Test Catalog

Test Id : CK

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Creatine Kinase (CK), Serum

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Overview

Test Catalog

Useful For
Suggests clinical disorders or settings where the test may be helpful

Diagnosing and monitoring myopathies or other trauma, toxin, or drug-induced muscle injury

Method Name
A short description of the method used to perform the test

Photometric, Creatine Phosphate + ADP

NY State Available
Indicates the status of NY State approval and if the test is orderable for NY State clients.

Yes

Reporting Name
Lists a shorter or abbreviated version of the Published Name for a test

Creatine Kinase (CK), S

Aliases
Lists additional common names for a test, as an aid in searching

CK (Creatine Kinase)

CPK (Creatine Phosphokinase)

Creatine Phosphokinase

Specimen Type
Describes the specimen type validated for testing

Serum

Necessary Information

Patient's age and sex are required.

Specimen Required
Defines the optimal specimen required to perform the test and the preferred volume to complete testing

Collection Container/Tube:

Preferred: Serum gel

Acceptable: Red top

Submission Container/Tube: Plastic vial

Specimen Volume: 1 mL

Collection Instructions:

1. Serum gel tubes should be centrifuged within 2 hours of collection.

2. Red-top tubes should be centrifuged, and the serum aliquoted into a plastic vial within 2 hours of collection.

Specimen Minimum Volume
Defines the amount of sample necessary to provide a clinically relevant result as determined by the testing laboratory. The minimum volume is sufficient for one attempt at testing.

0.25 mL

Reject Due To
Identifies specimen types and conditions that may cause the specimen to be rejected

Gross hemolysis Reject

Specimen Stability Information
Provides a description of the temperatures required to transport a specimen to the performing laboratory, alternate acceptable temperatures are also included

Specimen Type Temperature Time Special Container
Serum Refrigerated (preferred) 7 days
Frozen 28 days
Ambient 48 hours

Useful For
Suggests clinical disorders or settings where the test may be helpful

Diagnosing and monitoring myopathies or other trauma, toxin, or drug-induced muscle injury

Clinical Information
Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test

Creatine kinase (CK) is an enzyme that catalyzes the reversible phosphorylation of creatine (Cr) by adenosine triphosphate (ATP). Physiologically, when muscle contracts, ATP is converted to adenosine diphosphate (ADP), and CK catalyzes the rephosphorylation of ADP to ATP using creatine phosphate as the phosphorylation reservoir. The CK enzyme is a dimer composed of subunits derived from either muscle (M) or brain (B). Three isoenzymes have been identified: striated muscle (MM), heart tissue (MB), and brain (BB). Normal serum CK is predominantly the CK-MM isoenzyme.

 

CK activity is greatest in striated muscle (MM isoenzyme ), heart tissue (MB isoenzyme ), and brain (BB isoenzyme ). Serum CK concentrations are reflective of muscle mass causing males to have higher concentrations than females. CK may be measured to evaluate myopathy and to monitor patients with rhabdomyolysis for acute kidney injury.

Reference Values
Describes reference intervals and additional information for interpretation of test results. May include intervals based on age and sex when appropriate. Intervals are Mayo-derived, unless otherwise designated. If an interpretive report is provided, the reference value field will state this.

Males

< or =3 months: not established

>3 months: 39-308 U/L

Females

< or =3 months: not established

>3 months: 26-192 U/L

Reference values have not been established for patients that are less than 3 months of age.

Note: Strenuous exercise or intramuscular injections may cause transient elevation of creatine kinase (CK).

Interpretation
Provides information to assist in interpretation of the test results

Serum creatine kinase (CK) activity may increase in patients with acute cerebrovascular disease or neurosurgical intervention and with cerebral ischemia as well as in nearly all patients when injury, inflammation, or necrosis of skeletal or heart muscle occurs, including:

-All types of muscular dystrophy particularly in progressive muscular dystrophy (particularly Duchenne sex-linked muscular dystrophy).

-Viral myositis, polymyositis, and similar muscle diseases

-Malignant hyperthermia, an inherited life-threatening condition characterized by high fever and brought on by administration of inhalation anesthesia

-Muscle trauma, which causes CK elevations within 12 hours of onset, peaking within 1 to 3 days, and declining 3 to 5 days after cessation of muscle injury

---Serum CK activities exceeding 200 times the upper reference limit may be found in acute rhabdomyolysis, putting the patient at great risk for developing acute renal failure.

