LABORATORY VALUES

Na Cl BUN Hgb
Glucose wbc platelet
K HCO
3
SCr Hct

ELECTROLYTES AND LIVER FUNCTION TESTS (LFT), RENAL DYSFUNCTION
Laboratory Test
Normal Reference Values*
Comments
Conventional Units SI Units
ALT
a
3-30 U/L 3-30 U/L From heart, liver, muscle, kidney, pancreas. More liver specific than AST.
Albumin 3.5-5 g/dL 35-50 mg/L
Produced in liver; decreased in liver disease, malnutrition, ascites,
hemorrhage.
ALP or Alk
Phos
a

26-88 U/L 26-88 U/L
Largely found in bile ducts, placenta, bone. Increased in obstruction of bile
duct or liver or rapid bone growth.
AST
a
8-42 U/L 8-42 U/L
Found primarily in the liver and heart. Increased in liver injury and
myocardial infarction.
Bilirubin 0.3-1 mg/dL 5-17 mmol/L Breakdown of hemoglobin. Increased in hemolysis, cholestasis, liver injury.
BUN
a
8-20 mg/dL 2.9-7.1 mmol/L
End product of protein metabolism, produced by liver, excreted renally. in
renal dysfunction, high protein intake, GI bleed, varices, dehydration.
Calcium
Total

Unbound
8.5-10.8 mg/dL

4.6-5.2 mg/dL
2.1-2.7 mmol/L

1.15-1.3 mmol/L
Aids in neuromuscular activity, endocrine function, blood coagulation, and
bone/tooth metabolism. Level affected by changes in albumin. Unbound
calcium is the physiologically active form; remains unchanged as albumin
fluctuates.
CO
2
content 24-30 mEq/L 24-30 mmol/L
Reflects acid-base balance and compensatory pulmonary (CO2) and renal
(HCO3) mechanisms. Primarily affects HCO3.
Chloride 96-106 mEq/L 96-106 mmol/L
Important for acid-base balance. by chloride-rich fluid (vomiting, diarrhea,
GI suction, overdiuresis).
Cholesterol
Total
LDL
a

HDL
a


< 200 mg/dL
< 100 mg/dL
> 40 mg/dL

< 5.17 mmol/L
< 2.58 mmol/L
> 1.03 mmo/L
LDL and HDL are risk factors for cardiovascular disease. High in
hypothyroid, lupus, multiple myeloma, liver disease.
CK
a

Males
Females

40-200 U/L
35-150 U/L

40-200 U/L
35-150 U/L
Found in tissues that use high energy (muscle, myocardium, brain). by IM
injections, MI, acute psychotic episodes. CK-MM in skeletal muscle; CK-MB
in myocardial tissue.
Creatinine 0.7-1.5 mg/dL 62-133 mol/L Excreted renally; increased in renal dysfunction.
Cl
cr
a
90-140 mL/min Reflects glomerular filtration rate; in renal dysfunction
GGT
a
0-30 U/L 0-30 U/L Reflects hepatocellular injury. Usually high in chronic alcoholics.
Globulin 2-3 g/dL 20-30 g/dL
Active role in immunological mechanisms. Immunoglobulins increase in
acute infections, rheumatoid arthritis, multiple myeloma.
Glucose 70-110 mg/dL 3.9-6.1 mmol/L Increased in diabetes or by corticosteroids.
Iron 50-150 g/dL 9-26.9 mol/L
Blood loss a major cause of deficiency. Increased needs in pregnancy and
lactation.
TIBC
a
250-410 g/dL 45-73 mol/L Increase capacity to bind iron with iron deficiency.
LD or LDH
a
100-210 U/L 100-210 U/L High in heart, kidney, liver, and skeletal muscle.
Magnesium 1.5-2.2 mEq/L 0.75-1.1 nmol/L
Hypo- caused by pancreatitis, alcoholism, severe diarrhea, diuretics. Hyper-
caused by renal failure.
Phosphorus 2.6-4.5 mg/dL 0.84-1.45 mmol/L Increased with renal dysfunction. Decreased with malabsorption.
Potassium 3.5-5 mEq/L 3.5-5 mmol/L
Increased by renal dysfunction, acidosis, burns. Decreased by diuretics,
alkalosis, vomiting, diarrhea.
Sodium
136-145
mEq/L
136-145 mmol/L
Low sodium usually because of dilution with water and treated with water
restriction.
Triglycerides
(TG)
< 150 mg/dL < 1.69 mmol/L Increased by alcohol, saturated fats, drugs.
Uric acid 3.4-7 mg/dL 202-416 mmol/L Increased in gout or by drugs (diuretics, niacin)
* Normal reference values may vary slightly per institution.
a
ALT = alanine aminotransferase; ALP/Alk Phos = alkaline phosphatase; AST = aspartate aminotransferase; BUN = blood urea nitrogen; LDL = low-density
lipoprotein; HDL = high-density lipoprotein; CK = creatine kinase; Clcr = c
reatinine clearance; GGT = gamma-glutamyl transferase; TIBC = total iron binding capacity; LD or LDH = lactate dehydrogenase.
LABORATORY VALUES



Na Cl BUN Hgb
Glucose wbc platelet
K HCO
3
SCr Hct



HEMATOLOGIC LABORATORY VALUES
Laboratory Test
Normal Reference Values*
Comments
Conventional Units SI Units
ESR
a

Males
Females

1-15 mm/hr
1-20 mm/hr

1-15 mm/hr
1-20 mm/hr
Nonspecific; with inflammation, infection,
neoplasms, pregnancy, nephritis.
Hct
a

Males
Females

42-50%
36-45%

0.42-0.50
0.36-0.45
with anemia, bleeding, hemolysis. with
polycythemia, chronic hypoxia.
Hgb
a

Males
Females

14-17.5 g/dL
12.3-15.3 g/dL

140-175 g/L
123-153 g/L
Similar to Hct.
MCH
a
27-33 pg/cell 27-33 pg/cell Measures weight of Hgb in average RBC.
MCHC
a
33.4-35.5 g/dL 334-355 g/L
More reliable than MCH. Measures
concentration of Hgb in average RBC. Does
not fluctuate with weight or size of RBC.
MCV
a
80-96 m
3
80-96 fL/cell Describes cell size (macro- or microcytic).
Platelets

140000-440000/ L 1.4-4.4 x 10
11
/L
Decreased platelets = thrombocytopenia;
increased risk for bleeding.
RBC
a
count
Males
Females

4.5-5.9 x 10
6
/L
4.1-5.1 x 10
6
/L

4.5-5.9 x 10
12
/L
4.1-5.1 x 10
12
/L
Carries oxygen to all parts of the body. in
blood loss, renal failure, hematopoietic
malignancies, and insufficiency dietary iron or
vitamin B12.
Reticulocyte count 0.5-2.5% 0.005-0.025
secondary to in erythrocytes that are
released in response to a stimulus (iron
deficiency anemia).
WBC
a
count (overall)

4.4-11.3 x
10
3
/L

WBC consists of neutrophils, lymphocytes,
monophils, eosinophils, and basophils.

W
B
C

D
i
f
f
e
r
e
n
t
i
a
l

Bands or stabs 3-5% 0.03-0.05

bands (shift to the left) bacterial
infection.
Neutrophils
(PMNs or segs)
45-73%

0.45-0.73


neutrophils bacterial or fungal infection.
Lymphocytes

20-40%

0.20-0.40

lymphocytes viral infections, chronic
inflammation
Monocytes
2-8%

0.02-0.08
Eosinophils 0-4% 0-0.04 with allergies, parasitic infections, asthma.
Basophils 0-1% 0-0.01 Small association with allergies, inflammation.
* Normal reference values may vary slightly per institution.

a
ESR = erythrocyte sedimentation rate; Hct = hematocrit; Hgb = hemoglobin; MCH = mean corpuscular hemoglobin; MCHC = mean corpuscular
hemoglobin concentration; MCV = mean corpuscular volume; RBC = red blood cell; WBC = white blood cell.

Table adapted from Lee M. Basic Skills in Interpreting Laboratory Data and Koda-Kimble. Applied Therapeutics The Clinical Use of Drugs.






Absolute neutrophil count (ANC)
(% seg + % bands) x WBC
Neutropenia is defined as ANC<2000, when ANC<1000, there is an increased risk of infection, when
ANC<500, the risk is very high.

