Clinical Lab Handbook

Container/Tube: SST

Alternate Container: Lithium Heparin (Mint), Red Top

Specimen Volume: 5 mL of serum

Collection Instructions: Allow blood to clot for 30 minutes. Spin tube after the 30-minute interval.

Special Handling Instructions: Centrifuge specimens and remove the serum or plasma from the cellular material within 4 hours of collection

The ALKP test is a multilayered, analytical element coated on a polyester support. A drop of patient sample is deposited on the slide and is evenly distributed by the spreading layer to the underlying layers. The spreading layer contains the p-nitrophenyl phosphate substrate and other components needed for the reaction. The ALKP in the sample catalyzes the hydrolysis of the p-nitrophenyl phosphate to p-nitrophenol at alkaline pH. The p‑nitrophenol diffuses into the underlying layer, and it is monitored by reflectance spectrophotometry. The rate of change in reflection density is converted to enzyme activity.

The ALKP test within the VITROS XT Chemistry Products TBIL-ALKP Slides quantitatively measures alkaline phosphatase (ALKP) activity in serum and plasma using VITROS XT 3400 Chemistry Systems and VITROS XT 7600 Integrated Systems. Measurements of alkaline phosphatase or its isoenzymes are used in the diagnosis and treatment of liver, bone, parathyroid, and intestinal diseases.

Alkaline phosphatase is present mainly in bone, liver, kidney, intestine, placenta, and lung. Serum alkaline phosphatase may be elevated in increased bone metabolism, for example, in adolescents and during the healing of a fracture; primary and secondary hyperparathyroidism; Paget’s disease of bone; carcinoma metastatic to bone; osteogenic sarcoma; and Hodgkin’s disease if bones are invaded. Hepatobiliary diseases involving cholestasis, inflammation, or cirrhosis increase alkaline phosphatase activity; alkaline phosphatase activity may be increased in renal infarction and failure and in the complications of pregnancy. Low alkaline phosphatase activity may occasionally be seen in hypothyroidism.

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