Bilirubin

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Bilirubin

Bilirubin

A Marker of Hepatic Dysfunction

Benefits of the Randox Bilirubin Assay

Exceptional Correlation

Excellent correlation

The Randox bilirubin assay has a correlation coefficient > 0.99% CV when compared to commercially available methods.

Direct-Total

Direct & Total assays available

Randox offer both direct & total bilirubin assays offering choice and flexibility.

Wide measuring range

Wide measuring range

The Randox bilirubin assay has a measuring range of 0.95 – 606µmol/l for the comfortable detection of clinically important results.

Liquid ready-to-use

Liquid ready-to-use

The Randox bilirubin assay is available in a liquid ready-to-use format for convenience and ease-of-use.

Calibrator and dedicated control available

Calibrator and dedicated control available offering a complete testing package.

Applications available

Applications available detailing instrument-specific settings for the convenient use of the Randox bilirubin assay on a variety of clinical chemistry analysers.

  • Ordering Information
  • Physiological Significance
  • Clinical Significance
  • COVID-19

Direct

Cat NoSizeMethod    
BR23622 x 250 (L)Modified JendrassikEnquireKit Insert RequestMSDSBuy Online
BR3807R1 2 x 30ml (L)
R2 8 x 4ml
JendrassikEnquireKit Insert RequestMSDSBuy Online
BR8035R1 4 x 16ml (L)
R2 8 x 4ml
JendrassikEnquireKit Insert RequestMSDSBuy Online
(L) Indicates liquid option

Total

Cat NoSizeMethod    
BR23612 x 250ml (L)Modified JendrassikEnquireKit Insert RequestMSDSBuy Online
BR3859R1 2 x 50ml (L)
R2 8 x 4ml
JendrassikEnquireKit Insert RequestMSDSBuy Online
BR243R1 1 x 100ml (L)
R2 2 x 100ml
Dichloroaniline (DCA)EnquireKit Insert RequestMSDSBuy Online
BR8036R1 2 x 50ml (L)
R2 8 x 4ml
JendrassikEnquireKit Insert RequestMSDSBuy Online
(L) Indicates liquid option

Direct & Total

Cat NoSizeMethod    
BR4111 x 225ml (L) JendrassikEnquireKit Insert RequestMSDSBuy Online

Instrument Specific Applications (ISA’s) are available for a wide range of biochemistry analysers.  Contact us to enquire about your specific analyser.

Bilirubin is a metabolite of haem, derived from haem-containing proteins, including myoglobin, haemoglobin and various P450 enzymes, that serves to coordinate iron in various proteins. Half of it is excreted into bile and the rest contributes to blood bilirubin turnover 1. It is mainly produced in the spleen and liver but can also occur elsewhere in the body by macrophages and renal tubular cells 2. The internal hydrogen bonding causes it to be water-insoluble and so required enzyme-mediated glucuronidation in the liver for biliary excretion. Under normal conditions, it is mostly unconjugated and bound tightly to albumin 3.

Bilirubin is one of the most common diagnostic tests utilised in the diagnosis and monitoring of hepatic dysfunction. It is impaired in cholestatic and parenchymal liver diseases. The most common condition associated with elevated levels is jaundice (a clinical sign of hyperbilirubinaemia), characterised by the yellow colouring of skin, mucous membranes and sclera 3.

Today, it is recognised as being more than just an end-product and considered to be a fundamental substance. Bilirubin is recognised as acting as an antioxidant and anti-inflammatory agent in serum. Evidence exists that states that it can neutralise free radicals, prevent peroxidation of lipids and protects the cardiovascular system, hepatobiliary system, immune system, neuronal system and pulmonary system 4.

It has been established that bilirubin levels are significantly elevated in COVID-19 patients 5. Patients with abnormal liver function tests were at a significantly higher risk of progressing to a severe disease, such as pneumonia. The presence of abnormal liver function tests became more pronounced during hospitalisation within two weeks, with total bilirubin levels elevated 3 times the upper normal limit 6.

Want to know more?

Contact us or download the antioxidants brochure to learn more.

