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Copeptin, Serum/Plasma

Test ID: COPEPTIN
Test
Specimen
Performance / Interpretation
Interface / Setup

Test

Aliases/Synonyms

ProAVP; ADH; Antidiuretic hormone; Vasopressin; Arginine Vasopressin; AVP; ADH

Method

Fluorescent Immunoassay

Method Description

Kit: BRAHMS Copeptin proAVP KRYPTOR

Platform

Kryptor Compact Plus

Report Includes

Copeptin

Specimens

Serum; Plasma

Clinical Utility

Copeptin is a 39-amino acid glycopeptide, the C-terminal part of the AVP precursor (CT-proAVP), and is a stable and sensitive surrogate marker for Antidiuretic Hormone (ADH). Osmolality measurement is not performed as part of copeptin testing. To aid in interpretation of copeptin results, it is recommended that osmolality be ordered separately (separate specimen and billing) or tested at the laboratory where sample collection is performed.

Test Location

London Health Sciences Centre, 339 Windermere Road, London ON N6A 5A5

Test Version

27-Oct-2023

Specimen

Specimens

Serum; Plasma

Collection Containers

Preferred

Plasma (Li heparin green top)

Acceptable

Serum (Red top); Serum (Gold top); Plasma (Lavender top)

Sample Volume

0.5 mL

Collection & Handling

Handling Information

Store and send frozen.

Stability

Ambient 3 days
Refrigerated 3 days
Frozen 90 days

Test Version

27-Oct-2023

Performance / Interpretation

Method

Fluorescent Immunoassay

Method Description

Kit: BRAHMS Copeptin proAVP KRYPTOR

Platform

Kryptor Compact Plus

Turnaround Time

7 days

Results

Name Units Reference Range Conversion Factor
Copeptin pmol/L
  • Interpretive guidelines effective 16-Oct-2023:
    Adult (≥ 18 years):
  • Reference Interval (Non-Stimulated, Non-Fasting): < 13.1pmol/L (Keller T et al., JACC 2010; 55(19):2096-2106)
  • Nephrogenic Diabetes Insipidus (DI):
  • Baseline copeptin ≥21.4 pmol/L in adults with polyuria-polydipsia syndrome had 100% sensitivity (sens) and specificity (spec) (Timper K et al., JCEM 2015; 100(6):2268-2274)
  • Central DI:
    • Following hypertonic saline infusion, copeptin ≤ 4.9 pmol/L identified complete/partial central DI (vs. primary polydipsia (PP)) with 93% sens and 100% spec (Fenske W et al., NEJM 2018; 379:428-439)
    • At 60 min following arginine stimulation, copeptin ≤3.8 pmol/L identified complete/partial central DI (vs. PP) with 93% sens and 92% spec (Winzeler B et al., Lancet 2019; 394(10198):587-595)
    Pediatric (< 18 years):
  • Reference Intervals (Non-Stimulated, Non-Fasting): <14.5 pmol/L (Du J-M et al., Peptides 2013; 45:61-65)
  • Copeptin may be elevated at birth (< 3 days) with perinatal stress (Burckhardt M-A et al., JCEM 2014; 99(9):E1750-E1753)
  • Baseline Copeptin in Children with Polyuria-Polydipsia Syndrome:
  • Nephrogenic DI: > 20 pmol/L
  • Central DI: ≤ 3.5 pmol/L had 100% sens and 87% spec (so central DI excluded at > 3.5 pmol/L); ≤ 1.1 pmol/L had 29% sens and 100% spec (so PP excluded)(Bonnet L et al., ClinEndo 2022; 96:47-53)
  • Stimulated Copeptin in Children (e.g. Arginine, Water Deprivation, or Hypernatremia):
  • Complete Central DI: ≤ 3.5 pmol/L
  • Partial or Complete Central DI: ≤4.9 pmol/L
  • Sens 88-100%, spec 66-80% (Binder G et al., ClinEndo 2023; 98:548-553; Tuli G et al., ClinEndo 2018; 88:873-879; Al Nofal A et al., JPEM 2023; 36(5):492-499)

Sample Reports

Copeptin (Adult)
Copeptin (Pediatric)
Copeptin (age not provided)

Test Location

London Health Sciences Centre, 339 Windermere Road, London ON N6A 5A5

Test Version

27-Oct-2023

Interface / Setup

HL7 Interface Codes

Order Code Result Codes Units
COPEPTIN 62877COPEPTIN pmol/L
65174Copeptin Interpretation

Sample Reports

Copeptin (Adult)
Copeptin (Pediatric)
Copeptin (age not provided)

Test Version

27-Oct-2023