Test ID: DLAC
D-Lactate, Plasma
Secondary ID 
A test code used for billing and in test definitions created prior to November 2011
NY State Approved Indicates the status of NY State approval and if the test is orderable for NY State clients.
Useful For Suggests clinical disorders or settings where the test may be helpful
An adjunct to urine D-lactate (preferred), in the diagnosis of D-lactate acidosis
Method Name A short description of the method used to perform the test
Enzymatic
Reporting Name A shorter/abbreviated version of the Published Name for a test; an abbreviated test name
Aliases Lists additional common names for a test, as an aid in searching
Specimen Type Describes the specimen type needed for testing
Specimen Required Defines the optimal specimen. This field describes the type of specimen required to perform the test and the preferred volume to complete testing. The volume allows automated processing, fastest throughput and, when indicated, repeat or reflex testing.
Collection Container/Tube: Grey top (potassium oxalate/sodium fluoride)
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/8665 Lactate, Plasma.
Specimen Minimum Volume Defines the amount of specimen required to perform an assay once, including instrument and container dead space. Submitting the minimum specimen volume makes it impossible to repeat the test or perform confirmatory or perform reflex testing. In some situations, a minimum specimen volume may result in a QNS (quantity not sufficient) result, requiring a second specimen to be collected.
Reject Due To Identifies specimen types and conditions that may cause the specimen to be rejected
| Hemolysis | Mild OK; Gross OK |
| Lipemia | Mild OK; Gross OK |
| Icterus | Mild OK; Gross OK |
| Other | NA |
Specimen Stability Information Provides a description of the temperatures required to transport a specimen to the laboratory. Alternate acceptable temperature(s) are also included.
| Specimen Type | Temperature | Time |
|---|---|---|
| Plasma NaFl-KOx | Frozen (preferred) | 365 days |
| Ambient | 7 days | |
| Refrigerated | 7 days |
Clinical Information Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test
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.
Reference Values Describes reference intervals and additional information for interpretation of test results. May include intervals based on age and sex when appropriate. Intervals are Mayo-derived, unless otherwise designated. If an interpretive report is provided, the reference value field will state this.
0.0-0.25 mmol/L
Interpretation Provides information to assist in interpretation of the test results
Increased levels are consistent with D-lactic acidosis. However, because D-lactate is readily excreted, urine determinations are preferred.
Cautions Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances
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.
Clinical Reference Provides recommendations for further in-depth reading of a clinical nature
1. Brandt RB, Siegel SA, Waters MG, Bloch MH: Spectrophotometric assay for D-(-)-lactate in plasma. Anal Biochem1980;102(1):39-46
2. Petersen C: D-lactic acidosis. Nutr Clin Pract 2005;20(6):634-645
Method Description Describes how the test is performed and provides a method-specific reference
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)
Day(s) and Time(s) Test Performed Outlines the days and times the test is performed. This field reflects the day and time the sample must be in the testing laboratory to begin the testing process and includes any specimen preparation and processing time required before the test is performed. Some tests are listed as continuously performed, which means assays are performed several times during the day.
Monday, Thursday
Analytic Time Defines the amount of time it takes the laboratory to setup and perform the test. This is defined in number of days. The shortest interval of time expressed is "same day/1 day," which means the results may be available the same day that the sample is received in the testing laboratory. One day means results are available 1 day after the sample is received in the laboratory.
Maximum Laboratory Time Defines the maximum time from specimen receipt at Mayo Medical Laboratories until the release of the test result
Specimen Retention Time Outlines the length of time after testing that a specimen is kept in the laboratory before it is discarded
Performing Laboratory Location The location of the laboratory that performs the test
Test Classification Provides information regarding the medical device classification for laboratory test kits and reagents. Tests may be classified as cleared or approved by the US Food and Drug Administration (FDA) and used per manufacturer's instructions, or as products that do not undergo full FDA review and approval, and are then labeled as an Analyte Specific Reagent (ASR), Investigation Use Only (IUO) product, or a Research Use Only (RUO) product.
CPT Code Information Provides guidance in determining the appropriate Current Procedural Terminology (CPT) code(s) information for each test or profile. The listed CPT codes reflect Mayo Medical Laboratories interpretation of CPT coding requirements. It is the responsibility of each laboratory to determine correct CPT codes to use for billing.
83605
LOINC® Code Information Provides guidance in determining the Logical Observation Identifiers Names and Codes (LOINC) values for the result codes returned for this test or profile.
| Result ID | Reporting Name | LOINC Code |
|---|---|---|
| 8878 | D-Lactate, P | 14045-9 |
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