Related Products

Clinical Chemistry Calibrator

Bilirubin Elevated Control

Clinical Chemistry EQA

Reagents Resource Hub


Bilirubin (Vanadate Oxidation)

Bilirubin (Vanadate Oxidation)

A Superior Method for Paediatric & Lipemic Samples

Benefits of the Randox Vanadate Oxidation Bilirubin Assay

Superior Performance Icon

Superior methodology

The Randox vanadate oxidation bilirubin assay does not suffer from interferences from non-conjugated bilirubin unlike the diazo-based methods.

Direct-Total

Direct & Total bilirubin assays available

Randox offer both direct & total bilirubin assays offering choice and flexibility.

No Pre-step

No pre-step required

The Randox vanadate oxidation bilirubin assay eliminates the pre-step, increasing testing efficiency.

Liquid ready-to-use

Liquid ready-to-use

The Randox bilirubin assay is available in a liquid ready-to-use format for convenience and ease-of-use.

Calibrator and dedicated control available

Calibrator and a dedicated bilirubin elevated control available offering a complete testing package.

Applications available

Applications available detailing instrument-specific settings for the convenient use of the Randox vanadate oxidation bilirubin assay on a variety of clinical chemistry analysers.

  • Ordering Information
  • Physiological Significance
  • Clinical Significance
  • V.O vs Diazo
  • COVID-19

Direct vanadate oxidation bilirubin

Cat NoSize    
BR9765R1 4 x 14ml
R2 4 x 6ml
EnquireKit Insert RequestMSDSBuy Online
BR8133R1 4 x 52.2
R2 4 x 20ml
EnquireKit Insert RequestMSDSBuy Online
BR4060R1 4 x 20ml
R2 4 x 20ml
EnquireKit Insert RequestMSDSBuy Online
BR8308R1 4 x 20ml
R2 4 x 8ml
EnquireKit Insert RequestMSDSBuy Online
BR8376R1 4 x 20ml
R2 4 x 8ml
EnquireKit Insert RequestMSDSBuy Online

Total vanadate oxidation bilirubin

Cat NoSize    
BR9766R1 4 x 68ml
R2 4 x 25ml
EnquireKit Insert RequestMSDSBuy Online
BR4061R1 4 x 20ml
R2 4 x 8ml
EnquireKit Insert RequestMSDSBuy Online
BR8132R1 4 x 52.2ml
R2 4 x 20ml
EnquireKit Insert RequestMSDSBuy Online
BR8377R1 4 x 20ml
R2 4 x 8ml
EnquireKit Insert RequestMSDSBuy Online

Instrument Specific Applications (ISA’s) are available for a wide range of biochemistry analysers.  Contact us to enquire about your specific analyser.

Bilirubin is a metabolite of haem, derived from haem-containing proteins, including myoglobin, haemoglobin and various P450 enzymes, that serves to coordinate iron in various proteins. Half of this bilirubin is excreted into bile and the rest contributes to blood bilirubin turnover 1. The production of bilirubin mainly occurs in the spleen and liver but can also occur elsewhere in the body by macrophages and renal tubular cells 2. The internal hydrogen bonding causes bilirubin to be water-insoluble and so required enzyme-mediated glucuronidation in the liver for biliary excretion. Under normal conditions, bilirubin in mostly unconjugated and bound tightly to albumin 3.

Bilirubin is one of the most common tests to diagnose and monitor hepatic dysfunction. Bilirubin is impaired in cholestatic and parenchymal liver diseases. The most common condition associated with elevated bilirubin levels is jaundice (a clinical sign of hyperbilirubinaemia), characterised by the yellow colouring of skin, mucous membranes and sclera 3.

Today, bilirubin is recognised as being more than just an end-product and considered to be a fundamental substance. Bilirubin is recognised as acting as an antioxidant and anti-inflammatory agent in serum. Evidence exists that states that bilirubin can neutralise free radicals, prevent peroxidation of lipids and protects the cardiovascular system, hepatobiliary system, immune system, neuronal system and pulmonary system 4.

The main advantage of the vanadate oxidation method over the diazo method is that the V.O method is a superior method for haemolytic and lipemic samples. The advantages are particularly evident in neonatal and infant populations where haemolysis is common. Moreover, the V.O method offers a wider analytical measurement range 5.

It has been established that bilirubin levels are significantly elevated in COVID-19 patients 6. Patients with abnormal liver function tests were at a significantly higher risk of progressing to a severe disease, such as pneumonia. The presence of abnormal liver function tests became more pronounced during hospitalisation within two weeks, with total bilirubin levels elevated 3 times the upper normal limit 7.

