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Table 1.

Geriatric Laboratory Values and Interpretations of Hematology

Normal
Adult Value
Male (M) Geriatric
Test Female (F) Value Implications

Hemoglobin M 13.0 gm/dl M 11.5 gm/dl [down arrow]: Anemias,


F 12.0 gm/dl F 11.0 gm/dl cirrhosis of liver,
leukemias, Hodgkin's
disease, cancer (intestine,
rectum, liver, or bone),
kidney disease
[up arrow]: Dehydration,
COPD, CHF, polycythemia

Hematocrit M 40%-54% M 30%-45% [down arrow]: Anemias,


F 36%-46% F 36%-65% leukemia, Hodgkin's
disease, multiple myeloma,
cirrhosis of liver, protein
malnutrition, peptic ulcer,
chronic renal failure,
rheumatoid arthritis
[up arrow]: Dehydration,
severe diarrhea,
polycythemia vera, diabetic
acidosis, emphysema,
transient cerebral ischemia

White Blood 4,500-10,000 3,000-9,000 [down arrow]: Hemotopoietic


Cells [micro]l/ [micro]l/ diseases, viral infections,
[mm.sup.3] [mm.sup.3] alcoholism, systemic lupus
erythematous (SLE),
rheumatoid arthritis
[up arrow]: Acute
infection, tissue necrosis,
leukemias, hemolytic
anemia, parasitic diseases,
stress

Platelets 150,000- Minimal [down arrow]: Idiopathic


400,000 change thrombocytopenia purpura,
[micro]l multiple myeloma, cancer,
leukemias, anemias, liver
disease, SLE, kidney
disease
[up arrow]: Polycythemia,
trauma, post-splenectomy,
metastatic carcinoma,
pulmonary embolism,
tuberculosis

Source: Brigden & Heathcote, 2000

Table 2.
Geriatric Laboratory Values and Interpretations of Erythrocyte
Sedimentation Rate, Iron Metabolism, and Vitamin [B.sub.12]

Normal
Adult Value
Male (M) Geriatric
Test Female (F) Value Implications

Erythrocyte M 0-15 mm/hr M 0-40 mm/hr [down arrow]:


Sedimentation F 0-20 mm/hr F 0-45 mm/hr Polycythemia, CHF,
Rate (ESR) degenerative arthritis,
angina pectoris
[up arrow]: Rheumatoid
arthritis, rheumatic
fever, acute MI, cancer
(stomach, colon, breast,
liver, kidney), Hodgkin's
disease, multiple
myeloma, bacterial
endocarditis, gout,
hepatitis, cirrhosis of
liver,
glomerulonephritis, SLE,
theophylline use.

Serum Iron 50-150 60-80 [down arrow]: Iron


[micro]g/dl [micro]g/dl deficiency anemia, cancer
(stomach, intestine,
rectum, breast), bleeding
peptic ulcers, protein
malnutrition
[up arrow]: Hemolytic,
pernicious, and folic
acid anemias; liver
damage; lead toxicity

Ferritin M 15-445 10-310 ng/dl [down arrow]: Iron


ng/ml deficiency, inflammatory
F 10-235 bowel disease, gastric
ng/ml surgery
[up arrow]: Metastatic
carcinoma, leukemias,
lymphomas, hepatic
diseases, anemias, acute
and chronic infection,
inflammation, tissue
damage

Vitamin 200-900 150 pg/ml [down arrow]: Pernicious


[B.sub.12] pg/ml anemia, malabsorption
syndrome, liver disease,
hypothyroidism
[up arrow]: Acute
hepatitis

Source: Brigden, 1999; Brigden & Heathcote, 2000; Kee, 2000; Tripp,
2000
Table 3.
Geriatric Laboratory Values and Interpretations of Serum Proteins

