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Test Code DLAU D-Lactate, Urine

Reporting Name

D-Lactate, U

Useful For

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

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Specimen Type

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.


Specimen Minimum Volume

0.15 mL

Specimen Stability Information

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

Reference Values

0.0-0.25 mmol/L

Day(s) Performed

Monday, Thursday

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

LOINC Code Information

Test ID Test Order Name Order LOINC Value
DLAU D-Lactate, U 14046-7

 

Result ID Test Result Name Result LOINC Value
8873 D-Lactate, U 14046-7

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.

Interpretation

Increased levels are diagnostic.

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.

Report Available

3 to 6 days

Reject Due To

  All specimens will be evaluated at Mayo Clinic Laboratories for test suitability.

Method Name

Gas Chromatography Mass Spectrometry (GCMS) Stable Isotope Dilution Analysis