PHYSIOLOGICAL INDICATION AND CLINICAL IMPLICATIONS
Blood Chemistry Studies
Liver and renal function. Increased values in liver disease, renal
failure, newborn hemolytic disease, heart failure, cor pulmonale.
Decreased values in hypertension.
Pancreatic function. Increased values in pancreatitis, mumps,
obstruction of pancreatic duct, ketoacidosis. Decreased values
in kidney disease, pancreatic damage or cancer, toxemia of
(AST, or SGOT) (S)
Cellular damage. Increased after myocardial infarction, acute
liver disease, drug toxicity, muscle trauma. Decreased in
pyridoxine (vitamin B
Total: 0.1–1.0 mg/dl
Indirect: 0.1–1.0 mg/dl
Liver function and red cell breakdown. Increased levels of direct
in liver disease and biliary obstruction. Increased levels of indirect
in hemolysis of red blood cells.
Blood urea nitrogen (S)
Kidney function. Increased values in renal disease, dehydration,
urinary obstruction, congestive heart failure, myocardial
infarction, burns. Decreased values in liver failure, overhydration,
impaired protein absorption, pregnancy.
Metabolism—fat utilization. Increased values in diabetes mellitus,
pregnancy, use of oral contraceptives or anabolic steroids.
High-density lipoprotein (HDL)
20–30% of total
Increased levels in liver disease, aerobic exercise. Decreased levels
in atherosclerotic heart disease, malnutrition.
Low-density lipoprotein (LDL)
60–70% of total
Increased values in hyperlipidemia, atherosclerotic heart disease.
Decreased values in fat malabsorption and malnutrition.
Very low density lipoprotein
cholesterol (VLDL) (S)
10–15% of total
Same as LDL.
Creatine kinase (CK) (S)
Cellular damage. Increased values in myocardial infarction,
muscular dystrophy, hypothyroidism, pulmonary infarction,
cerebrovascular accident (CVA), shock, tissue damage, and
Renal function. Increased values in renal disease and acromegaly.
Decreased in muscular dystrophy.
Reference Values for Selected Blood and Urine Studies
The reference values listed for the selected blood and urine studies
are common ranges for adults, but speciﬁc “normals” are estab-
lished by the laboratory performing the analysis. The values may be
affected by a wide range of circumstances, including testing meth-
ods and equipment used, client age, body mass, sex, diet, activity
level, medications, and extent of disease processes.
Reference values are identiﬁed in both standard or conventional
units and in the system of international (SI) units. SI units (given in
parentheses) are measurements of amount per volume and are used
in most countries and scientiﬁc journals. SI units are often given as
moles or millimoles per liter. Most clinical laboratories and textbooks
in the United States use conventional or standard units, which mea-
sure mass per volume. These values are given as grams, milligrams,
or milliequivalents per deciliter or liter. It is anticipated that the
United States will eventually use SI units exclusively.
For enzymes, 1 international unit (IU) represents an arbitrary but
deﬁned amount of activity, whereas 1 katal (kat) is the amount of
enzyme required to consume 1 mol of substrate per second.
Sample types in column 1 are serum (S), plasma (P), arterial
whole blood (A), and whole blood (WB).