Want to know more?

Contact us or download the antioxidants brochure to learn more.

Related Products

Clinical Chemistry Calibrator

Bilirubin Elevated Control

Clinical Chemistry EQA

Reagents Resource Hub


Randox – Nutritional Status

Randox are dedicated to improving health worldwide, throughout the month of July we hope to highlight how the Randox clinical product range can assess an individual’s nutritional status both accurately and swiftly allowing the necessary steps to be taken in order to improve nutritional status. Nutritional status is influenced by diet, the levels of nutrients in the body and the body’s ability to maintain normal levels of metabolic integrity. Assessing nutritional status will generally indicate if an individual is eating the correct variety and quantity of nutrients. The Randox portfolio comprises a wide range of products to combat nutritional status issues including the RX series range of biochemistry analysers, diagnostic reagents such as zinc, copper & lipase and an extensive QC range catering for nutritional status testing in both liquid & lyophilised formats.

Nutritional Status: Reagents

Randox Reagents have the highest quality reagents on the market and a test menu comprising of over 113 assays. Unique to Randox is the copper and zinc assays that hold equal importance in the diagnosis of kidney and liver damage.

The Randox zinc assay can be used to measure levels of zinc in a patient’s urine providing insight into the levels of zinc in the body. The Randox copper assay is used to measure the levels of copper in the blood in order to determine copper toxicity. Combining these Randox assays can aid in identifying the cause of liver damage in a patient, leading to correct treatment and recovery.

Nutritional Status: RX series

The RX series range offers the most comprehensive testing profile for assessing nutritional status to identify any nutritional deficiencies or any other nutritional issues within an individual. The world famed RX series test menu possesses the most extensive nutritional status testing panel available to give an expansive picture of an individual’s nutritional status. The RX series zinc test can identify a zinc deficiency in an individual which is often a result of a low dietary intake and can lead to many problems including impaired immune & cognitive functions, kidney disease and diabetes. To view the full RX series test menu click here.

Nutritional Status: Quality Control

The Randox Acusera Liquid Chemistry Premium Plus control is designed for use in the routine monitoring of reproducibility and is the most comprehensive chemistry control available. As a true third party control it is suitable for use with all major instruments and covers over 100 parameters including routine chemistries, immunoassays, lipids, cardiac markers, proteins, therapeutic drugs and electrophoresis effective consolidation and significant cost savings are guaranteed.

Nutritional Status: RIQAS

The RIQAS General Clinical Chemistry EQA programme is designed to monitor the performance of up to 52 parameters covering routine chemistries, lipids, hormones and trace metals. Three flexible, cost effective programme options allow you to choose the correct challenge that is right for your lab. Bi-weekly, online reporting with reports returned within 72 hours allows corrective action to be taken sooner, avoiding dangerous misdiagnoses.

 


Improving Women’s Health With Randox

Randox are dedicated to improving health worldwide, Throughout the month of June we hope to highlight how the Randox clinical product range can ensure accurate and swift diagnosis and by doing so improving women’s health by allowing for the necessary steps to be taken post diagnoses. A common held misconception is that breast cancer is the biggest threat to a women’s health however the biggest health risk to a woman statistically is heart disease which accounts for roughly 27% of female death. The Randox clinical product range offers a wide range of products to combat heart issues including the RX series extensive cardiac testing panel, reagents such as H-FABP, Adiponectin an TxB Cardio and an extensive cardiac QC range available in both liquid & lyophilised format.

 

Women's Health: Reagents

Randox Reagents have the highest quality reagents on the market and a test menu comprising of over 118 assays covering over 100 disease markers. Several of these reagents will play a key role in diagnosis in woman such as Randox’s Lipoprotein (a) – Lp(a) test,   The Randox Lp(a) offers swift and accurate diagnosis of elevated circulation Lp(a) levels which is significant for woman as women have an increased risk of CVD due to elevated levels of Lp(a).  Several traditional CVD risk markers, including elevated LDL may be absent in some women, elevated Lp(a) levels may identify women at high risk of developing CVD.