Activate partial thromboplastin time (aPPT)
see partial thromboplastin time
Alanine aminotransferase (ALT)
Formerly SGPT
0-45 IU/L
Found primarily in liver, less in heart, kidney, skeletal muscle. ALT is more liver-specific, more
sensitive to hepatic damage than AST.
Albumin
3.5-4.9 gm/dl
One of the primary plasma proteins (accounts for 65% of total protein). Produced by the liver. Major
determinant of colloidal osmotic pressure (~80% is due to albumin). Non-specific measure of
nutritional status.
Many medications and circulating elements (i.e. calcium) bind to albumin. Drugs such as phenytoin,
warfarin, many sulfonamides, valproic acid, et al. bind to albumin (>90%). Tends to bind to acidic
drugs. Bound drug is inactive, free drug is active.
See also hyperalbuminemia, hypoalbuminemia

Alkaline phosphatase (AlkPhos)
30-130 IU/L
In adults, found primarily in bone and liver and secreted into bile
Elevated AlkPhos occurs with mild intra or extra-hepatic biliary obstruction with increases often noted
prior to elevation in bilirubin; may or may not be elevated in cirrhosis.
Good indicator of space-occupying lesions in liver.
In bone, elevated AlkPhos in Pagets disease, hyperthyroidism, metastatic CA, fractures.
Amikacin
see aminoglycosides

Aminoglycoside serum concentrations:

Therapeutic Range (traditional dosing):
Gentamicin/Tobramycin: Cpeak 4-12 mcg/ml
Ctrough < 2 mcg/ml
Amikacin: Cpeak 20-30 mcg/ml
Ctrough < 10 mcg/ml
Obtain Levels at Steady State:
Cpeak: 30 min post 30 min infusion
Ctrough: immediately prior to dose
Pharmacokinetic Properties:
-Linear pharmacokinetics
-Vd: distributes into body water
Vd= 0.2 -0.5 l/kg
Weight based on IBW or dosing weight
(Dosing Weight: IBW (kg) + (0.4 * TBW-IBW)
-CL: eliminated renally
-t1/2 normal renal function 2-3hours
-Protein binding: minimal
Toxicities: nephrotoxicity, ototoxicity and neuromuscular blockade (rare)
Normal Dosing:
Gentamicin/tobramycin: LD: 1-2 mg/kg
MD: 3-5 mg/kg/d in 3 divided doses
Amikacin: LD 5 - 7.5 mg/kg
MD: 15 mg/kg/d in 2-3 divided doses
Anion Gap (R)
The sum of all the unmeasured acids
Usually has a numerical value of ~10
AG= (Na + K) - (HCO3 + Cl)
Greater than ~10 may be caused by:
Organic acids, inorganics, protein, toxins, lab error
Most common cause of AG >12-14 is diabetic ketoacidosis
Less than ~10 may be caused by:
Hypoalbuminemia, lab error

Aspartate aminotransferase (AST)
Formerly SGOT
2-35 IU/L
Found primarily in heart and liver tissue with smaller amounts in skeletal muscle, kidney, and
pancreas.
Elevated AST in 96-98% of MI patients with onset of elevation ~4-6 hours after episode with peak
elevations 24-36 hours; return to baseline after 4-5 days. Peak values approximate extent of
myocardial injury.
Elevated AST in acute hepatic necrosis (also increased ALT) caused by viral hepatitis or
hepatotoxins, also elevated, sometimes, markedly in other types of liver disease. AST does NOT
correlate with extent of liver disease.

Bilirubin
Total: 0.1-1.1 mg/dl (2-18.8 mcmol/L)
Direct (conjugated): 0-0.3 mg/dl (0-5.1 mcmol/L)
Increased bilirubin causes jaundice which is a yellow color to skin and sclera, patient look icteric.
Bilirubin is a breakdown product of hemoglobin and is formed in the reticuloendothelial system,
transferred to blood, and almost completely bound to albumin. This is the unconjugated or indirect
bilirubin. The bilirubin-albumin complex goes to the liver where it is conjugated (direct bilirubin) and
excreted into the bile.

Blood Urea Nitrogen (BUN)
8-20 mg/dl (1.3-3.3 mmol/L)
End product of protein metabolism; produced only by liver, transported through blood, and excreted
by kidneys. Completely filtered at glomerulus, then reabsorbed and secreted into the tubules.
BUN will not reflect renal function if used alone.
BUN increased in: acute or chronic renal failure, dehydration, high protein intake, GI bleeding,
hyperthyroidism, decreased cardiac output from CHF or MI, protein catabolism.
BUN decreased in: water excess, end-stage liver disease
See also BUN:SCr ratio

BUN:SCr
Normal: 10:1-15:1
Increases > 15:1 indicate pre-renal azotemia if SCr is nl, also if SCr nl elevated ratio can be due to GI
bleed, catabolic states, high protein intake, tetracyclines.
Increases in ratio with concomitant increase in Scr can indicate post-renal azotemia, pre-renal
azotemia with existing renal disease.
Decreases in ratio with decreased BUN can indicate acute tubular necrosis, low protein diet, severe
liver disease, pregnancy, et al.

Calcium (Ca)
8.6-10.2 mg/dl (2.1-2.54 mmol/L)
Important in neuromuscular function, enzymatic reactions, blood coagulation, bone formation
Total serum Ca will decrease by 0.8 mg/dl for each 1.0 gm/dl decrease in serum albumin
concentration
Corrected Ca
= observed Ca + 0.8(nl albumin - obs alb)
See also hypercalcemia, hypocalcemia

Calicum, corrected
Corrected Ca
= observed Ca + 0.8(nl albumin - obs alb)
Carbon Dioxide (CO2)
24-34 mEq/L (24-34 mmol/L)
Represents the sum of the bicarbonate (HCO3) concentration and the dissolved CO2 concentration in
the serum
The carbonic acid-sodium bicarbonate system is the most important buffering system in regulating
physiological pH
Ratio of HCO3 to H2CO3 should be
20:1 for normal acid-base balance
Total CO2 is ~95% HCO3 and ~5% CO2

Chloride
99-111 mEq/L (99-111 mmol/L)
Primary anion of extracellular fluid compartment; aids in maintenance of acid-base balance.
See also hyperchloremia, hypochloremia

Cholesterol
Desirable: <200 mg/dl
Borderline: 200-239 mg/dl
High Risk: >/= 240 mg/dl
Cholesterol exists in the muscle, RBCs, and cell membranes. It is used by the body to form steroid
hormones, bile acids, and cell membranes. Elevated cholesterol is associated with atherosclerosis
and an increased risk of coronary artery disease.
A patient must fast for 12 hours before blood is obtained to measure the concentration accurately.

Creatinine Clearance (Clcr)
75-125 ml/min (1.24-2.08 ml/s)
Clcr estimates true GFR with ~10% error because creatinine is primarily filtered only. Clcr serves as
an indication of renal function, useful in dosing certain medications. Estimation based on SCr. Most
commonly used formula is Cockroft-Gault:
Males:
LBW 50kg + 2.3kg/inch>5ft
(140-age) (LBW in kg) / (SCr) (72kg)
Females:
LBW 45kg + 2.3kg/inch>5ft
[(140-age) (LBW in kg) / (Scr) (72kg)] x 0.85
Remember this and any formula is an estimation and is subject to limitations! Cr must be steady-state
levels, patient must be >18 yo, and adjust for obesity.

Differential
1. Segmented neutrophils 50-60% (mature)
2. Band neutrophils 0-3%
3. Lymphocytes 20-40%
4. Monocytes 2-6%
5. Eosinophils 1-5%
6. Basophils 0-1%
The differential indicates the fraction of the total WBC by type.
See also neutrophils, lymphocytes, monocytes, eosinophils, basophils

Digoxin
Therapeutic Range:
0.8 - 2ng/ml
Serum Sampling at Steady State:
Obtain concentration > 6 hours post ingestion
Pharmacokinetic Properties:
Linear pharmacokinetics, 2 compartment model
Bioavailability:
Elixer: 75-85%
Tablets: 70-80%
IV: 100%
Vd (normal renal function): 6-7 l/kg
CL: 50-70% eliminated renally (unchanged)
t1/2 (normal renal function): approx. 2 days
Protein binding 30%
Toxicities: tachyarrhythmias
Usual Dose:
PO .125 - .5 mg po q day
IV 0.1 -0.4 mg iv q day
Erythrocytes (Red Blood Cells)
Males: 4.6-6.2 x 10 6 /mm3 (4.6-6.2 x 10 12 / L)
Females: 4.2-5.4 x 10 6 /mm3 (4.2-5.4 x 10 12 / L)
Primary function is to carry oxygen from lungs to tissues.
RBC production is regulated by tissue oxygenation; avg. lifespan of a RBC in circulation is 120 days.
RBCs are described by size: normocytic (normal size), microcytic (small size), macrocytic (large
size)
Anemia: condition where RBC, Hgb, and/or Hct is low; can be due to impaired RBC production, RBC
destruction, blood loss.

Ferritin
Males (>19 yo): 7.3-199 ng/ml (7.3-199 mcg/L)
Females (>19 yo):
premenopausal 5.0-201.9 ng/ml (5.0-201.9 mcg/L)
postmenopausal 8.1-204 ng/ml (8.1-204 mcg/L)
Iron is complexed to ferritin (a protein) and is considered the storage form of iron. Correlates with total
body iron stores.
Decreased in iron deficiency anemia
Increased in, e.g. other anemias, acute-phase reactant (liver disease, hyperthyroidism), iron overload

Gamma-glutamyl transferase (GT)
1-35 IU/L
Found in kidney, liver, pancreas.
Elevated GGT in cholestatic disease and metastatic liver CA, chronic excessive alcohol intake, drugs
that cause enzyme induction (phenobarb, phenytoin); normal levels in bone disease.

Gentamicin
See aminoglycosides

Glucose
73-115 mg/dl (0.4-6.1 mmol/L)
Primary purpose is provision of energy. The brain is the only organ that does not depend on insulin
for glucose utilization
Plasma glucose is measured in fasting state or postprandially depending on the information desired
Whole blood samples are used in fingerstick devices often performed in a home setting. Plasma and
serum glucose samples are identical, but are 10-15% higher than whole blood.
See also hyperglycemia, hypoglycemia

Hematocrit (Hct)
Males: 42-52% (0.42-0.52 fraction of 1.00)
Females: 37-47% (0.37-0.47 fraction of 1.00)
(Hct = ~ 3 x Hgb)
Defined as the ratio of the volume of RBC's to volume of whole blood.
Decreases in RBC, Hgb, Hct: blood loss, medications, chronic disease, hemolysis
Increases in RBC, Hgb, Hct: hemoconcentration, polycythemia, increased altitude, smokers

Hemoglobin
Males: 14-18 gm/dl (140-180 gm/L)
Females: 12-16 gm/dl (120-160 gm/L)
Gender difference is due to androgens stimulate erythropoiesis, estrogen may have slight
suppressive effect on erythropoiesis, menstrual blood loss.
Hgb is the component in the RBC which carries O2 (and CO2).
RBCs can be described by color: normochromic (normal color = normal amt of Hgb), hypochromic
(paler color = decreased amt of Hgb), hyperchromic (more color = increased amt of Hgb) (very rare).

