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Test Code DLAC D-Lactate, Plasma  

Reporting Name

D-Lactate, P

Useful For

An adjunct to urine D-lactate (preferred), in the diagnosis of D-lactate acidosis

Testing Algorithm

DLAU / D-Lactate, Urine is the preferred specimen for D-lactate determinations.

Method Name

Enzymatic

Performing Laboratory

Mayo Medical Laboratories in Rochester

Specimen Type

Plasma NaFl-KOx


Necessary Information


For L-lactate (lactic acid), order LAA / Lactate, Plasma



Specimen Required


Collection Container/Tube: Grey top (potassium oxalate/sodium fluoride) (T275)

Submission Container/Tube: Plastic vial

Specimen Volume: 1 mL

Collection Instructions: Spin down and immediately freeze specimen.

Additional Information: For L-lactate (lactic acid), order LLA / Lactate, Plasma.


Specimen Minimum Volume

0.55 mL

Specimen Stability Information

Specimen Type Temperature Time
Plasma NaFl-KOx Frozen (preferred) 365 days
  Ambient  7 days
  Refrigerated  7 days

Reject Due To

Hemolysis

Mild OK; Gross OK

Lipemia

Mild OK; Gross OK

Icterus

Mild OK; Gross OK

Other

NA

Reference Values

0.0-0.25 mmol/L

Day(s) and Time(s) Performed

Varies

CPT Code Information

83605

LOINC Code Information

Test ID Test Order Name Order LOINC Value
DLAC D-Lactate, P 14045-9

 

Result ID Test Result Name Result LOINC Value
8878 D-Lactate, P 14045-9

Method Description

D-lactate is oxidized to pyruvate in the presence of D-lactate dehydrogenase and nicotinamide adenine dinucleotide phosphate (NAD). The reaction proceeds because the pyruvate is continually removed as a pyruvate-hydrazone complex. The quantity of reduced NAD produced is directly proportional to the amount of D-lactate oxidized and is measured spectrophotometrically at 340 nm.(Oh MS, Phelps KR, Traube M, et al: D-Lactic acidosis in a man with the short-bowel syndrome. N Engl J Med 1979;301:249-252; Dahlquist NR, Perrault J, Callaway CW, Jones JD: D-Lactic acidosis and encephalopathy after jejunoileostomy: response to overfeeding and to fasting in humans. Mayo Clin Proc 1984;59:141-145)

Cautions

Urine is the preferred specimen to determine D-lactate.

 

The test performed was 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.

Specimen Retention Time

1 month

Test Classification

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

Interpretation

Increased levels are consistent with D-lactic acidosis. However, because D-lactate is readily excreted, urine determinations are preferred.

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, particularly dysarthria and ataxia.

 

D-lactic acidosis is typically observed in patients with a malabsorptive disorder, such as short-bowel syndrome, or, following a jejunoileal bypass. In addition, healthy children presenting with gastroenteritis may also develop the critical 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, DLAU / D-Lactate, Urine is the preferred specimen for D-lactate determinations.

Analytic Time

4 days