Women's Health: RX series

The RX series range of clinical chemistry analysers offers the most comprehensive testing profile for assessing health in males and females. Urinary tract infections are more commonly found in women and the RX series extensive renal function panel will provide clarity  in terms of a woman’s urological health by testing for 19 separate analytes, including microalbumin. The RX series microalbumin test can detect very low levels of albumin in urine and if albumin is detected it can be an indicator of kidney injury and can result in irreversible damage. To view the full RX series test menu click here.

 

Women's Health: Quality Control

The Randox Acusera Maternal Screening quality control is the only commercially available control which covers all six analytes used during first and second trimester screening of Down’s syndrome and Spina Bifida. Instrument specific target values and ranges are provided for AFP, Inhibin A, PAPP-A, β hCG, Total hCG and Unconjugated Estriol. The inclusion of PAPP-A and Inhibin A eliminates the need to purchase additional controls at extra expense.

Women's Health: RIQAS

The RIQAS Maternal Screening EQA programme is designed to monitor the performance of screening tests used during the first and second trimester of pregnancy to assess the risk of Down’s syndrome, Spina Bifida and Trisomy 18. 100% human serum ensures commutability while the lyophilised material allows for enhanced stability. Monthly reporting allows laboratories to become aware of issues and remedy them early.


Neonatal health testing from Randox: what to expect after birth

It’s been almost a month since the Duke and Duchess of Cambridge welcomed Prince Louis into the Royal Family, and as reported it was a natural birth with no complications.

But caring for a newborn baby in the first few hours of its life isn’t quite as simple as it may have seemed in the picture-perfect media coverage of Kate and William introducing their third child to the world for the first time.

Behind the doors of the hospital maternity ward, doctors and nurses are busy carrying out a wealth of tests to ensure the health of the neonates in their care. Because the time immediately following a baby’s birth is crucial for their development in the coming months.

Newborn babies are particularly at risk for some diseases because their immune systems aren’t yet developed enough to fight bacteria, viruses and parasites. Just a few minutes after a baby’s arrival, they will be poked, pricked, measured, tested, examined, cleaned and swaddled – all in the name of making sure they are – and importantly, remain – healthy.

The first test to be conducted is usually an Apgar score – a simple assessment of how a baby is doing at birth, to help determine whether they are ready to meet the world without additional medical assistance.   Based on heart rate, colour, reflex response, activity, muscle tone and breathing, the Apgar score ranges from zero to ten, with anything above seven or above being considered a healthy score. Babies with a score below seven will have their issues addressed – it could be something as simple as moving them to a warmer room until they are able to maintain their own body temperature, or clearing their nose and mouth for more efficient breathing.

The baby is then weighed and measured, and may be given antibiotic eye ointment to prevent infections, and vitamin K to prevent clotting problems.

They will also have their pulse, abdomen, genitals, fingers and toes examined, and their Ballard score taken. This takes into account head circumference, chest circumference and length, to confirm gestational age.

A paediatrician will then assess risk factors for infection and ensure that the baby is feeding well. They will also check for jaundice, which causes yellowish skin when bilirubin, a compound formed by the liver, isn’t being broken down properly.

Neonatal jaundice is extremely common, because during the first week of their life nearly every newborn develops a somewhat elevated bilirubin level, which could potentially lead to jaundice. And the good news is, that if diagnosed early, jaundice can easily be eradicated, by exposure to a specialist light that can help break down bilirubin.

At Randox, we offer a test for bilirubin to diagnose and monitor newborn jaundice, which, in rare cases if left untreated, can lead to brain damage. Early, accurate diagnosis is therefore imperative and so to ensure the precision of the bilirubin tests, Randox also offers Acusera Bilirubin Elevated Quality Control.

The baby will also have their heel pricked for a variety of metabolic conditions including sickle cell anaemia, which causes red blood cell destruction. The Randox test for haptoglobin, a protein found in blood plasma, can help to diagnose sickle cell anaemia.

Or if the baby is premature, they will remain in the hospital nursery. Depending on how premature the baby is there will be different types of tests and treatment given, but they will have their temperature, heart rate and respiratory rate closely monitored. These vital signs will be checked regularly for the first few hours of the baby’s life.

So as you can see, within just a few short hours newborn babies are kept incredibly busy. Procedures may vary from one hospital to the other, but one thing is for sure: neonatal tests are vital in determining and protecting the health of babies.

