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Common Test-Ordering Errors
Part 1: Misordered Tests

1,25-Dihydroxyvitamin D
PTH-related Peptide
Uroporphyrinogen III Synthase



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Vitamin D

Slide 6

April 2010

Vitamin D plays a key role in calcium homeostasis and is vital for strong bones. Deficiencies may result in osteoporosis, rickets, osteomalacia, and secondary hyperparathyroidism.

Vitamin D also likely has important, emerging roles in many other aspects of health including muscle tone, immune function, diabetes, hypertension, heart disease, infections, cancer, and mental status (including depression in the elderly). Because of diet and life-style factors in the United States, it is generally accepted that a significant part of our population (especially children, young adults, pregnant women, the elderly, and individuals with dark skin) are vitamin D deficient. A small study of ICU patients reported in the New England Journal of Medicine found that over half of those patients were vitamin D deficient.

The CDC periodically assesses nutritional status in the United States via their National Health and Nutrition Examination Surveys (abbreviated NHANES).  The latest NHANES data showed that over three-fourths of Americans did not have adequate vitamin D stores. Although more research is needed, we do know that physicians are increasingly interested in monitoring patients’ vitamin D status. This is reflected in our monthly test volumes for 25-Hydroxyvitamin D, the test that reflects vitamin D stores. However, we are also experiencing significant increases in orders for 1,25-Dihydroxyvitamin D, a form of vitamin D that is deficient in limited clinical situations.

Vitamin D

 


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