Cost of the blood count
The costs for a blood count examination differ from case to case, depending on whether the patient concerned is covered by statutory or private health insurance and to what extent the blood test is carried out (small blood count, large blood count, additional values such as liver values, inflammation values, thyroid values, kidney values, electrolytes, etc.). In general, the health insurance companies pay for a routine blood count determination by the attending physician every two years, but if there is a plausible medical need for more frequent blood samples, the insurance companies usually pay for these as well. Blood samples taken without medical indication, purely at the patient’s request, on the other hand, often have to be paid out of the patient’s own pocket.
The costs for this are then made up as follows in accordance with the (GOA): The blood collection itself costs 4.20€, the symptom-related examination of the blood 10.72€ and the medical consultation costs 10.72€ (<10 minutes of discussion time) – 20.11€ (>10 minutes of discussion time), which can take place both before the blood collection as clarification and after the blood collection for discussion of the results. “Liver values” is a term for the measurable concentrations of certain enzymes in the blood serum, which are mainly formed in the liver cells and can therefore be regarded as liver-specific parameters or markers. They are usually determined in the context of the diagnosis of liver and also bile duct diseases.
In routine diagnostics, the concentration of four enzymes is determined: gamma-glutamyl transferase (short: gamma-GT/gGT), glutamate-pyruvate transaminase (short: GPT, also alanine aminotransferase – short: ALT or ALAT), the glutamate-oxalacetate transaminase (GOT, also called aspartate aminotransferase – AST or ASAT) and the alkaline phosphatase (AP). GPT is one of the specific liver values, as it is mainly found in the cells of the liver, but it is also found in small amounts in the cells of the skeletal and cardiac muscles, where its function is primarily to participate in the protein metabolism of the cells or the respective organ. If the GPT value in the patient’s blood count is elevated, this can thus usually be an indication that a disease of the liver and/or bile ducts may be present (e.g. inflammation of the liver, fatty liver disease, drug/alcohol abuse, bile duct obstruction due to gallstones etc.).
GPT represents the enzyme that is most specific to the liver, as it is least produced in other organs. However, in the case of possible liver damage, it does not rise the earliest of the liver values (the gGT rises earlier, for example), since the enzyme is located inside the (liver/bile duct) cells and is only released into the blood when these are damaged to such an extent that they perish. “.
Alkaline phosphatase (AP) is typically elevated in diseases of the bile ducts (bile stasis, viral hepatitis) and in disorders of bone metabolism (rickets, osteomalacia, Paget’s disease). The INR is the modern reference value of the previously used quick value and is a measure of human blood coagulation. The INR was invented in order to make blood coagulation internationally comparable, since the Quick value, which was often used in the past, was highly dependent on the different laboratory methods used in a laboratory.
The INR value is determined using citrate blood, which prevents premature blood clotting in the tube. Only in the laboratory is blood clotting then stopped using special substances and the time until the first blood clot is formed is measured. In healthy people this time is 20 seconds.
This would correspond to an INR of 1 (quick value = 100%). In certain diseases, such as a vitamin K deficiency (usually severe liver disease or a disturbance in the absorption of vitamin K from the intestine), coumarin or marcoumar therapy or a lack of fibrinogen, the INR can be increased or the Quick value can be reduced. Ammonia is a foul-smelling gas that is produced in the intestine by bacteria from undigested protein meals.
A healthy liver can absorb and metabolize the harmful ammonia through the blood before it causes damage to the human body. If, on the other hand, the liver’s performance is so severely reduced that it can no longer absorb and detoxify the ammonia; the ammonia then enters the large bloodstream. Ammonia can cause severe damage, especially to the central nervous system (CNS).
A typical consequence would be hepatic encephalopathy, which can be accompanied by convulsions, confusion and coma. – GOT (also ASAT) : 10-50 U/L| 10-30 U/L
- GPT (also ALAT) : 10-50 U/L| 10-35 U/L
- GGT (Gamma-GT) : < 66 U/L| < 39 U/L
- GLDH : < 6.4 U/L| < 4.8 U/L
- Bilirubin : < 1.1 mg/dL| < 1.1 mg/dL
- Alkaline phosphatase (AP) : 40-129 U/L| 35-104 U/L
- GOT (also ASAT) : 10-30 U/L
- GPT (also ALAT) : 10-35 U/L
- GGT (Gamma-GT) : < 39 U/L
- GLDH : < 4.8 U/L
- Bilirubin : < 1.1 mg/dL
- Alkaline phosphatase (AP) : 35-104 U/L
Behind the abbreviation GFR in the context of blood testing is the so-called “glomerular filtration rate”. It is a kidney value that indicates the volume of blood that is filtered per unit of time from the kidney (or the filtration apparatus of the kidney) and thus “cleaned”.
The GFR, along with other kidney values of the blood count, is an important parameter that can be used to assess kidney function. One problem in determining the value is that it cannot be measured directly in blood serum, but must be determined on the basis of the so-called creatine clearance. If the glomerular filtration rate is reduced, this can thus be an indication of renal insufficiency.
The GFR value is thus not only used for the diagnosis or screening of renal dysfunction, but can also be used for monitoring the course of renal disease. The standard value for the GFR for patients around 20 years old with normal, healthy blood pressure is approximately 120 ml/min. In general, the standard value may vary individually, depending on the time of day, the underlying blood pressure conditions of the patient, as well as age, height and weight.