-When given at pharmacologic doses, some drugs including statins, fibrates, antiretrovirals, and angiotensin II receptor antagonists

-Endocrine myopathy, for which hpothyroidism is a common cause, about 60% of hypothyroid subjects show an average elevation of CK activity 5-fold greater than the upper reference limit

-Normal childbirth causes a 6-fold elevation in maternal serum

 

For detection of myocardial infarction, changes in serum CK and its heart tissue (MB) isoenzyme have been largely replaced by the more cardiac-specific nonenzymatic markers, cardiac troponin I or T.

Cautions
Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances

Exercise, muscle trauma (contact sports, traffic accidents, intramuscular injections, surgery, convulsions, wasp or bee stings, and burns), and drugs such as cholesterol-lowering statins can damage muscle and increase serum creatine kinase (CK) concentrations.

 

CK concentrations have been found to be relatively higher in black race populations.

Clinical Reference
Recommendations for in-depth reading of a clinical nature

1. Tietz Clinical Guide to Laboratory Tests. Fourth edition. Edited by Wu AHB. St. Louis, Saunders Elsevier, 2006;306-307

2. Huerta-Alardin AL, Varon J, Marik PE: Bench-to-bedside review: Rhabdomyolysis -- an overview for clinicians. Crit Care 2005 Apr;9(2):158-169

3. Morandi L, Angelini C, Prelle A, et al: High plasma creatine kinase: review of the literature and proposal for a diagnostic algorithm. Neurol Sci 2006 Nov:27(5):303-311

Method Description
Describes how the test is performed and provides a method-specific reference

Creatine kinase (CK) is determined by a coupled enzyme reaction where the rate of NADPH formation is measured photometrically and is directly proportional to the CK activity.(Package insert: Roche CK reagent. Indianapolis, IN, July 2016)

PDF Report
Indicates whether the report includes an additional document with charts, images or other enriched information

No

Day(s) Performed
Outlines the days the test is performed. This field reflects the day that the sample must be in the testing laboratory to begin the testing process and includes any specimen preparation and processing time before the test is performed. Some tests are listed as continuously performed, which means that assays are performed multiple times during the day.

Monday through Sunday

Report Available
The interval of time (receipt of sample at Mayo Clinic Laboratories to results available) taking into account standard setup days and weekends. The first day is the time that it typically takes for a result to be available. The last day is the time it might take, accounting for any necessary repeated testing.

Same day/1 to 2 days

Specimen Retention Time
Outlines the length of time after testing that a specimen is kept in the laboratory before it is discarded

1 week

Performing Laboratory Location
Indicates the location of the laboratory that performs the test

Rochester

Fees
Several factors determine the fee charged to perform a test. Contact your U.S. or International Regional Manager for information about establishing a fee schedule or to learn more about resources to optimize test selection.

  • Authorized users can sign in to Test Prices for detailed fee information.
  • Clients without access to Test Prices can contact Customer Service 24 hours a day, seven days a week.
  • Prospective clients should contact their account representative. For assistance, contact Customer Service.

Test Classification
Provides information regarding the medical device classification for laboratory test kits and reagents. Tests may be classified as cleared or approved by the US Food and Drug Administration (FDA) and used per manufacturer instructions, or as products that do not undergo full FDA review and approval, and are then labeled as an Analyte Specific Reagent (ASR) product.

This test has been cleared, approved, or is exempt by the US Food and Drug Administration and is used per manufacturer's instructions. Performance characteristics were verified by Mayo Clinic in a manner consistent with CLIA requirements.

CPT Code Information
Provides guidance in determining the appropriate Current Procedural Terminology (CPT) code(s) information for each test or profile. The listed CPT codes reflect Mayo Clinic Laboratories interpretation of CPT coding requirements. It is the responsibility of each laboratory to determine correct CPT codes to use for billing.

CPT codes are provided by the performing laboratory.

82550

LOINC® Information
Provides guidance in determining the Logical Observation Identifiers Names and Codes (LOINC) values for the order and results codes of this test. LOINC values are provided by the performing laboratory.

Test Id Test Order Name Order LOINC Value
CK Creatine Kinase (CK), S 2157-6
Result Id Test Result Name Result LOINC Value
Applies only to results expressed in units of measure originally reported by the performing laboratory. These values do not apply to results that are converted to other units of measure.
CK Creatine Kinase (CK), S 2157-6

Test Setup Resources

Setup Files
Test setup information contains test file definition details to support order and result interfacing between Mayo Clinic Laboratories and your Laboratory Information System.

Excel | Pdf

Sample Reports
Normal and Abnormal sample reports are provided as references for report appearance.

Normal Reports | Abnormal Reports

SI Sample Reports
International System (SI) of Unit reports are provided for a limited number of tests. These reports are intended for international account use and are only available through MayoLINK accounts that have been defined to receive them.

SI Normal Reports | SI Abnormal Reports