Hemoglobin A1C
The normal range is 4-7%.
Diabetics should be <9%
Action suggested >8
This is an indicator of glucose control over the past 6-12 weeks.
Also known as glycosylated hemoglobin

High Density Lipoproteins (HDL)
Male < 35 mg/dl represent a coronary risk factor
Female < 40 mg/dl represent a coronary risk factor
HDL are the products of liver and intestinal synthesis and triglyceride catabolism.
There is an inverse relationship between HDL-cholesterol levels and the incidence of coronary artery
disease. HDL is also known as the "good" cholesterol.

Hyperalbuminemia
Normal range: 3.5-4.9 gm/dl
Rare
1. Disease-related, e.g. dehydration
2. Drug-induced, e.g. administration of exogenous albumin

Hypercalcemia
Normal range: 8.6-10.2 mg/dl
Corrected Ca > ~10.5 mg/dl
Clinical symptoms: weakness, anorexia, constipation, N/V, decreased renal function, coma
1. Disease-related, e.g. malignancy, hyperprathyroidism, Pagets disease chronic renal failure
2. Drug-induced, e.g. thiazides diuretics, estrogens, lithium, vitamin D toxicity
3. Lab error

Hyperchloremia
Normal range: 99-111 mEq/L
Clinical symptoms: may indicate hyperchloremic metabolic acidosis
Rarely occurs otherwise because hyperchloremia is accompanied by sodium and water retention

Hypercholesterolemia
Levels > 200 mg/dl are considered to be high and require a triglyceride evaluation.
Desirable: <200 mg/dl
Borderline: 200-239 mg/dl
High Risk: >/= 240 mg/dl
1. Disease-related, e.g. cardiovascular disease, atherosclerosis, familial hypercholesterolemia,
hypothyroidism

Hyperglycemia
Levels > 200 mg/dl are considered to be high and require a triglyceride evaluation.
Desirable: <200 mg/dl
Borderline: 200-239 mg/dl
High Risk: >/= 240 mg/dl
1. Disease-related, e.g. cardiovascular disease,atherosclerosis, familial hypercholesterolemia,
hypothyroidism

Hyperkalemia
Normal range: 3.5-5.0 mEq/L
Clinical symptoms: fatigue, seizures, cardiac arrhythmias, hyperreflexia
1. Excessive intake
2. Excessive cell lysis, e.g. trauma, burn, hemolysis, infections
3. Impaired excretion, i.e. renal failure
4. Drug-induced, e.g. ACE-inhibitors, NSAIDs, K-pcn, K-sparing diuretics, K-supplements,
antineoplastics

Hypermagnesemia
Normal range: 1.5-2.3 mg/dl
Clinical symptoms: muscle weakness, sedation, lethargy, hypotension, arrhythmias
1. Disease-related, e.g. renal failure, diabetes mellitus, hypothyroidism
2. Drug-induced, e.g. lithium, Mg containing antacids

Hypernatremia
Male, Desirable: 40-160 mg/dl
Female, Desirable: 35-135 mg/dl
1. Disease-related, e.g. alcoholic cirrhosis, alcoholism, diabetes mellitus, gout, ischemic heart
disease, liver disease, hypothyroidism
2. Drug-induced, e.g. corticosteroids, estrogens, cholestyramine, spironolactone

Hyperphosphatemia
Normal range: 2.5-4.9 mg/dl
Clinical symptoms: usually accompanied by decrease calcium and symptoms of hypocalcemia
1. Disease-related, e.g. renal failure, hypoparathyroidism, vitamin D toxicity

Hypertriglyceridemia
Male, Desirable: 40-160 mg/dl
Female, Desirable: 35-135 mg/dl
1. Disease-related, e.g. alcoholic cirrhosis, alcoholism, diabetes mellitus, gout, ischemic heart
disease, liver disease, hypothyroidism
2. Drug-induced, e.g. corticosteroids, estrogens, cholestyramine, spironolactone
Hypoalbuminemia
Normal range: 3.5-4.9 gm/dl
Clinical symptoms: edema, ascites
1. Disease-related, e.g. liver failure, malnutrition, trauma, kidney failure

Hypercalcemia
Normal range: 8.6-10.2 mg/dl
Corrected Ca > ~10.5 mg/dl
Clinical symptoms: weakness, anorexia, constipation, N/V, decreased renal function, coma
1. Disease-related, e.g. malignancy, hyperprathyroidism, Pagets disease chronic renal failure
2. Drug-induced, e.g. thiazides diuretics, estrogens, lithium, vitamin D toxicity
3. Lab error
Hyperchloremia
Normal range: 99-111 mEq/L
Clinical symptoms: may indicate hyperchloremic metabolic acidosis
Rarely occurs otherwise because hyperchloremia is accompanied by sodium and water retention
Hypercholesterolemia
Levels > 200 mg/dl are considered to be high and require a triglyceride evaluation.
Desirable: <200 mg/dl
Borderline: 200-239 mg/dl
High Risk: >/= 240 mg/dl
1. Disease-related, e.g. cardiovascular disease, atherosclerosis, familial hypercholesterolemia,
hypothyroidism

Hyperglycemia
Levels > 200 mg/dl are considered to be high and require a triglyceride evaluation.
Desirable: <200 mg/dl
Borderline: 200-239 mg/dl
High Risk: >/= 240 mg/dl
1. Disease-related, e.g. cardiovascular disease,atherosclerosis, familial hypercholesterolemia,
hypothyroidism

Hyperkalemia
Normal range: 3.5-5.0 mEq/L
Clinical symptoms: fatigue, seizures, cardiac arrhythmias, hyperreflexia
1. Excessive intake
2. Excessive cell lysis, e.g. trauma, burn, hemolysis, infections
3. Impaired excretion, i.e. renal failure
4. Drug-induced, e.g. ACE-inhibitors, NSAIDs, K-pcn, K-sparing diuretics, K-supplements,
antineoplastics

Hypermagnesemia
Normal range: 1.5-2.3 mg/dl
Clinical symptoms: muscle weakness, sedation, lethargy, hypotension, arrhythmias
1. Disease-related, e.g. renal failure, diabetes mellitus, hypothyroidism
2. Drug-induced, e.g. lithium, Mg containing antacids

Hypernatremia
Male, Desirable: 40-160 mg/dl
Female, Desirable: 35-135 mg/dl
1. Disease-related, e.g. alcoholic cirrhosis, alcoholism, diabetes mellitus, gout, ischemic heart
disease, liver disease, hypothyroidism
2. Drug-induced, e.g. corticosteroids, estrogens, cholestyramine, spironolactone
Hyperphosphatemia
Normal range: 2.5-4.9 mg/dl
Clinical symptoms: usually accompanied by decrease calcium and symptoms of hypocalcemia
1. Disease-related, e.g. renal failure, hypoparathyroidism, vitamin D toxicity

Hypertriglyceridemia
Male, Desirable: 40-160 mg/dl
Female, Desirable: 35-135 mg/dl
1. Disease-related, e.g. alcoholic cirrhosis, alcoholism, diabetes mellitus, gout, ischemic heart
disease, liver disease, hypothyroidism
2. Drug-induced, e.g. corticosteroids, estrogens, cholestyramine, spironolactone

Hypoalbuminemia
Normal range: 3.5-4.9 gm/dl
Clinical symptoms: edema, ascites
1. Disease-related, e.g. liver failure, malnutrition, trauma, kidney failure

Hypocalcemia
Normal range: 8.6-10.2 mg/dl
Corrected Ca < ~ 8.5 mg/dl
Clinical symptoms: tingling fingers, muscle cramps, tetany, seizures

Hypochloremia
Normal range: 99-111 mEq/L
Clinical symptoms: often occurs during metabolic alkalosis, but may occur in acidosis if other acids
are the primary cause of the acidosis
1. Drug-induced, e.g. diuretics
2. Excessive loss, e.g. diarrhea, vomiting, gastric suctioning

Hypocholesterolemia
Desirable: <200 mg/dl
Borderline: 200-239 mg/dl
High Risk: >/= 240 mg/dl
1. Disease-related, e.g. malabsorption, liver disease, sepsis, pernicious anemia, hyperthyroidism

Hypochromic
Decreased MCH
Decreased MCHC

Hypoglycemia
Normal range: 73-115 mg/dl
Clinical symptoms: sweating, confusion, tachycardia, headache
1. Disease-related, e.g. tumor, massive liver disease
2. Drug-induced, e.g. insulin, oral hypoglycemics, ethanol, salicylates
3. Reactive hypoglycemia

Hypokalemia
Normal range: 3.5-5.0 mEq/L
Clinical symptoms: muscle fatigue, dizziness, drowsiness, confusion, ECG changes, et al.
1. Drug-induced, e.g. amphotericin B, diuretics, aminoglycosides, penicillins, corticosteroids
2. Excessive loss, e.g. diarrhea, vomiting

Hypomagnesemia
Normal range: 1.5-2.3 mg/dl
Clinical symptoms: tetany, muscle irritability, depression, N/V, cardiac arrhythmias
Low Mg may cause unexplained symptomatic hypocalcemia or hypokalemia
1. Disease-related, e.g. malabsorption, abnormal GI fluid loss, renal disease, dibetes mellitus
2. Drug-induced, e.g. cyclosporine, amphotericin B, diuretics, aminoglycosides, laxatives

