Unit Code 8873:
D-Lactate, Urine
Useful For
Diagnosing D-lactate acidosis, especially in patients with jejunoileal
bypass and short-bowel syndrome.
Clinical Information
D-lactate is produced from carbohydrates not absorbed in the small
intestine by bacteria residing in the colon. When large amounts are
absorbed it can cause metabolic acidosis, altered mental status
(from drowsiness to coma) and a variety of other neurologic symptoms,
in particular dysarthria and ataxia. Although a temporal relationship
has been described between elevations of plasma and urine D-lactate
and the accompanying encephalopathy, the mechanism of neurologic
manifestations has not been elucidated.
D-lactic acidoses is typically observed in patients with short-bowel
syndrome and following jejunoileal bypass resulting in carbohydrate
malabsorption. In addition, healthy children presenting with gastroenteritis
may also develop the critical presentation of D-lactic acidosis.
Measured concentrations are diagnostic, but It is important to realize that
lactic acid determinations in blood will not reveal abnormalities because
routine lactic acid assays measure only L-lactate. Accordingly, D-lactate
analysis must be specifically requested. Because D-lactate is readily
excreted, urine is the preferred specimen for D-lactate determinations.
Reference Values
0.0-0.25 mmol/L
Interpretation
Increased levels are diagnostic.
Cautions
No significant cautionary statements
Clinical Reference
1. 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
2. Uribarri J, Oh MS, Carroll HJ: D-lactic acidosis. A review of clinical
presentation, biochemical features, and pathophysiologic
mechanisms. Medicine 1998;77:73-82
3. Hingorani AD, Chan NN: D-lactate encephalopathy. Lancet 2001;
Nov 24;358(9295):1814
External
link
PDF
document
Excel
document
Word
document