Urine Potassium

Test Code
URK


CPT Codes
84133

Includes
Random Specimen includes Urine Potassium. Timed Specimen includes Urine Volume, Hours Collected, Urine Potassium, and Potassium/Total Volume Ratio.


Preferred Specimen

Random or timed urine specimen



Minimum Volume
1 mL


Instructions

Collect random or timed specimen per orders.  For timed specimen, record start and stop time of collection or number of hours.  To transfer specimen from large container to smaller container for transport, measure volume first and record on smaller container, along with start/stop time or hours of collection.  Timed specimens are typically collected for 24 hours, but can be collected in other increments, for example, 4 hours or 12 hours.

This test is for Potassium measurent on Urine.  For Potassium measurement on Plasma or Serum, order K.  For Potassium measurement on Body Fluids, order MISK.



Transport Container

24-hour urine container or sterile urine cup



Transport Temperature
Refrigeration


Specimen Stability
3 days


Reject Criteria (Eg, hemolysis? Lipemia? Thaw/Other?)
Quantity Not Sufficient


Methodology
Potentiometric

Setup Schedule

Monday - Sunday, 8:00 am - 3:00 pm upon receipt



Report Available
Upon completion of analysis


Limitations
Cisplatan (Plantinol) can alter potassium levels. This drug is known to treat metastatic testicular tumors, metastatic ovarian tumors and advanced bladder cancer. Also, any cationic surfactant (laxative) is known to alter potassium results.


Reference Range

Urine Volume:                   800 - 1800 mL/24 Hours
Potassium/Total Volume:  25 - 125 mmol/24 hours



Clinical Significance

Urine Potassium is useful in determining the cause for hyper- or hypokalemia.

Potassium (K+) is the major intracellular cation. Functions of potassium include regulation of neuromuscular excitability, heart contractility, intracellular fluid volume, and hydrogen ion concentration. The physiologic function of K+ requires that the body maintain a low extracellular fluid (ECF) concentration of the cation; the intracellular is 20 times greater than the extracellular K+concentration. Only 2% of total body K+ circulates in the plasma.

The kidneys provide the most important regulation of K+. The proximal tubules reabsorb almost all the filtered K+. Under the influence of aldosterone, the remaining K+ can then be secreted into the urine in exchange for sodium in both the collecting ducts and the distal tubules. Thus, the distal nephron is the principal determinant of urinary K+ excretion.

Decreased excretion of K+ in acute renal disease and end-stage renal failure are common causes of prolonged hyperkalemia.

Renal losses of K+ may occur during the diuretic (recovery) phase of acute tubular necrosis, during administration of non-potassium sparing diuretic therapy, and during states of excess mineralocorticoid or glucocorticoid.

Hypokalemia reflecting true total body deficits of K+ can be classified into renal and nonrenal losses based on the daily excretion of K+ in the urine. During hypokalemia, if urine excretion of K+ is < 30 mmol/24 Hours, it can be concluded that renal reabsorption of K+ is appropriate. In this situation, the causes for the hypokalemic state are either decreased K+ intake or extra renal loss of K+ rich fluid. Urine excretion of >30 mmol/24 Hours in a hypokalemia setting is inappropriate and indicates that the kidneys are the primary source of the lost K+.

This test is for Potassium measurent on Urine.  For Potassium measurement on Plasma or Serum, order K.  For Potassium measurement on Body Fluids, order MISK.





The CPT Codes provided in this document are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payor being billed. Any Profile/panel component may be ordered separately. Reflex tests are performed at an additional charge.