Hyponatremia
Normal range: 136-146 mEq/L
Clinical symptoms: H/A, confusion, seizures, weight gain
1. Depletional: low Na in the absence of edema
a. Drug-induced, e.g. diuretics
b. Disease-related, e.g. diarrhea, vomiting, hyperlipidemia, hypoaldosteronism
2. Dilutional: expansion of extracellular fluid compartment with no change in Na
a. Drug-induced, e.g. APAP, barbiturates, opiates, chlorpropamide
b. Disease-related, e.g. CHF, cirrhosis with ascites

Hypophosphatemia
Normal range: 2.5-4.9 mg/dl
Clinical symptoms: non-specific, weakness, malaise, irritability, convulsions, coma
1. Disease-related, e.g. diabetic ketoacidosis, nutritional deficiency, hypoerparathyroidism
2. Drug-induced, e.g. overuse of Al containing antacids, diuretics

Hypotriglyceridemia
Male, Desirable: 40-160 mg/dl
Female, Desirable: 35-135 mg/dl
1. Disease-related, e.g. COPD, malabsorption , malnutrition, hyperthyroidism
2. Drug-induced, e.g. ascorbic acid, clofibrate, heparin
INR = (PTobserved/PTcontrol) to the ISI power
Target values
Low-intensity INR range: 2-3
High-intensity INR range: 3-4.5
INR is used in the same capacity as the PT.
The purpose of the INR is to standardize the value of the PT so that interlaboratory differences
caused by differences in thromboplastin sensitivities can be eliminated.
Iron
Males: 80-180 mcg/dl (14-32 mcmol/L)
Females: 60-160 mcg/dl (11-29 mcmol/L)
Used to determine amount of iron in circulation.
Iron is bound to transferrin in circulation and serum iron measures only the iron present in the iron-
transferrin complex.
The complex is in equilibrium with other iron stores, so this provides an indirect indication of total
body iron.
High serum iron, e.g. iron-storage diseases, RBC production defects, hemolytic anemias
Low serum iron, e.g. iron deficiency anemia, anemia of chronic disease

Iron saturation ratio
% iron saturation =
serum iron / TIBC x 100
Saturation ratio <15% is consistent with iron deficiency anemia
Lactate dehydrogenase (LDH)
60-200 U/L
High concentration in heart, liver, skeletal muscle, kidney, lung, RBCs, so non-specific
Consists of 5 isoenzymes which help differentiate affected organ: heart primarily LDH, LDH2; skeletal
muscle and liver are primarily LDH4, LDH5; lung primarily LDH2, LDH3.
Low Density Lipoprotein (LDL)
Desirable: <130 mg/dl
Borderline: 130-159 mg/dl
High risk: >/= 160 mg/dl
High LDL values are associated with coronary vascular disease or familial hyperlipidemia.
Levels may be falsely elevated in samples taken from non-fasting subjects.
LDL is also known as the bad cholesterol.
Decreased LDL levels may occur in patients with hypoproteinemia.

Lymphocytes
Involved in immunity
1. T-cell involved in cell-mediated immunity
2. B-cell involved in humoral immunity
Increased lymphocytes may indicate viral infections.

Macrocytic
Increased MCV
Increased MCH
e.g. B12 deficiency, folic acid deficiency,
1. Disease-related, e.g. myxedema, multiple myeloma, neoplastic disease
2. Drug-induced, e.g. methotrexate, trimethoprim, sulfonamides, oral contraceptives, phenytoin,
ethanol

Magnesium
1.5-2.3 mg/dl (0.75-1.15 mmol/L)
Important in maintenance of normal cardiac function, bone formation, and enzymatic reactions
See hypermagnesemia, hypomagnesemia

Mean corpuscular hemoglobin (MCH)
27.0-31.0 pg (1.7-2.1 fmol)
MCH = Hgb / RBC count
MHC is the average weight of one RBC

See also microcytic, hypochromic

Mean corpuscular hemoglobin concentration (MCHC)
32.2-36.0 gm/dl (320-360 gm/L)
MCHC = MCH / MCV
MCHC is the average concentration of Hgb in a given volume of packed RBCs
MCHC is a more reliable index of Hgb than MCH

Mean corpuscular volume (MCV)
80.0-100.0 microns
MCV = Hct / RBC count
MCV is the average volume of one RBC; immature RBCs are larger in size than mature RBCs
Detects changes in cell size (normocytic, macrocytic, microcytic)
See also microcytic, macrocytic

Microcytic
Decreased MCV
Decreased MCH
e.g. iron deficiency, anemia of chronic disease
Monoytes
Transported in blood to tissue where they mature into macrophages
Increased in malaria and TB
Neutrophils
Various terms including polys, segs, PMNs (polymorphonuclear), granulocytes
Stored in bone marrow and along blood vessel walls and capillary beds
Shift to the left means an increase in immature neutrophils (i.e. increased bands compared to
segs) occurring during bacterial infection.
See also absolute neutrophil count
Partial thromboplastin time (PIT)
~20-30 seconds
Used to screen for Hemophilia A and B, Christmas disease, DIC, liver failure, et al.
Evaluation of intrinsic and common coagulation pathways (Factors XII, XI, IX, VIII, X, V, II, IIa, I).
Prolonged in conditions with defects in any of these factors.
Used to monitor heparin therapy.
Phenytoin
Therapeutic Range:
Ctrough 10-20 mcg/ml
Obtain Sample at Steady State:
Obtain trough sample

Pharmacokinetic Properties:
-Nonlinear pharmacokinetics
-Vd 0.65 l/kg
-CL: eliminated by the liver
concentration dependent elimination
Vm 7mg/kg/day
Km 4mg/kg/day
-T1/2: concentration dependent
-Protein binding: 90%
Toxicities: nystagmus, CNS reactions, ataxia
Normal Dosing: 5-7 mg/kg/day
Phosphate
2.5-4.9 mg/dl (0.8-1.6 mmol/L)
Phosphate is a source for ATP, bone formation, and phospholipid synthesis.
Should be expressed as mg/dl or
mmol/L, NOT mEq/L because it is present in several ionic forms
Phosphate alone not usually a problem except in chronic renal failure
See also hyperphosphatemia, hypophosphatemia
Platelets (thrombocytes)
150,000-350,000/mm3 (150,000-350,000 x 10 6 /L)
Produced in bone marrow and responsible for blood clotting.
Platelets circulate for 8-11 days then are destroyed in the spleen or by antibodies.
See also thromobocytosis, thrombocytopenia
Potassium
3.5-5.0 mEq/L (3.5-5.0 mmol/L)
Primary cation of intracellular fluid compartment.
See also hyperkalemia, hypokalemia
Prothrombin Time (PT)
11-13 seconds
The PT is time required for clotting to occur.
Used in combination with aPTT to evaluate extrinsic and common coagulation pathway: Factors VII,
X, V, II, IIa, I.
PT prolonged if defects in any of above factors.
Used to evaluate:
*Oral anticoagulant therapy (warfarin, coumarin).
Therapeutic PT value can be 1.5-2.5 times control.
*Liver function.
PT prolonged in severe liver dysfunction, vitamin K deficiency, poor fat absorption, leukemias.
Decreased PT in cases of excessive vitamin K.
Red cell distribution width (RDW)
11.5-14.5%
Estimates RBC anisocytosis (variation in size)
Red cell indices (Wintrobe Indices)
Describe the cells and add meaning to above values
Reticulocyte count, corrected
Calculated to account for the longer maturation time in circulation and avoid overestimation of
erythropoietic response.
Corrected count = Retic ct % x (Pts Hct/Nl Hct) / maturation time
Reference maturation chart in Herfindal
Reticulocytes
0.5-2.5% expressed as % of 50,000 RBCs
Retics are immature RBCs found primarily in bone marrow with very small amts in blood; retic count
estimates RBC production (absolute count is more useful than %)
Retics are larger than RBCs and contain less Hgb.
Elevated retic counts, e.g. acute blood loss, hemolytic anemia, metastatic cancer of bone marrow,
drug therapy for anemia.
Depressed retic counts, e.g. chronic bleeding, chronic diseases, bone marrow suppression, factor-
deficiency anemias.
See also reticulocyte count, corrected
Serum Creatinine (SCr)
Males: 0.9-1.3 mg/dl (80-115 mcmol/L)
Females: 0.6-1.0 mg/dl (53-88 mcmol/L)
Amino acid derived from muscle tissue (creatine and phosphocreatine) with constant rate of formation
for a given individual determined by lean body weight (muscle mass). Excreted almost exclusively by
glomerular filtration; so decreased in GFR will cause SCr to increase.
But alone does not reflect renal function!
Used to estimate creatinine clearance.
Influenced by age, muscle mass, drug interference, renal function.
Shift to the left
This means an increase in immature neutrophils (i.e. increased bands compared to segs) occurring
during bacterial infection.
Sodium
136-146 mEq/L (136-146 mmol/L)
Primary cation of extracellular fluid
Indicates water balance, not sodium need.
See also hypernatremia, hyponatremia
Thrombocytopenia
Decreased platelets
Normal range: 150,000-350,000/mm3

1. Disease-related, e.g. certain neoplastic disorders, metabolic disorders, liver disease
2. Drug-induced, e.g. quinine, quinidine, heparin