Normal Geriatric
Test Adult Value Value Implications

Total Protein 6.0-8.0 g/dl 5.6-7.6 g/dl [down arrow]: Prolonged


malnutrition,
low-protein diet, cancer
(GI tract), severe liver
disease, chronic renal
failure
[up arrow]: Dehydration,
vomiting, multiple
myeloma

Albumin 3.0-5.0 g/dl Slight [down arrow]: Severe


52- 8% of decrease malnutrition, liver
total protein failure, renal
disorders, prolonged
immobilization
[up arrow]: Dehydration,
severe vomiting,
diarrhea

Source: Beers & Berkow, 2000; Kee, 2002

Table 4.
Geriatric Laboratory Values and Interpretations of Selected Renal
Function Tests

Normal Geriatric
Test Adult Value Value Implications

BUN 5-25 mg/dl 8-28 mg/dl [down arrow]: Liver


or slightly damage, low protein diet,
higher overhydration,
malnutrition
[up arrow]: Dehydration,
high protein diet, GI
bleeding, pre-renal
failure

Creatinine 0.5-1.5 mg/dl 0.6-1.2 mg/dl [down arrow]: None for


older adult
[up arrow]: Renal failure,
shock, leukemia, SLE,
acute MI, CHF, diabetic
neuropathy

Creatinine 85-135 ml/min Formula [down arrow]:


Clearance Mild-to-severe renal
impairment,
hyperthyroidism,
amyotrophic lateral
sclerosis, thiazide use
[up arrow]:
Hypothyroidism,
renal-vascular
hypertension
F G M 125 ml/min F 110 mil/Min

Source: Brigden & Heathcote, 2000; Engelberg et al., 2000;


Kennedy-Malone et al., 2004.

Table 5.
Estimating Creatinine Clearance Values for Men

Creatinine clearance =
(140 - age in years) x (body weight in kilograms)/
(72 x serum creatinine in mg/dl)

Table 6.
Geriatric Laboratory Values and Interpretations of Hepatic Enzymes

Normal
Adult Value
Male (M) Geriatric
Test Female (F) Value Implications

Serum Alanine 10-35 U/I 17-30 U/I [down arrow]: Exercise,


Aminotransferase salicylates
(ALT, SGPT) [up arrow]: Viral
hepatitis, liver
necrosis, CHF, acute
alcohol intoxication

Serum Aspartate 8-38 U/I 18-30 U/I [down arrow]: Diabetic


Aminotransferase ketoacidosis
(AST, SGOT) [up arrow]: Acute MI,
hepatitis, liver
necrosis, musculoskeletal
disease and trauma,
pancreatitis, cancer
(liver), angina pectoris,
muscle trauma related to
IM injections

Alkaline 20-130 U/I 30-140 U/I [down arrow]:


Phosphatase Hypothyroidism,
malnutrition, pernicious
anemia
[up arrow]: Cancer
(liver, bone), hepatitis,
leukemia, healing
fractures, multiple
myeloma, rheumatoid
arthritis, ulcerative
disease

Gamma-Gluta- M 4-23 IU/I 9-55 U/I [down arrow]: None


Myltransferase F 3-12 IU/I [up arrow]: Cirrhosis of
(GGT) liver, necrosis of liver,
alcoholism, hepatitis,
cancer (liver, pancreas,
prostate, breast, kidney,
liver, lung), diabetes
mellitus, acute MI, CHF,
pancreatitis,
cholecystitis, nephritic
syndrome

Source: Brigden & Heathcote, 2000; Kee, 2002

Table 7.
Geriatric Laboratory Values and Interpretations of Blood Lipids

Normal
Adult Value
Male (M) Geriatric
Test Female (F) Value Implications

Cholesterol <200 mg/dl M may increase [down arrow]:


by 30 mg/dl Hyperthyroidism,
F may increase starvation,
by 55 mg/dl malnutrition, anemia
[up arrow]: Acute MI,
atherosclerosis,
uncontrolled diabetes
mellitus,
hypothyroidism, biliary
obstruction, cirrhosis