Randox is committed to saving and improving lives – at any age and any stage of life.

Our innovative diagnostic technologies are versatile and easily adapted for use in the paediatric setting – keeping your baby healthy now and into the future.

 

For more information on neonatal health tests available from Randox, please email randoxpr@randox.com or phone 028 9442 2413

 

 

 


Neonatal health testing from Randox: keeping your baby healthy now and into the future

Most newborns enter the world healthy. But sometimes, infants develop conditions that require medical tests and treatment. Newborns are particularly at risk for some diseases, and in particular infections, because their immune systems aren’t developed enough to fight bacteria, viruses, and parasites.

At Randox we offer a number of accurate and reliable tests capable of detecting illnesses in newborn babies, enabling early medical intervention to allow for the best possible outcome for the baby.

Testing for Jaundice with Randox Bilirubin

In the routine care of newborns, a test for bilirubin is commonly conducted.

Bilirubin is formed by the breakdown of haemoglobin in the spleen, liver and bone marrow. It travels to the liver where it is secreted into the bile ducts as bile, and stored in the gallbladder where it is later released into the small intestines for digestion.

Increased levels of bilirubin within the body are associated with a condition called jaundice, which occurs in toxic or infectious diseases of the liver. The most common symptom of jaundice is a yellow pigmentation of the skin.

Elevated levels of bilirubin may also arise as a result of an obstruction in the bile duct or gall bladder, as a result of haemolysis (the destruction of red blood cells), or by the liver not actively treating the haemoglobin it is receiving.

Therefore the Randox Bilirubin test is essential in the screening, monitoring and diagnosis of hepatic (liver function) disorders and jaundice in newborn babies.

Neonatal jaundice, otherwise known as hyperbilirubinemia, is extremely common in babies, because nearly every newborn develops a somewhat elevated bilirubin level during the first week of life.

Side effects may include excess sleepiness or poor feeding, but in some more extreme cases babies may experience seizures, cerebral palsy, delayed intellectual development, or physical abnormalities.

Early and accurate detection is therefore extremely important – making bilirubin testing fundamental. To ensure the precision of the bilirubin tests conducted in paediatric testing, Randox also offers Acusera Bilirubin Elevated Quality Control.

Monitoring the destruction of red blood cells with Randox G-6-PDH

Glucose-6-Phosphate Dehydrogenase (G-6-PDH) is an enzyme located on the X-chromosome, and so is found in every bodily cell as soon as a baby is born.

G-6-PDH is involved in the normal processing of carbohydrates and plays a critical role in red blood cells, protecting them from damage and destruction. Depleted levels of G-6-PDH can therefore cause red blood cells to become particularly vulnerable to haemolysis. G-6-PDH deficiency, which causes rapid heart rate, shortness of breath, excess tiredness, and mild to severe jaundice in new-borns, affects more than 400 million people globally.

During a baby’s new-born screening, a test for the G-6-PDH enzyme will be conducted to check for this deficiency disorder. Early diagnosis is imperative, as untreated haemolysis can result in haemolytic anaemia.

Genetic Disease Screening with Randox Copper

Copper is an essential mineral in human nutrition, and is mainly found in the brain, liver, kidneys, heart and skeletal muscle.

It aids in some of the key bodily functions including the production of red blood cells, the maintenance of nerve cells and the immune system, and the formation of bone and connective tissue. A deficiency in this mineral can therefore result in bone abnormalities or fractures in premature babies.

Copper deficiency can also be caused by an inherited disorder called Menkes Disease. Affecting approximately 1 in 100,000 children worldwide, this condition is characterised by sparse, kinky hair; failure to gain weight and grow at the expected rate, and deterioration of the nervous system.

The first signs of Menkes Disease – curly, sparse, coarse, dull, and discoloured hair – usually first develop at 2-3 months of age and therefore monitoring copper levels in babies is a way to catch this rare condition at the earliest possible opportunity.

Testing for Lupus with Randox Complement C4 and Complement C3

Another condition which can affect newborn babies is neonatal lupus, which occurs when the mother’s antibodies affect the foetus. A rare condition, it is an autoimmune disease caused by the body’s immune system attacking its own tissues and organs.

