union of Pure and Applied Chemistry and the International Federation of Clin­ ical Chemistry. Few other abbreviations are used: B, blood; Ca, calcium; d, day; EDT A, ethylenediaminetetraacetate, edetic acid; f, female; hr, hour; m, male; min, minute; mo, month; RBC, red blood cell; P, plasma; S, serum; U, urine; wk, week; yr, year. Conventional International Test Specimen units units g/dl giL Albumin S Premature 3.0-4.2 30-42 NB 3.6-5.4 36-54 Infant 4.0-5.0 40-50 Thereafter 3.5-5.0 35-50 U Look under urine protein ng/dl nmoljL Aldosterone P (heparin, EDT A) Newborn: 5-60 0.14-1.7 S I wk-I yr: 1-160 0.03-4.4 1-3 yr: 5-60 0.14-1.7 3-5 yr: <5-80 <0.14-2.2 5-7 yr: <5-50 <0.14-1.4 7-11 yr: 5-70 0.14-1.9 II-IS yr: <5-50 <0.14-1.4 414 Amin Y. Barakat Conventional International Test Specimen units units ngJdl nmol/L Adult: Average sodium diet Supine: 3-10 0.08-0.3 Upright F: 5-30 0.14-0.8 M: 6-22 0.17-0.61 2-3 X higher during pregnancy Adrenal vein: 200-800 ngJdl 5.5-22 Low sodium diet: increases 2-5 fold Florinef suppression: <4 ngJdl <0.11 ACTH or angiotensin stimulation, I hr: 2-5 fold ngJdl or (6,7) P Premature 110-250 Full-term 110-200 3-12 mo 49-71 Adult 13.38-14.84 U, 24 hr Plasma renin Total activity ng UNa angiotensin U Aldosterone U Aldosterone -----mmol/d I/ml/hr mgJd nmol/d < 20 5-24 35-80 <97-220 50 2-7 13-33 36-91 100 1-5 5-24 14-66 150 0.5-4 3-19 8-53 200 1-16 3-44 250 1-13 3-36 (assuming normal serum Na, K and extracellular volume) "gJd or (7) Premature 2.5- 4.1 Newborn 6.4- 9.2 Adult 9.8-12.0 U/L Alkaline S Infant: 150-400 Same phosphatase Child, 2-10 yr 100-300 11-18 yr, 50-375 M: 30-300 F: 30-100 Adult: Angiotensin I P (EDTA) Peripheral vein 11-88 pgJml 11-88 ngJL Angiotensin II P (EDTA) Arterial: \.2-3.6 ngJdl 12-36 ngJL Venous: 50-75% of arterial Fraction of arterial conc. conc.0.50-0.75 Anion gap P (heparin) 7-16 mmol/L Same [Na- (Cl+ CO,)] Appendix I: Reference Intervals 415 Conventional International Test Specimen units units Antidiuretic P (EDTA) Plasma Plasma ADH Plasma hormone (ADH, mOsm/kg pg/ml ADH, ng/L vasopressin) 270-280: <1.5 Same 280-285: <2.5 285-290: 1-5 290-295: 2-7 395-300: 4-12 Anti-nDNA <1:20 antibody Anti-nuclear <1:20 antibody titer (ANA) Anti-streptolysin S :s 166 Todd units (ASO) titer (170-330 in school-aged children) mmol/L Base excess B (heparin) Newborn: -10 to -2 Same Infant: -7 to -I Child: -4 to +2 Thereafter: -2 to +3 mEq/L mmol/L Bicarbonate S Premature 18-26 Same (HCO;) Infant 20-26 1-2 yr 20-25 >2 yr 22-26 Blood volume B (heparin) M: 52-83 ml/kg M: 0.052-0.083 L/kg F: 50-75 ml/kg F: 0.050-0.075 L/kg pg/mL ng/L Calcitonin S, P Newborn