If a specimen appears to be moderately lipemic, which analytes can still be run?

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Lipemia makes specimens turbid and can throw off many tests, especially those that rely on light transmission or on assuming a clear aqueous phase. Ion-selective electrodes come in two forms: direct and indirect. In a lipemic sample, the dilution step used in indirect ISE helps minimize the impact of turbidity because the lipid-rich matrix is further diluted and the measurement depends on ion activity in the diluted aqueous portion. With moderate lipemia, the instrument’s calibration for the diluted matrix allows Na, Cl, and K to be measured reliably, so these electrolytes can still be run. Tests like total protein and albumin, or enzyme assays such as amylase and lipase, are more susceptible to turbidity and matrix effects from lipids, making them less reliable in a lipemic specimen.