The Complement C4 and Complement C3 proteins, which play an important role in eliminating certain infections, can be used as biomarkers in the diagnosis and monitoring of lupus. Complement C4 deficiency is commonly associated with lupus, as the protein is required to clear damaged cells, promote inflammation, and attack pathogens.

Although there is no cure for lupus at present, the condition is very treatable and usually responds well to a number of different types of medication – especially when treatment is started in the early stages of the disease.

Early diagnosis is therefore imperative, and the Randox Complement C4 and Complement C3 tests can help to diagnose babies with lupus at the earliest possible stage. Randox also offer Acusera Immunology controls.

Monitoring a baby’s anti-infection defences with Randox IgA

IgA (immunoglobulin A) is an antibody present in the cells of the immune system, and plays a crucial role in the immune function of mucous membranes including tears, saliva, and sweat. It is also present in colostrum, often referred to as ‘liquid gold’, which is the first secretion from the mammary glands after giving birth.

It’s the IgA in colostrum and milk that is important in neonatal protection against infection and it is therefore imperative to monitor the levels of this antibody to make sure your baby is receiving the anti-infection defences he or she requires.

Testing for allergic reactions with Randox IgE

IgE (immunoglobulin E) is an antibody released by the immune system as a defence mechanism when it believes the body is at risk. IgE determinations are therefore used as an aid in the diagnosis of allergic diseases.

In babies, an allergen-specific IgE test may be done to look for some kinds of allergies, including food, animal dander, pollen, mould, medicine, dust mites, or insect venom.

Increased concentrations of IgE will confirm that an allergic response has occurred, facilitating further investigation as to the specific allergy present.

Testing for bacterial infection with Randox CRP

C-reactive protein (CRP) is an acute phase protein found in blood plasma and produced by the liver. The concentration levels of CRP increase in response to cytokines which are produced by white blood cells during inflammation, infection and tissue injury.

Testing for this protein can therefore be used in the detection of bacterial infections in neonates – enabling antibiotic prescription and a speedy recovery. If infection is identified, CRP can also be used to monitor treatment response or identify neonatal septicaemia.

Randox is committed to saving and improving lives – at any age and any stage of life.

Our innovative diagnostic technologies are versatile and easily adapted for use in the paediatric setting – keeping your baby healthy now and into the future.

 

For more information on neonatal health tests available from Randox click here or email randoxpr@randox.com or phone 028 9442 2413

 

 

 

 


Neonatal Health With Randox

Neonatal screening is vital for the overall health of newborn babies. Although it is not a mandatory procedure it is highly recommended to detect infections and diseases that can have devastating consequences if not diagnosed soon after birth. Randox’s range of neonatal reagents include CRP, Bilirubin and Complement C4 that are essential in the detection of neonatal lupus and jaundice; which if left undetected can lead to sickle cell anaemia, rubella and even syphilis. Armed with these specific and high quality reagents and Randox Quality Control material ensures not only the early detection of such diseases but also the accuracy and reliability of the laboratory test results that can help to ensure that your baby gets the best start in life.

Neonatal Health: Reagents

Randox Reagents have the highest quality reagents on the market and a test menu comprising of over 118 assays covering over 100 disease markers. Our specific reagents for neonatal health include, G-6-PDH, IgEBilirubin, Copper, Complement C4 & C3IgA , CRP and CRP full range. With flexible pack sizes and a comprehensive list of analyser applications available, you are sure to find what you are looking for.

Neonatal Health: RX series

Randox has developed the RX series of clinical chemistry analysers for superior semi-automated and fully automated testing. The RX series extensive dedicated test menu goes beyond routine testing and has many unique and high-performance tests available. Our range of tests covers several parameters to assess neonatal health.

Neonatal Health: Quality Control

Randox Liquid Bilirubin Control provides a true third party solution for the measurement of bilirubin. Designed to deliver unbiased and independent results, it ensures your instrument is accurate and reliable when testing real patient samples. An elevated bilirubin control is also available to monitor accuracy at higher levels enabling early medical intervention when it matters.

Neonatal Health: RIQAS

RIQAS is the largest international external quality assessment scheme with 45,000 participants worldwide. With 33 comprehensive EQA programmes and world renowned consolidation, it reduces the number of individual programmes required. RIQAS programmes are available to compliment neonatal health tests.


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