COPEPTIN proAVP (ANTI-DIURETIC HORMONE)

General Information

HLAB/HOL Code: COAVP
UPHSM LIS Test #: 731
Schedule: MONDAY-FRIDAY
Testing Time: 3 Days
Testing Lab: Mayo Labs

Specimen Info
Only 1 specimen type required, unless otherwise specified

Volume: 2.0 mL
Temperature: Frozen
Tube Type: EDTA PLASMA
Collection Info:
Collection Instructions:

1. Have patient fast and thirst for at least 8 hours (no liquids, including water, are allowed).
2. Process 5 mL of EDTA whole blood as follows:
      Spin down.  Aliquot plasma into plastic vial, carefully avoiding the platelet/buffy coat.  Do NOT submit in original tube.

Specimen Acceptability

Reject Due To

Hemolysis
Mild OK; Gross reject

Lipemia
Mild OK; Gross OK

Icterus
Mild OK; Gross OK

Methods

Immunofluorescent Assay (IFA)

Clinical Utilities

Useful For:

The investigation of the differential diagnosis of patients with water balance disorders, including diabetes insipidus, in conjunction with osmolality and hydration status

May aid in the evaluation of cardiovascular disease in conjunction with other cardiac markers


Arginine vasopressin (AVP) and copeptin (also known as copeptin proAVP or copeptin AVP) are derived from the same precursor peptide. Copeptin has been proposed as a more stable, potentially superior, surrogate marker of AVP in the assessment of water balance disorders. Unlike AVP, copeptin is stable in plasma. Both copeptin and AVP are responsive to osmotic stimuli and increase in response to water deprivation. In healthy subjects, water deprivation causes the plasma osmolality to rise above approximately 280-290 mOsmol/kg, leading to the release of AVP and copeptin into the circulation. Copeptin increases gradually with fasting and water deprivation and declines rapidly after intake of water and/or food.

Copeptin is also a marker of acute hemodynamic stress, and has been reported to aid in the prognosis or diagnosis of several cardiac disorders such as acute coronary syndrome, stable coronary artery disease, congestive heart failure, and acute ischemic stroke. Some studies have demonstrated that copeptin may improve prediction of mortality and heart disease outcome when combined with natriuretic peptides such as B-type natriuretic peptide (BNP) and N-terminal pro b-type natriuretic peptide (NT-proBNP).

CPT Codes

84588

* The CPT codes provided 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 payer being billed.

Reference Range

Non-water deprived, non-fasting adults: <13.1 pmol/L

Water deprived, fasting adults: <15.2 pmol/L

Non-water deprived, non-fasting pediatric patients: <14.5 pmol/L