CAP Pro Course - Chemistry - Liver and Renal Testing (2026 & 2027)

Author: DeRhonda Crawford, MLS(ASCP)
Reviewer: Laurie Bjerklie, MA, MLS(ASCP)CM

Continuing Education Credits

Objectives

  • Discuss the clinical significance of liver function assays.
  • Identify methodologies used for certain liver function assays.
  • Discuss the clinical significance of renal function assays.
  • Describe the relationships between serum creatinine, glomerular filtration rate, and estimated glomerular filtration rate.
  • Recognize preanalytical variables that may affect liver and renal function assay results and describe measures to ensure accuracy.

Course Outline

  • Discuss the clinical significance of liver function assays.
      • Liver Enzymes
      • Other Relevant Liver Assays
      • Clinical Significance of Liver Tests
      • Which one of these analytes is always elevated in the presence of liver disease?
      • Which analyte would be decreased in liver disease?
      • A patient who is jaundiced complains of stomach pain. The physician orders alkaline phosphatase and total bilirubin tests. These results are obtained:...
      • A college student who appears jaundiced complains of nausea, vomiting, general malaise, and fatigue. The student had spent spring break in Mexico. The...
  • Identify methodologies used for certain liver function assays.
      • Measurement of Enzyme Activity
      • Direct Spectrophotometric Method for Determination of Total Bilirubin
      • Diluting Specimens for Enzyme Testing
      • Which analyte is typically measured using a methodology based on kinetic principles?
      • Your facility deals mainly with liver transplant procedures and those patients that are in end-stage liver failure. You need to purchase a new automat...
      • A patient sample for ALT is flagged on your analyzer as being out of the upper limit of the analytic measurement range (AMR). The AMR for ALT is 0R...
      • A serum sample for a liver panel is placed on the analyzer in the chemistry laboratory. The analyzer flags the AST and total bilirubin results as limi...
  • Discuss the clinical significance of renal function assays.
      • Blood and Urine Renal Function Assays
      • Urine Protein and Renal Function
      • Urine Albumin
      • Clinical Significance of Renal Function Assays
      • Serum albumin, total serum protein, and 24-hour urine protein are assayed on a patient in the critical care unit of a hospital. These results are obta...
      • A physician has ordered urine albumin testing for a patient with a diagnosis of type 2 diabetes. What is the purpose of this testing?
      • Which assay is used in routine monitoring of diabetic patients to detect renal disease at an early stage?
      • What substance is found in decreased levels in urine and increased levels in plasma in patients with renal disorders?
      • Urine protein is an important measure of renal function. Which of the following serum/plasma tests is also frequently used to evaluate renal function?
  • Describe the relationships between serum creatinine, glomerular filtration rate, and estimated glomerular filtration rate.
      • Relationship Between Creatinine, GFR, and eGFR
      • Limitations on Using the MDRD Equation for Estimating GFR
      • Joe was a contestant that was eliminated from the game Survivor. After elimination, he arrives at your facility and appears dehydrated and emaciated f...
      • Sally is a 75-year-old woman with renal damage. Which plasma creatinine and GFR result would most likely be related to her diagnosis?Normal values for...
      • Approximately what percentage of glomerular filtration capacity would be lost before the serum creatinine level rises above the upper limit of normal?
  • Recognize preanalytical variables that may affect liver and renal function assay results and describe measures to ensure accuracy.
      • Preanalytical Errors Affecting Measurement of Liver and Renal Analytes
      • Preanalytical Factors That May Affect Plasma Ammonia Test Results
      • A patient brings a 24-hour urine to the laboratory after completing the collection at home. The tests that are ordered are total protein and creatinin...
      • A serum aspartate aminotransferase (AST) result is lower than expected. If the serum specimen was hemolyzed, should that also be investigated as a pos...
      • How would hemolysis affect a plasma ammonia level?
  • References
      • References

Additional Information

Level of Instruction: Intermediate
Intended Audience: This program is designed as an educational and training tool for MLS and MLT personnel, phlebotomists, medical laboratory science students and interns, pathology residents, and practicing pathologists.
Author Information: DeRhonda Crawford, MLS(ASCP) is the chemistry supervisor at Gwinnett Medical Center in Lawrenceville, Georgia and the technical supervisor for the Gwinnett Medical Center in Duluth, Georgia. She holds a BS in Medical Technology from the Medical College of Georgia.
The author has no conflict of interest to disclose. 
Reviewer Information: Laurie Bjerklie, MA, MLS(ASCP)CM, is a Lead Education Developer. She earned a B.S. in Medical Laboratory Science from the University of North Dakota and an M.A. in Curriculum and Instruction from Saint Xavier University. She has over 15 years of experience in higher education and has held program director and faculty positions in both MLT and MLS programs.

This course is part of the CAP Competency Assessment Hub.

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