Cystatin C
| PATIENT INFO |
| Patient Name: |
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| BD: / / Sex: F M |
| PHYSICIAN INFO |
| Physician Name : |
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| Ph: ( ) - Fax: ( ) - |
| Additional Report to: |
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| TESTS REQUESTED | |
| Test Name: | ICD9 Code: (required) |
| 1. Cystatin C | |
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| SPECIMEN INFO |
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Test ID :
CYSTC
Test Workstation :
MAYO
Specimen Type:
Blood
Tube Type:
GOLD TOP (SST) TUBE
Alternate Tube Type:
Red top tube
Collection Volume:
1.5 mL (minimum 1.0 mL)
Storage:
Refrigerated
Availability:
Sent to reference lab
Methodology:
Immunoturbidimetric
Special Instructions:
Cystatin C:
1849 years: 0.631.03 mg/L;
> or =50 years: 0.671.21 mg/L;
017 years: Reference values have not been established. Refer to estimated glomerular filtration rate (eGFR).
Estimated GFR:
>60 mL/min/BSA;
Adult eGFR: Estimated GFR calculated using CKDEPI Cystatin C equation.
Pediatric eGFR: Estimated GFR calculated using Schwartz Cystatin C equation
Lab/Phone:
330-543-8418
CPT Code:
82610
Panel Includes:
Cystatin C, Serum
Estimated Glomerular Filtration Rate (eGFR) by Cystatin C