Thrombocytosis
Increased platelets
Normal range: 150,000-350,000/mm3
Disease-related, e.g. some leukemias
Tobramycin
see aminoglycosides
Total iron binding capacity (TIBC)
210-400 mcg/dl (37.59-71.60 mcmol/L)
Determines the total amount of binding sites available on transferrin and therefore a direct estimate of
the bodys ability to carry iron. It is an indirect estimate of the transferrin concentration.
Total Protein
6.0-8.3 gm/dl (60-80 gm/L)
Includes albumin and other circulating proteins: globulins (alpha-1 (antitrypsin, acid glycoprotein,
alpha-2 (macroglobulin, haptoglobin, ceruloplasmin), beta (LDL, transferrin, C3, fibrinogen), gamma
(IgA, IgE, IgG, IgM).
This lab value is rarely used alone, but can indicate a need for further testing.
Triglycerides
Male, Desirable: 40-160 mg/dl
Female, Desirable: 35-135 mg/dl
Values are age and diet related. Values in women are about 10 mg/dl lower than in men.
Triglycerides account for more than 90% of dietary intake and comprise 95% of the fat stored in
tissues. They are stored in adipose tissue as glycerol, fatty acids, and monoglyceroids. The liver
reconverts them to triglycerides.
Urinalysis
Usually performed on first morning urine, if possible, to rule out dilutional effect.
Clean catch urine is usually performed.
Includes attributes such as gross appearance, pH, specific gravity, et al.
Urinalysis - Casts
0-3 hyaline casts/LPF
Usually composed of protein or fatty material which outline the shape of the renal tubule where they
were deposited.
Significance of casts varies with presence or absence of other factors.
Urinalysis - Crystals
Formation of pH dependent and may appear as cloud in the urine.
In acid urine, crystals may be uric acid or calcium oxalate; in alkaline urine they may be phosphates.
Crystalluria alone is not significant, though may indicate a tendency to form renal calculi.
Urinalysis - Gross appearance
Color should be slightly yellow
Should not be red (blood, porphyria, phenolphthalein), brown (blood or melanin), or dark orange
(excess urobilinogen, drugs, such as rifampin, phenazopyridine).
Should be relatively clear/hazy.
Urinalysis - Leukocyte esterase
Reference: Negative
This is a rapid indirect test for detection of bacteriuria. It can indicate the presence of intact or lysed
neutrophils.
Presence of leukocytes esterases imply urinary tract infection in females or urethritis in males.
Urinalysis - Microscopic
Examined for RBCs, WBCs, casts, yeast, crystals, epithelial cells
Urinalysis - Nitrate
Reference: Negative
This detects the presence of potentially significant bacteriuria. It reacts with bacteria that reduce
urinary nitrate to nitrite.
The presence of nitrites in the urine aid in the diagnosis of urinary tract infection, cystitis, and
pyelonephritis.
Urinalysis - pH
Normally acidic: 4.6-8.0
Elevated pH may indicate an aged urine specimen, systemic alkalosis, infection, urine left at room
temperature.
Urinalysis - Protein
0-30 mg/dl
Adult usually excretes 30-130 mg/day
Positive tests are common and transient even with normal renal function.
Sustained proteinuria indicates renal damage.
mild = < 1 gm/day
mod = 1-3.5 gm/day
nephrotic range = >3.5 gm/day
Nonrenal causes of proteinuria, excessive exercise, exposure to cold, postural changes, pregnancy,
CHF, seizures, febrile illness.
Urinalysis - RBC's
0-3/HPF
Elevated in bleeding disorders, some collagen disease, bladder/urethral/prostate conditions
Urinalysis - Specific gravity
1.001-1305
Indicates kidneys ability to concentrate urine.
Decreased spgr in diabetes insipidus, increased in dehydration
Urinalysis - WBC's
0-3/HPF
Presence indicates UTI, non-infectious inflammatory disease of urinary tract may cause WBCs in
urine
Vancomycin
Therapeutic Range:
Ctrough < 10-15 mcg/ml
Serum Sampling at Steady State:
Obtain trough
(controversial to obtain Cpeaks)
Pharmacokinetic Properties:
-Linear pharmacokinetics, 2-3 compartment model
-Vd: 0.5 - 1.0 l/kg (average 0.7 l/kg)
-CL: eliminated renally
-t1/2: Normal renal function- 7 hours
Anephric t1/2- 7.5 days
-Protein binding: 30 - 55%
Toxicities:
Infusion rate related: phlebitis, red man's syndrome Concentration related: nephrotoxicity, ototoxicity
Normal Dosing:
1000 mg iv q 12 hours
White blood cells (WBC's) (Leukocytes)
4000-10,000 / mm3 (4.0-10.0 x 10 9 /L)
WBC's increased in, e.g. acute infections, intoxications, acute hemorrhage, myeloproliferative
disease, acute stress, drugs (epinephrine, corticosteroids, lithium, heparin)
WBC's decreased in, e.g. bone marrow suppression, radiation
See also differential
http://sitemaker.umich.edu/medical.history.interview/lab_values












