term: (heparin, EDTA) cord 30-240 Same 48 h: 91-580 7 d: 77-293 Premature, cord: 30-265 48 hr: 108-670 7 d: 79-570 Adult, M: <100 F: 4 X lower (increases in pregnancy) Concentrations decrease with age mg/dl mmol/L Calcium, ionized S, P, B Newborn 3-24 hr: 4.3-5.1 1.07-1.27 24-48 hr: 4.0-4.7 1.00-1.17 Thereafter: 4.48-4.92 or 1.12-1.23 2.24-2.46 mEq/L 1.12-1.23 mg/dl mmol/L Calcium, total S Cord: 9.0-11.5 2.25-2.88 416 Amin Y. Barakat Conventional International Test Specimen units units mg/dl mmol/L Newborn Premature: 6.1-11.6 1.52-2.90 3-24 hr: 9.0-10.6 2.3 -2.65 24-48 hr: 7.0-12.0 \.75-3.0 4-7 d: 9.0-10.9 2.25-2.73 Child: 8.8-10.8 2.2 -2.70 Thereafter: 8.4-10.2 2.1 -2.55 U Look under urine calcium mmHg kP. Carbon dioxide, B (heparin) partial pressure Newborn: 27-40 3.6-5.3 (pCO) Infant: 27-41 3.6-5.5 Thereafter M: 35-48 4.7-6.4 F: 32-45 4.3-6.0 mmol/L Carbon dioxide, S, P (heparin) Cord: 14-22 Same total (tCO) Premature: 14-27 Newborn: 13-22 Infant: 20-28 Child: 20-28 Thereafter: 23-30 pgfml pmol/L Catecholamines, P (EDTA) Norepinephrine fractionated Supine 100-400 591-2364 Standing 300-900 1773-5320 Epinephrine Supine < 70 <382 Standing <100 <546 Dopamine < 30 <196 (no postural change) U, 24 hr Norepinephrine ILg/d mmol/d 0-1 yr: 0-10 0-59 1-2 yr: 0-17 0-100 2-4 yr: 4-29 24-171 4-7 yr: 8-45 47-266 7-10 yr: 13-65 77-384 Thereafter: 15-80 87-473 Epinephrine 0-1 yr: 0-2.5 0-13.6 1-2 yr: 0-3.5 0-19.1 2-4 yr: 0-6.0 0-32.7 4-7 yr: 0.2-10 1.1-55 7-10 yr: 0.5-14 2.7-76 Dopamine 0-1 yr: 0-85 0-555 1-2 yr: 10-140 65-914 2-4 yr: 40-260 261-1697 Thereafter: 65-400 424-2611 Appendix I: Reference Intervals 417 Conventional International Test Specimen units units I'gJd Catecholamines, V, 24 hr 0-1 yr: 10-15 Same total free 1-5 yr: 15-40 6-15 yr: 20-80 Thereafter: 30-100 mg/dl I'mol/L Ceruloplasmin S Newborn: 1-30 0.06-\.99 6-12 rna: 15-50 0.99-3.31 1-12 yr: 30-65 \.99-4.30 Thereafter: 14-40 0.93-2.65 mmol/L Chloride S, P (heparin) Cord: 96-104 Same Premature: 100-117 Newborn: 97-110 Thereafter: 98-106 V Look under urine chloride mmol/L Sweat Normal 0-35 Same Marginal 30-60 Cystic fibrosis 60-200 Increases by 10 mmol/L during lifetime mg/dl mmol/L Cholesterol, total S, P (EDTA or Cord: 45-100 1.17-2.59 heparin) Newborn: 53-135 1.37-3.50 Infant: 70-\75 \.81-4.53 Child: 120-200 3.11-5.18 Adolescent: 120-210 3.11-5.44 Adult: 140-250 3.63-6.48 Complement, total P (EDTA) 75-160 V/ml or hemolytic <33% of plasma Same CH,o classic pathway mg/dl mg/L components Clq S Cord: \.0-14.9 10-149 I mo: 2.2- 6.2 22- 62 6 mo: 1.2- 7.6 12- 76 Adult: 5.1- 7.9 51- 79 mg/dl mg/L C3 ------ RID S Cord: 65-112 0.65-1.12 I rna: 