High-Density M >45 mg/dl M increases by [down arrow]: Chronic


Lipoproteins F >55 mg/dl 30% between obstructive lung disease
(HDL) ages 30 and 80 [up arrow]: Acute MI,
F decreases by hypothyroidism, diabetes
30% between mellitus, multiple
ages 30 and 80 myeloma, high-fat diet

Triglycerides M 40-160 M increases by [down arrow]:


mg/dl 30% Hyperthyroidism,
F 35-135 F increases by hyperparathyroidism,
mg/dl 50% protein malnutrition,
exercise
[up arrow]: Acute MI,
hypertension,
hypothyroidism,
nephritic syndrome,
alcoholic cirrhosis,
pancreatitis,
high-carbohydrate diet

Source: Brigden & Heathcote, 2000; Kee, 2002

Table 8.
Geriatric Laboratory Values and Interpretations of Glucose, Selected
Electrolytes

Normal Geriatric
Test Adult Value Value Implications

Serum Glucose 70-110 mg/dl 70-120 [down arrow]: Hypoglycemia,


mg/dl cancer (stomach, liver),
malnutrition, alcoholism,
cirrhosis of liver
[up arrow]: Diabetes
mellitus, adrenal gland
hyperfunction, acute MI,
stress, crushing injury,
renal failure, cancer
(pancreas), CHF

Calcium 4.5-5.5 mEq/I No change [down arrow]: Diarrhea,


lack of calcium intake,
chronic renal failure,
alcoholism, pancreatitis
[up arrow]:
Hyperparathyroidism,
malignant neoplasms (bone,
lung, breast, bladder,
kidney), malignant myeloma,
prolonged immobilization,
multiple fractures, renal
calculi

Potassium 3.5-5.3 mEq/I Slight [down arrow]: Vomiting,


increase diarrhea, dehydration,
malnutrition, starvation,
stress, diabetic acidosis
[up arrow]: Acute renal
failure, acidosis
(metabolic or lactic),
crushing injury, Addison's
disease

Source: Kee, 2002; Kennedy-Malone et al., 2004; Martin et al., 1997;


Tripp, 2000

Table 9.
Geriatric Laboratory Values and Interpretations of Selected Blood Gases

Normal Geriatric
Test Adult Value Value Implications

Pa[O.sub.2] 75-100 mmHg 100.1-(0.325 [down arrow]: Emphysema,


x age) pneumonia, pulmonary edema
[up arrow]:
Hyperventilation

Pa[Co.sub.2] 35-45 mmHg 2% per decade [down arrow]:


Hyperventilation
[up arrow]: COPD

Source: Brigden & Heathcote, 2000; Kee, 2002; Martin et al., 1997

Table 10.
Geriatric Laboratory Values and Interpretations of Thyroxine,
Triiodothyronine, Prostate-Specific Antigen

Normal
Adult Value
Male (M) Geriatric
Test Female (F) Value Implications

Thyroxine 4.5-11.5 3.3-8.6 [down arrow]:


([T.sub.4]) [micro]g/dl [micro]g/dl Hypothyroidism, protein
malnutrition,
corticosteroids
[up arrow]:
Hyperthyroidism, viral
hepatitis, thyroiditis,
myasthenia gravis

Thyroid- 0.5-5.0 Slight [down arrow]: Excessive


Stimulating [micro]IU/ml increase thyroid hormone
Hormone TSH) replacement, Graves'
disease, primary
hyperthyroidism
[up arrow]: Primary
hypothyroidism, thyroid
hormone resistance

Prostate- PSA 1.45 Ages 50-59: [up arrow]: Prostate


Specific ng/ml 0.0-2.45 ng/ml cancer, benign
Antigen (PSA) Ages 60-69: prostatic hyperplasia
0.0-5.0 ng/ml
Ages 70-79:
0.0-6.3 ng/ml
Post-radical
prostatectomy
0.0-0.3ng/ml

Source: Beers & Berkow, 2000; Daniels, 2002; Kee, 2002