Serum Creatinine (SCr): Normal Range, Male, mg/dL
0.9-1.3 mg/dL
Cara Membaca Hasil Laboratorium | Nilai Normal
Hasil Laboratorium
HB (HEMOGLOBIN)
Hemoglobin adalah molekul di dalam eritrosit (sel darah merah) dan bertugas untuk mengangkut oksigen.
Kualitas darah dan warna merah pada darah ditentukan oleh kadar Hemoglobin.
Nilai normal Hb :
Wanita 12-16 gr/dL
Pria 14-18 gr/dL
Anak 10-16 gr/dL
Bayi baru lahir 12-24gr/dL
Penurunan Hb terjadi pada penderita: anemia penyakit ginjal, dan pemberian cairan intra-vena (misalnya infus)
yang berlebihan. Selain itu dapat pula disebabkan oleh obat-obatan tertentu seperti antibiotika, aspirin,
antineoplastik (obat kanker), indometasin (obat antiradang).
Peningkatan Hb terjadi pada pasien dehidrasi, penyakit paru obstruktif menahun (COPD), gagal jantung
kongestif, dan luka bakar. Obat yang dapat meningkatkan Hb yaitu metildopa (salah satu jenis obat darah
tinggi) dan gentamicin (Obat untuk infeksi pada kulit
TROMBOSIT (PLATELET)
Trombosit adalah komponen sel darah yang berfungsi dalam proses menghentikan perdarahan dengan
membentuk gumpalan.
Penurunan sampai di bawah 100.000 permikroliter (Mel) berpotensi terjadi perdarahan dan hambatan perm-
bekuan darah. Jumlah normal pada tubuh manusia adalah 200.000-400.ooo/Mel darah. Biasanya dikaitkan
dengan penyakit demam berdarah.
HEMATOKRIT (HMT)
Hematokrit menunjukkan persentase zat padat (kadar sel darah merah, dan Iain-Iain) dengan jumlah cairan
darah. Semakin tinggi persentase HMT berarti konsentrasi darah makin kental. Hal ini terjadi karena adanya
perembesan (kebocoran) cairan ke luar dari pembuluh darah sementara jumlah zat padat tetap, maka darah
menjadi lebih kental.Diagnosa DBD (Demam Berdarah Dengue) diperkuat dengan nilai HMT > 20 %.
Nilai normal HMT :
Anak 33 -38%
Pria dewasa 40 48 %
Wanita dewasa 37 43 %
Penurunan HMT terjadi pada pasien yang mengalami kehilangan darah akut (kehilangan darah secara
mendadak, misal pada kecelakaan), anemia, leukemia, gagalginjal kronik, mainutrisi, kekurangan vitamin B dan
C, kehamilan, ulkuspeptikum (penyakit tukak lambung).
Peningkatan HMT terjadi pada dehidrasi, diare berat,eklampsia (komplikasi pada kehamilan), efek
pembedahan, dan luka bakar, dan Iain-Iain.
LEUKOSIT (SEL DARAH PUTIH)
Leukosit adalah sel darah putih yang diproduksi oleh jaringan hemopoetik yang berfungsi untuk membantu
tubuh melawan berbagai penyakit infeksi sebagai bagian dari sistem kekebalan tubuh.
Nilai normal :
Bayi baru lahir 9000 -30.000 /mm3
Bayi/anak 9000 12.000/mm3
Dewasa 4000-10.000/mm3
Peningkatan jumlah leukosit (disebut Leukositosis) menunjukkan adanya proses infeksi atau radang
akut,misalnya pneumonia (radang paru-paru), meningitis (radang selaput otak), apendiksitis (radang usus
buntu), tuberculosis, tonsilitis, dan Iain-Iain. Selain itu juga dapat disebabkan oleh obat-obatan misalnya aspirin,
prokainamid, alopurinol, antibiotika terutama ampicilin, eritromycin, kanamycin, streptomycin, dan Iain-Iain.
Penurunan jumlah Leukosit (disebut Leukopeni) dapat terjadi pada infeksi tertentu terutama virus, malaria,
alkoholik, dan Iain-Iain. Selain itu juga dapat disebabkan obat-obatan, terutama asetaminofen
(parasetamol),kemoterapi kanker, antidiabetika oral, antibiotika (penicillin, cephalosporin, kloramfenikol),
sulfonamide (obat anti infeksi terutama yang disebabkan oleh bakter).
Hitung Jenis Leukosit (Diferential Count)
Hitung jenis leukosit adalah penghitungan jenis leukosit yang ada dalam darah berdasarkan proporsi (%) tiap
jenis leukosit dari seluruh jumlah leukosit.
Hasil pemeriksaan ini dapat menggambarkan secara spesifik kejadian dan proses penyakit dalam tubuh,
terutama penyakit infeksi. Tipe leukosit yang dihitung ada 5 yaitu neutrofil, eosinofil, basofil, monosit, dan
limfosit. Salah satu jenis leukosit yang cukup besar, yaitu 2x besarnya eritrosit (se! darah merah), dan mampu
bergerak aktif dalam pembuluh darah maupun di luar pembuluh darah. Neutrofil paling cepat bereaksi terhadap
radang dan luka dibanding leukosit yang lain dan merupakan pertahanan selama fase infeksi akut.
Peningkatan jumlah neutrofil biasanya pada kasus infeksi akut, radang, kerusakan jaringan, apendiksitis akut
(radang usus buntu), dan Iain-Iain.
Penurunan jumlah neutrofil terdapat pada infeksi virus, leukemia, anemia defisiensi besi, dan Iain-Iain.
EOSINOFIL
Eosinofil merupakan salah satu jenis leukosit yang terlibatdalam alergi dan infeksi (terutama parasit) dalam
tubuh, dan jumlahnya 1 2% dari seluruh jumlah leukosit. Nilai normal dalam tubuh: 1 4%
Peningkatan eosinofil terdapat pada kejadian alergi, infeksi parasit, kankertulang, otak, testis, dan
ovarium. Penurunan eosinofil terdapat pada kejadian shock, stres, dan luka bakar.
BASOFIL
Basofil adalah salah satu jenis leukosit yang jumlahnya 0,5 -1% dari seluruh jumlah leukosit, dan terlibat dalam
reaksi alergi jangka panjang seperti asma, alergi kulit, dan lain-lain.Nilai normal dalam tubuh: o -1%
Peningkatan basofil terdapat pada proses inflamasi(radang), leukemia, dan fase penyembuhan infeksi.
Penurunan basofil terjadi pada penderita stres, reaksi hipersensitivitas (alergi), dan kehamilan
LIMPOSIT
Salah satu leukosit yang berperan dalam proses kekebalan dan pembentukan antibodi. Nilai normal: 20 35%
dari seluruh leukosit.
Peningkatan limposit terdapat pada leukemia limpositik, infeksi virus, infeksi kronik, dan Iain-Iain.
Penurunan limposit terjadi pada penderita kanker, anemia aplastik, gagal ginjal, dan Iain-Iain.
MONOSIT
Monosit merupakan salah satu leukosit yang berinti besar dengan ukuran 2x lebih besar dari eritrosit sel darah
merah), terbesar dalam sirkulasi darah dan diproduksi di jaringan limpatik. Nilai normal dalam tubuh: 2 8%
dari jumlah seluruh leukosit.
Peningkatan monosit terdapat pada infeksi virus,parasit (misalnya cacing), kanker, dan Iain-Iain.
Penurunan monosit terdapat pada leukemia limposit dan anemia aplastik.
ERITROSIT
Sel darah merah atau eritrosit berasal dari Bahasa Yunani yaitu erythros berarti merah dan kytos yang berarti
selubung. Eritrosit adalah jenis se) darah yang paling banyak dan berfungsi membawa oksigen ke jaringan
tubuh. Sel darah merah aktif selama 120 hari sebelum akhirnya dihancurkan. Pada orang yang tinggal di dataran
tinggi yang memiliki kadar oksigen rendah maka cenderung memiliki sel darah merah lebih banyak.
Nilai normal eritrosit :
Pria 4,6 6,2 jt/mm3
Wanita 4,2 5,4 jt/mm3
MASA PERDARAHAN
Pemeriksaan masa perdarahan ini ditujukan pada kadar trombosit, dilakukan dengan adanya indikasi (tanda-
tanda) riwayat mudahnya perdarahan dalam keiuarga.
Nilai normal :
dengan Metode Ivy 3-7 menit
dengan Metode Duke 1-3 menit
Waktu perdarahan memanjang terjadi pada penderita trombositopeni (rendahnya kadar trombosit hingga 50.000
mg/dl), ketidaknormalan fungsi trombosit, ketidaknormalan pembuluh darah, penyakit hati tingkat berat,
anemia aplastik, kekurangan faktor pembekuan darah, dan leukemia. Selain itu perpanjangan waktu perdarahan
juga dapat disebabkan oleh obat misalnya salisilat (obat kulit untuk anti jamur), obat antikoagulan warfarin (anti
penggumpalan darah), dextran, dan Iain-Iain.
Masa Pembekuan
Merupakan pemeriksaan untuk melihat berapa lama diperlukan waktu untuk proses pembekuan darah. Hal ini
untuk memonitor penggunaan antikoagulan oral (obat-obatan anti pembekuan darah). Jika masa pembekuan
>2,5 kali nilai normal, maka potensial terjadi perdarahan.Normalnya darah membeku dalam 4 8 menit
(Metode Lee White).
Penurunan masa pembekuan terjadi pada penyakit infark miokard (serangan jantung), emboli pulmonal
(penyakit paru-paru), penggunaan pil KB, vitamin K, digitalis (obat jantung), diuretik (obat yang berfungsi
mengeluarkan air, misal jika ada pembengkakan).
Perpanjangan masa pembekuan terjadi pada penderita penyakit hati, kekurangan faktor pembekuan darah,
leukemia, gagal jantung kongestif.
LAJU ENDAP DARAH (LED)
LED untuk mengukur kecepatan endap eritrosit (sel darah merah) dan menggambarkan komposisi plasma serta
perbandingannya antara eritrosit (sel darah merah) dan plasma. LED dapat digunakan sebagai sarana
pemantauan keberhasilan terapi, perjalanan penyakit, terutama pada penyakit kronis seperti Arthritis
Rheumatoid (rematik), dan TBC.
Peningkatan LED terjadi pada infeksi akut lokal atau sistemik (menyeluruh), trauma, kehamilan trimester II dan
III, infeksi kronis, kanker, operasi, luka bakar.Penurunan LED terjadi pada gagal jantung kongestif, anemia sel
sabit, kekurangan faktor pembekuan, dan angina pektoris (serangan jantung).Selain itu penurunan LED juga
dapat disebabkan oleh penggunaan obat seperti aspirin, kortison, quinine, etambutol.
G6PD (GLUKOSA 6 PHOSFAT DEHIDROGENASE)
Merupakan pemeriksaan sejenis enzim dalam sel darah merah untuk melihat kerentanan seseorang terhadap
anemia hemolitika. Kekurangan G6PD merupakan kelainan genetik terkait gen X yang dibawa kromosom
wanita. Nilai normal dalam darah yaitu G6PD negatif
Penurunan G6PD terdapat pada anemia hemolitik, infeksi bakteri, infeksi virus, diabetes asidosis.
Peningkatan G6PD dapat juga terjadi karena obat-obatan seperti aspirin, asam askorbat (vitamin C) vitamin K,
asetanilid.
BMP (BONE MARROW PUNCTION)
Pemeriksaan mikroskopis sumsum tulang untuk menilai sifat dan aktivitas hemopoetiknya (pembentukan sel
darah). Pemeriksaan ini biasanya dilakukan pada penderita yang dicurigai menderita leukemia.
Nilai normal rasio M-E (myeloid-eritrosit) atau perbandingan antara leukosit berinti dengan eritrosit berinti
yaitu 3 :1 atau 4 :1
HEMOSIDERIN/FERITIN
Hemosiderin adalah cadangan zat besi dalam tubuh yang diperlukan untuk pembentukan hemoglobin.
Pemeriksaan ini ditujukan untuk mengetahui ada tidaknya kekurangan zat besi dalam tubuh yang mengarah ke
risiko menderita anemia.
PEMERIKSAAN ALKOHOL DALAM PLASMA
Pemeriksaan untuk mendeteksi adanya intoksikasi alkohol (keracunan alkohol) dan dilakukan untuk
kepentingan medis dan hukum. Peningkatan alkohol darah melebihi 100 mg/dl tergolong dalam intoksikasi
alkohol sedang berat dan dapat terjadi pada peminum alkohol kronis, sirosis hati, malnutrisi, kekurangan asam
folat, pankreatitis akut (radang pankreas), gastritis (radang lambung), dan hipo-glikemia (rendahnya kadar gula
dalam darah).
PEMERIKSAAN TOLERANSI LAKTOSA
Laktosa adalah gula sakarida yang banyak ditemukan dalam produk susu dan olahannya. Laktosa oleh
enzim usus akan diubah menjadi glukosa dan galaktosa. Penumpukan laktosa dalam usus dapat terjadi karena
kekurangan enzim laktase, sehingga menimbulkan diare, kejang abdomen (kejang perut), dan flatus (kentut)
terus-menerus, hal ini disebut intoleransi laktosa. dalam jumlah besar kemudian diperiksa kadar gula darah .
Apabila nilai glukosa darah sewaktu >20 mg/dl dari nilai gula darah puasa berarti laktosa diubah menjadi
glukosa atau toleransi laktosa, dan apabila glukosa sewaktu <20 mg/dl dari kadar gula darah puasa, berarti
terjadi intoleransi glukosa. Sebaiknya menghindari konsumsi produk susu. Hal ini dapat diatasi dengan sedikit
demi sedikit membiasakan konsumsi produk susu.
Nilai normal :
dalam plasma < 0,5 mg/dl
dalam urin 12-40 mg/dl
LDH (LAKTAT DEHIDROGENASE)
Merupakan salah satu enzim yang melepas hidrogen, dan tersebar luas pada jaringan terutama ginjal, rangka,
hati, dan otot jantung.
Peningkatan LDH menandakan adanya kerusakan jaringan. LDH akan meningkat sampai puncaknya 24-48 jam
setelah infark miokard (serangan jantung) dan tetap normal 1-3 minggu kemudian. Nilai normal: 80 240 U/L
SGoT (Serum Glutamik Oksoloasetik
Transaminase)
Merupakan enzim transaminase, yang berada pada serum dan jaringan terutama hati dan jantung. Pelepasan
SGOT yang tinggi dalam serum menunjukkan adanya kerusakan pada jaringan jantung dan hati.
Nilai normal :
Pria s.d.37 U/L
Wanita s.d. 31 U/L
Pemeriksan ini bertujuan untuk mendeteksi adanya intoleransi laktosa dengan cara memberi minum laktosa
Peningkatan SGOT <3x normal = terjadi karena radang otot jantung, sirosis hepatis, infark paru, dan Iain-lain.
Peningkatan SGOT 3-5X normal = terjadi karena sumbatan saluran empedu, gagal jantung kongestif, tumor
hati, dan Iain-lain.
Peningkatan SGOT >5x normal = kerusakan sei-sel hati, infark miokard (serangan jantung), pankreatitis akut
(radang pankreas), dan Iain-lain.
SGPT (Serum Glutamik Pyruvik Transaminase)
Merupakan enzim transaminase yang dalam keadaan normal berada dalam jaringan tubuh terutama hati.
Peningkatan dalam serum darah menunjukkan adanya trauma atau kerusakan hati.
Nilai normal :
Pria sampai dengan 42 U/L
Wanita sampai dengan 32 U/L
Peningkatan >20x normal terjadi pada hepatitis virus, hepatitis toksis.
Peningkatan 3 10x normal terjadi pada infeksi mond nuklear, hepatitis kronik aktif, infark miokard
(serangan jantung).
Peningkatan 1 3X normal terjadi pada pankreatitis, sirosis empedu.