61-130 0.61-1.30 Adult: 111-171 1.11-1.71 Maternal: 161-175 1.61-1.75 At birth, cone. is 50-75% of adult values Nephelom- S Newborn: 58-120 0.58-1.20 etry C4 RID S Newborn: 16-39 160-390 mg/L Adult: 15-45 150-450 418 Amin Y. Barakat Conventional International Test Specimen units units mgjdl mgjL Nephelom- S Newborn: 10-26 100-260 etry Adult: 13-37 130-370 mgjdl mgjL Properdin S Cord: 1.3-\.7 13-17 I mo: 0.6-2.2 6-22 6 mo: 1.3-2.5 13-25 Adult: 2.0-3.6 20-36 "gjdl "mol/L Copper S Birth-6 mo: 20-70 3.14-10.99 6 yr: 90-190 14.13-29.83 12 yr: 80-160 12.56-25.12 Adult, M: 70-140 10.99-21.98 F: 80-155 12.56-24.34 U, 24 hr 0-30 "g/d 0-0:47 "mol/d "gjdl nmol/L Cortisol S, P (heparin) Newborn: 1-24 28-662 Adults: 08:00 hr 5-23 138-635 16:00 hr 3-15 82-413 20:00 hr ::s50% of 08:00 h Fraction of 08:00 hr ::sO. 50 "g/d nmol/d Cortisol. free U, 24 hr Child: 2-27 5.5-74 Adolescent: 5-55 14-152 Adult: 10-100 27-276 mg/dl "mol/L Creatinine S, P Cord: 0.6-1.2 53-106 Jaffe, kinetic or Newborn: 0.3-1.0 27-88 enzymatic Infant: 0.2-0.4 18-35 Child: 0.3-0.7 27-62 Adolescent: 0.5-1.0 44-88 Adult M: 0.6-1.2 53-106 F: 0.5-1.1 44-97 Jaffe, manual S, P 0.8-1.5 mg/dl 70-133 U, 24 hr mg/kgfd "mol/kgjd Premature: 8-20 71-180 Full-term: 10-16 90-144 Infant: 8-20 71-180 Child: 8-22 71-195 Adolescent: 8-30 71-265 Adult, M: 14-26 124-230 F: 11-20 97-177 mgjd mmol/d or M: 800-1800 7 -15.9 F: 600-1600 5.2-14.1 Appendix I: Reference Intervals 419 Conventional International Test Specimen units units Cyclic AMP P (EDTA) ng/ml nmoljL M: 5.6-10.9 17-33 F: 3.6-8.9 11-27 U, 24 hr <3.3 mgjd or <1.64 mgjg 1000-11,500 creatinine nmoljd, <6000 nmol cAMP/g creatinine Erythropoietin S mU/ml U/L RIA <5-20 Same Hemagglutination 25-125 Bioassay 5-18 Oi-Fetoprotein (8) S Fetal peak of 200-400 mg/dl in first trimester ngjml Premature 134,734 ±41,444 Newborn 48,406 ± 34,718 2-4 wk 2,654 ± 3,080 2 mo 323 ± 278 3 mo 88 ± 87 4 mo 74 ± 56 5 mo 46.5± 19 6 rno 12.5± 9.8 7 rno 9.7± 7.1 8 mo 8.5± 5.5 I yr <30 Adult <40 weeks: mg/dl mgjL Amniotic fluid 10-12 0.5-3.3 5-33 13-14 0.3-3.7 3-37 15-16 0.4-2.7 4-27 17-18 0.1-2.6 1-26 19-20 <0.1-1.14 <1-14 21-22 <0.1-1.1 <I-II 23-24 <0.1-0.7 <1-7 Fibrin degradation B (thrombin and proteolytic inhibitor <10 ILg/mL <10 mgjL products in tube) Agglutination U: 2 ml in similar tube <0.25 ILg/ml <0.25 mgjL (Thrombo­ Wellco test®) Fibrinogen B (sodium citrate) Newborn: 125-300 mg/dl 1.25-3.00 gjL Adult: 200-400 2.00-4.00 Folate S Newborn: 7.0-32 ng/ml 15.9-72.4 nmoljL Thereafter: 1.8-9 4.1-20.4 RBC (EDTA) 150-140 ng/ml 340-1020 nmoljL cells cells 420 Amin Y.
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