ASAM URAT
Asam urat merupakan produk akhir metabolisme purin (bagian penting dari asam nukleat pada DNA dan
RNA).Purin terdapat dalam makanan antara lain: daging, jeroan, kacang-kacangan, ragi, melinjo dan hasil
olahannya. Pergantian purin dalam tubuh berlangsung terus-menerus dan menghasilkan banyak asam urat
walaupun tidak ada input makanan yang mengandung asam urat.
Asam urat sebagian besar diproduksi di hati dan diangkut ke ginjal. Asupan purin normal melalui makanan akan
menghasilkan 0,5 -1 gr/hari. Peningkatan asam urat dalam serum dan urin bergantung pada fungsi ginjal,
metabolisme purin, serta asupan dari makanan. Asam urat dalam urin akan membentuk kristal/batu dalam
saluran kencing. Beberapa individu dengan kadar asam urat >8mg/dl sudah ada keluhan dan memerlukan
pengobatan.

Nilai normal :
Pria 3,4 8,5 mg/dl (darah)
Wanita 2,8 7,3 mg/dl (darah)
Anak 2,5 5,5 mg/dl (darah)
Lansia 3,5 8,5 mg/dl (darah)
Dewasa 250 750 mg/24 jam (urin)
Peningkatan kadar asam urat terjadi pada alkoholik, leukemia, penyebaran kanker, diabetes mellitus berat, gagal
ginjal, gagal jantung kongestif, keracunan timah hitam, malnutrisi, latihan yang berat. Selain itu juga dapat
disebabkan oleh obat-obatan misalnya asetaminofen, vitamin C,aspirin jangka panjang,diuretik.
Penurunan asam urat terjadi pada anemia kekurangan asam folat, luka bakar, kehamilan, dan Iain-Iain. Obat-
obat yang dapat menurunkan asam urat adalah allopurinol, probenesid, dan Iain-Iain.
Kreatinin
Merupakan produk akhir metabolisme kreatin otot dan kreatin fosfat (protein) diproduksi dalam hati.
Ditemukan dalam otot rangka dan darah, dibuang melalui urin. Peningkatan dalam serum tidak dipengaruhi oleh
asupan makanan dan cairan.
Nilai normal dalam darah :
Pria 0,6 1,3 mg/dl
Wanita 0,5 0,9 mg/dl
Anak 0,4 -1,2 mg/dl
Bayi 0,7 -1,7 mg/dl
Bayi baru lahir 0,8 -1,4 mg/dl
Peningkatan kreatinin dalam darah menunjukkan adanya penurunan fungsi ginjal dan penyusutan massa otot
rangka. Hal ini dapat terjadi pada penderita gagal ginjal, kanker, konsumsi daging sapi tinggi, serangan jantung.
Obat-obatan yang dapat meningkatkan kadar kreatinin nyaitu vitamin C, antibiotik golongan
sefalosporin,aminoglikosid, dan Iain-Iain.

BUN (BLOOD UREA NITROGEN)
BUN adalah produk akhir dari metabolisme protein, dibuat oleh hati. Pada orang normal, ureum dikeluarkan
melalui urin.

Nilai normal :
Dewasa 5-25 mg/dl
Anak 5-20 mg/dl
Bayi 5-15 mg/dl
Rasio nitrogen urea dan kreatinin = 12 :1 20 :1
Pemeriksaan Trigliserida
Merupakan senyawa asam lemak yang diproduksi dari karbohidrat dan disimpan dalam bentuk lemak
hewani. Trigliserida ini merupakan penyebab utama penyakit penyumbatan arteri dibanding kolesterol.
Nilai normal :
Bayi 5-4o mg/dl
Anak 10-135 mg/dl
Dewasa muda s/dl50 mg/dl
Tua (>50 tahun) s/d 190 mg/dl
Penurunan kadartrigliserid serum dapatterjadi karena malnutrisi protein, kongenital (kelainan sejak lahir). Obat-
obatan yang dapat menurunkan trigliserida yaitu asam askorbat (vitamin C), metformin (obata anti diabetik
oral).
Peningkatan kadar trigliserida terjadi pada hipertensi (penyakit darah tinggi), sumbatan pembuluh darah
otak,diabetes mellitus tak terkontrol, diet tinggi karbohidrat, kehamilan. Dari golongan obat, yang dapat
meningkatkan trigliserida yakni pil KB terutama estrogen.
HDL (High Density Lipoprotein)
Merupakan salah satu dari 3 komponen lipoprotein (kombinasi protein dan lemak), mengandung kadar protein
tinggi, sedikit trigliserida dan fosfolipid, mempunyai sifat umum protein dan terdapat dalam plasma darah. HDL
sering disebut juga lemak baik, yang dapat membantu mengurangi penimbunan plak pada pembuluh darah.
Nilai normal :
Pria >55 mg/dl
Wanita >65 mg/dl
Nilai yang berisiko terhadap Penyakit Jantung Koroner (PJK) yaitu
Risiko tinggi <35 mg/dl
Risiko sedang 35 45 mg/dl
Risiko rendah >6o mg/dl
Peningkatan lipoprotein dapat dipengaruhi oleh obat aspirin, kontrasepsi, sulfonamide.
LDL (Low Density Lipoprotein)
Merupakan lipoprotein plasma yang mengandung sedikit trigliserida, fosfolipid sedang, protein sedang, dan
kolesterol tinggi. LDL mempunyai peran utama sebagai pencetus terjadinya penyakit sumbatan pembuluh darah
yang mengarah ke serangan jantung, stroke, dan Iain-Iain.
Nilai normal : <150 mg/dl
risiko ringgi terjadi jantung koroner >16o mg/dl
risiko sedang terjadi jantung koroner 130 -159 mg/dl
risiko rendah terjadi jantung koroner <130 mg/dl

VLDL (Very Low Density Lipoprotein)
Merupakan lipoprotein plasma yang mengandung trigliserida, tinggi,fosfolipid,dan kolesterol sedang, serta
protein rendah. Tergolong lipoprotein yang punya andil besar dalam menyebabkan penyakit jantung koroner.
Albumin
Albumin adalah protein yang larut air, membentuk lebih dari 50% protein plasma, ditemukan hampir di setiap
jaringan tubuh. Albumin diproduksi di hati, dan berfungsi untuk mempertahankan tekanan koloid osmotik darah
sehingga tekanan cairan vaskular (cairan di dalam pembuluh darah) dapat dipertahankan.
Nilai normal :
Dewasa 3,8 5,1 gr/dl
Anak 4,0 5,8 gr/dl
Bayi 4,4 5,4 gr/dl
Bayi baru lahir 2,9 5,4 gr/dl
Penurunan albumin mengakibatkan keluarnya cairan vascular (cairan pembuluh darah) menuju jaringan
sehingga terjadi oedema (bengkak). Penurunan albumin bisa juga disebabkan oleh :
1.
Berkurangnya sintesis (produksi) karena malnutrisi, radang menahun, sindrom malabsorpsi, penyakit hati
menahun, kelainan genetik.
2. Peningkatan ekskresi (pengeluaran), karena luka bakar luas, penyakit usus, nefrotik sindrom (penyakit ginjal).
NATRIUM (Na)
Natrium adaiah salah satu mineral yang banyak terdapat pada cairan elektrolit ekstraseluler (di luar sel),
mempunyai efek menahan air, berfungsi untuk mempertahankan cairan dalam tubuh, mengaktifkan enzim,
sebagai konduksi impuls saraf.
Nilai normal dalam serum :
Dewasa 135-145 mEq/L
Anak 135-145 mEq/L
Bayi 134-150 mEq/L
Nilai normal dalam urin :
40 220 mEq/L/24 jam
Penurunan Na terjadi pada diare, muntah, cedera jaringan, bilas lambung, diet rendah garam, gagal ginjal, luka
bakar, penggunaan obat diuretik (obat untuk darah tinggi yang fungsinya mengeluarkan air dalam tubuh).
Peningkatan Na terjadi pada pasien diare, gangguan jantung krohis, dehidrasi, asupan Na dari makanan
tinggi,gagal hepatik (kegagalan fungsi hati), dan penggunaan obat antibiotika, obat batuk, obat golongan
laksansia (obat pencahar).
Sumber garam Na yaitu: garam dapur, produk awetan (cornedbeef, ikan kaleng, terasi, dan Iain-Iain.),
keju,/.buah ceri, saus tomat, acar, dan Iain-Iain.
KALIUM (K)
Kalium merupakan elektrolit tubuh yang terdapat pada cairan vaskuler (pembuluh darah), 90% dikeluankan
melalui urin, rata-rata 40 mEq/L atau 25 -120 mEq/24 jam wa laupun masukan kalium rendah.
Nilai normal :
Dewasa 3,5 5,0 mEq/L
Anak 3,6 5,8 mEq/L
Bayi 3,6 5,8 mEq/L
Peningkatan kalium (hiperkalemia) terjadi jika terdapat gangguan ginjal, penggunaan obat terutama golongan
sefalosporin, histamine, epinefrin, dan Iain-Iain.
Penurunan kalium (hipokalemia) terjadi jika masukan kalium dari makanan rendah, pengeluaran lewat urin
meningkat, diare, muntah, dehidrasi, luka pembedahan.
Makanan yang mengandung kalium yaitu buah-buahan, sari buah, kacang-kacangan, dan Iain-Iain.
KLORIDA (Cl)
Merupakan elektrolit bermuatan negatif, banyak terdapat pada cairan ekstraseluler (di luar sel), tidak berada
dalam serum, berperan penting dalam keseimbangan cairan tubuh, keseimbangan asam-basa dalam tubuh.
Klorida sebagian besar terikat dengan natrium membentuk NaCI (natrium klorida).
Nilai normal :
Dewasa 95-105 mEq/L
Anak 98-110 mEq/L
Bayi 95 -110 mEq/L
Bayi baru lahir 94-112 mEq/L
Penurunan klorida dapat terjadi pada penderita muntah, bilas lambung, diare, diet rendah garam, infeksi akut,
luka bakar, terlalu banyak keringat, gagal jantung kronis, penggunaan obatThiazid, diuretik, dan Iain-lain.
Peningkatan klorida terjadi pada penderita dehidrasi,cedera kepala, peningkatan natrium, gangguan
ginjal,penggunaan obat kortison, asetazolamid, dan Iain-Iain.
KALSIUM (Ca)
Merupakan elektrolit dalam serum, berperan dalam keseimbangan elektrolit, pencegahan tetani, dan dapat
dimanfaatkan untuk mendeteksi gangguan hormon tiroid dan paratiroid.
Nilai normal :
Dewasa
9-11 mg/dl (di serum) ; <150 mg/24 jam (di urin & diet rendah Ca) ; 200 300 mg/24 jam (di urin
& diet tinggi Ca)
Anak 9 -11,5 mg/dl
Bayi 10 -12 mg/dl
Bayi baru
lahir
7,4 -14 mg/dl.
Penurunan kalsium dapat terjadi pada kondisi malabsorpsi saluran cerna, kekurangan asupan kalsium dan
vitamin D, gagal ginjal kronis, infeksi yang luas, luka bakar, radang pankreas, diare, pecandu alkohol,
kehamilan. Selain itu penurunan kalsium juga dapat dipicu oleh penggunaan obat pencahar, obat maag, insulin,
dan Iain-Iain.
Peningkatan kalsium terjadi karena adanya keganasan (kanker) pada tulang, paru, payudara, kandung kemih,
dan ginjal. Selain itu, kelebihan vitamin D, adanya batu ginjal, olah raga berlebihan, dan Iain-Iain, juga dapat
memacu peningkatan kadar kalsium dalam tubuh.
PEMERIKSAAN KADAR GULA DARAH

Pemeriksaan terhadap kadar gula dalam darah vena pada saat pasien puasa 12 jam sebelum pemeriksaan (gula
darah puasal nuchter) atau 2 jam setelah makan (gula darah post prandial).
Nilai normal gula darah puasa :
Dewasa 70 -110 mg/dl
Anak 60-100 mg/dl
Bayi baru lahir 30-80 mg/dl
Tes Widal
Merupakan pemeriksaan untuk membantu menegakkan diagnosa thypus.Tes ini menggunakan antigen
Salmonella jenis O (somat/k) dan H {flagel) untuk menentukan tinggi rendahnya titer antibodi. Titer antibodi
pada penderita thypus akan meningkat pada minggu ke II. Kemudian titer antibodi O akan menurun setelah
beberapa bulan, dan titer antibodi H akan menetap sampai beberapa tahun.
Jika titer antibodi 0 meningkat segera setelah adanya demam, menunjukkan adanya infeksi Salmonella strain O
dan demikian pula untuk strain H.
PEMERIKSAAN TORCH
Pemeriksaan untuk identifikasi adanya virus Toksoplasma Rubella, Cytomegalovirus (CMV) dan herpes
simplek pada ibu dan bayi baru lahir, melalui sampel darah ibu. Pemeriksaan ini perlu dilakukan jika ada
riwayat sebelumnya atau dugaan infeksi kongen/tal (bawaan) pada bayi baru lahir yang ditandai dengan hasil
pemeriksaan imunoglobulin G pada janin lebih tinggi dibanding pada ibu.
Toksoplasma gondii merupakan parasit yang hidup dalam usus hewan piaraan rumah terutama anjing dan
kucing. Selain itu, diduga parasit ini juga terdapat pada tikus, merpati, ayam, sapi, kambing, dan kerbau,
sehingga mudah menular pada manusia. Jika parasit ini menginfeksi ibu hamil, maka dapat menyebabkan
infeksi pada
Nilai normal pemeriksaan TORCH pada lgG ibu hamil dan janin adalah negatif.
POSTAT SPESIFIK ANTIGEN (PSA)
PSA adalah glikoprotein dari jaringan prostat yang meningkat jika terjadi hipertropi (pembesaran) dan
meningkat lebih tinggi lagi pada penderita kanker prostat.
Pemeriksaan PSA pada pasien kanker prostat ini berfungsi untuk memonitor perkembangan sel kanker.
Pemeriksaan ini lebih sensitif daripada fosfatase prostat, namun pemeriksaan kombinasi keduanya akan lebih
akurat.
Nilai rujukan :
Tidak ada kelainan prostat 0-4 ng/ml
Pembesaran prostat jinak 4 -19 ng/ml
Kanker prostat 10-20 ng/ml
PEMERIKSAAN REDUKSI
Pemeriksaan untuk mendeteksi adanya glukosa dalam urin dengan menggunakan reagen Benedict, Fehling, dan
Iain-lain. Hasil dinyatakan dengan :
Negatif jika warna tetap (tidak ada glukosa)
Positif 1 (+) jika warna hijau kekuningan dan keruh (terdapat 0,5 -1% glukosa)
Positif 2 (++) jika warna kuning keruh (terdapat 1 -1,5% glukosa)
Positif 3 (+++) jika warna jingga seperti lumpur keruh (terdapat 2 3,5% glukosa)
Positif 4 (++++) jika warna merah keruh (terdapat > 3,5% glukosa)
Janin dan kecacatan fisik setelah lahir, dengan gejala retinitis, hydrocephalus, microcephalus, dan Iain-
Iain.Reduksi (+) dalam unn menunjukkan adanya hiperglikemia (tingginya kadar gula dalam darah) di atas
170mg%, karena nilai ambang batas ginjal untuk absorpsi glukosa adalah 170 mg%. Jika hasii pemeriksaan
reduksi (+) disertai hiperglikemia maka menandakan adanya penyakit Diabetes Mellitus.

ANALISA SPERMA
Merupakan pemeriksaan dengan bahan sperma untuk melihat jumlah, volume cairan, persentase sperma
matang,pergerakan, dan Iain-Iain. Pemeriksaan ini berguna untuk menentukan penyebab kemandulan pada pria.
Nilai normal pada pria dewasa :
Jumlah 50-150 juta/ml
Volume 1,5-5,0 ml
Bentuk 75 % matang
Mobilitas 60 % bergerak aktif
Penyimpangan dari niTai normaf cff atas, Dfasanya terjadi pada pasien vasektomi, kemandulan, pengobatan
kanker, dan pengobatan yang mengandung estrogen (hormon wanita).
Sumber Artikel : Aboutlabkes
http://infolaboratoriumkesehatan.wordpress.com/2012/07/26/cara-membaca-hasil-laboratorium-nilai-normal-
hasil-laboratorium/

Gula darah yang tinggi pada DM mnyebabkan gangguan pemb. Darah, gula tidak dapat dimasukan ke
sel,akibatnya sel haus,menyebabkan semua metabolism lain dipacu , misalnya lemak, lemah darah yang bnyak
mnyebabkan osteosklerosis, akibatnya Vasokontriksi
Gula darah yang tinggi menyebabkab aktifits katekolamin meninggkat, menyebabkan vasokontriksi,aliran darah
ke ginjal menurun,jika pembulh darah kecil kolap,terjadi kerusakan (nefropati)
Gula darah yang tinggi setelah di filtrasi tidak bisa di reabsorbsi,sehingga sisa nya akan menyebabkan diuretic
osmotic,,

Cara mengukur fungsi ginjal = srCl ml/dl
140 umur (BB) / 72 x sCr
% ginjal = Cl cr / cl glomerulus (125 ml/menit)
Jika dibawah 25 pasien harus cuci darah.