Diabetes And Kidney Disease
About 20 to 30 per cent of people with diabetes develop a type of kidney disease called diabetic nephropathy. This is a serious disease and may worsen other diabetic complications such as nerve and eye damage, as well as increasing the risk of cardiovascular disease.
Diabetic nephropathy is the main cause of kidney failure .
What To Watch For
Kidney disease gets worse over time as waste and fluid build up in your body. Here are the warning signs:
- Changes in your urine. You might pee more or less than normal. Or you could notice a change in color or that your pee is foamy. This means that protein is seeping out of your kidneys. Blood in the urine is another sign.
- Dry and itchy skin. This can happen when your kidneys are no longer able to balance the minerals and nutrients in your blood.
- Swelling. Your kidneys help even out the amount of sodium in your body. When theyâre not working well, your body hangs on to extra salt. This can cause puffy skin around your ankles and feet. You may also notice it in your hands or around your eyes.
- Upset stomach. Built-up waste in your blood can cause nausea and loss of appetite.
- Fatigue. Your kidneys produce a hormone that tells your body to make red blood cells that carry oxygen throughout your body. If theyâre not working right, this doesnât get done, and you can have a health problem called anemia. You may feel tired, even after you rest. Your sleep quality may suffer, too.
What Happens If You Have Kidney Disease
Kidney disease can be treated. The sooner you know you have kidney disease, the sooner you can get treatment to help delay or prevent kidney failure. Treating kidney disease may also help prevent heart disease.
Treatment goals are to:
- If you smoke, take steps to quit.
- Take medicines the way your provider tells you to.
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What Do The Results Of My Kidney Function Test Mean
Interpreting blood test results can be difficult. Your doctor or nurse will contact you if there is anything that needs discussing or further action is needed. Increased creatinine levels in your blood suggest diseases that affect kidney function such as:
- diabetic kidney disease
- urinary tract obstruction, or reduced blood flow to your kidneys due to shock, dehydration, congestive heart failure, atherosclerosis or complications of diabetes.
High urea levels suggest impaired kidney function. This may be due to acute or chronic kidney disease. However, there are many things besides kidney disease that can affect urea levels, such as dehydration, decreased blood flow to your kidneys as in congestive heart failure, shock, stress, recent heart attack or severe burns, bleeding from your gastrointestinal tract, conditions that cause obstruction of urine flow.
Total Iron Binding Capacity
Iron is transported in your blood bound to a protein called transferrin. Transferrin transports the iron in your body from the iron storage sites to where it is needed. It also transports the iron when not needed back to the storage sites. A low TIBC suggests malnutrition or iron excess. A high TIBC suggest iron deficiency.
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Who Needs A Kidney Test
The chances of developing kidney disease increase as you get older. If you’re male and if you’re black or south Asian you’re also more likely to develop kidney disease.
Visit your GP for a kidney test if you have:
Imaging Tests For Kidney Disease
Tests that create various pictures or images may include:
- x-rays to check the size of the kidneys and look for kidney stones
- cystogram a bladder x-ray
- voiding cystourethrogram where the bladder is x-rayed before and after urination
- ultrasound sound waves are bounced off the kidneys to create a picture. Ultrasound may be used to check the size of the kidneys. Kidney stones and blood vessel blockages may be visible on ultrasound
- computed tomography x-rays and digital computer technology are used to create an image of the urinary tract, including the kidneys
- magnetic resonance imaging a strong magnetic field and radio waves are used to create a three-dimensional image of the urinary tract, including the kidneys.
- radionuclide scan.
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How Is A Renal Panel Different From A Kidney Profile Test
The renal panel and kidney profile are designed to assess kidney health. However, there are important differences between them.
The renal panel is only a blood test, and it includes a combination of measurements that can vary based on the laboratory.
In contrast, the kidney profile is a standardized series of two different tests. It includes a blood test for the estimated glomerular filtration rate and a urine test to measure albumin and the albumin-to-creatinine ratio.
While eGFR is calculated on some renal panel tests, it is always included in the kidney profile test. The kidney profile also adds a second test component by measuring urine albumin, which can be an indicator of chronic kidney disease.
This specific two-part kidney profile test was formalized in 2018 through collaboration by professional medical organizations, advocacy groups, and laboratories to enhance the detection of kidney disease. When appropriate, the kidney profile can be ordered along with a renal panel to obtain a wider range of measurements related to kidney health.
Urine Tests For Kidney Disease
Damaged or inflamed kidneys leak substances such as blood or protein into the urine. The preferred test for detecting protein in the urine is a urine albumin-to-creatinine ratio test, which shows the amount of albumin in the urine.
A urine ACR test should be done at least once a year if the person has diabetes or high blood pressure, and every two years if the person has any of the other identified risk factors for developing chronic kidney disease.
A urine ACR test is performed by sending a sample of your urine to a laboratory for analysis.
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Kidney Disease And Cardiovascular Risks
Cardiovascular disease is the most common cause of death in people with chronic kidney disease. Compared to the general population, people with chronic kidney disease are two to three times more likely to have cardiovascular problems such as:
This increased risk is partly caused by factors common to both chronic kidney disease and cardiovascular disease, such as high blood pressure. However, researchers are discovering that chronic kidney disease is, in itself, an important risk factor for the development of cardiovascular disease, and a history of cardiovascular disease is a risk factor for the development of chronic kidney disease.
The kidneys regulate water and salts, remove certain wastes and make various hormones. Kidney disease increases the risk of cardiovascular disease in many ways, including:
Treatment For Kidney Disease
If detected early enough, the progress of kidney disease can be slowed and sometimes even prevented. In the early stages, changes to diet and medication can help to increase the life of your kidneys.
If kidney function is reduced to less than 10 per cent of normal, the loss of function must be replaced by dialysis or a kidney transplant. Dialysis is a treatment for kidney failure that removes waste products and extra water from the blood by filtering it through a special membrane .
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Other Tests Of Kidney Function
The routine kidney blood test is a general marker of kidney function. If the blood test is abnormal it cannot say what is causing the kidney problem. Therefore, if you have an abnormal result you may need further tests to find the cause of a kidney problem. For example: urine tests, other blood tests, scans, X-rays, kidney biopsy, etc.
Are All Renal Panel Tests The Same
It is common for there to be some variation in the individual components of a renal panel based on the specific laboratory that performs your test. However, some test elements, such as the electrolytes, glucose, calcium, phosphorus, and albumin are found on the most common renal panel tests offered by major laboratories.
In addition, your doctor can request that other specific measurements be included with your renal panel. You will see a line item for each component when you review your test report, and your doctor can explain the significance of each component and the results in the context of your health situation.
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Why Do Some Blood Tests Require Fasting
Everything you eat and drink contains vitamins, proteins, and other nutrients that can cause the related levels in your blood to temporarily spike or drop.
Fasting for 812 hours helps ensure that blood test results are free from these variables, making your test results as accurate as possible.
Some common tests that may require fasting include:
- cholesterol tests
Results may take anywhere from a few hours to a few days to become available. Heres an overview of how long some common tests may take:
- complete blood count : 24 hours
- basic metabolic panel: 24 hours
- complete metabolic panel: 2472 hours
- lipid panel: 24 hours.
This can depend on the specific lab where you get tested or how many tests you get done at once. If you order multiple tests, you may not get the complete results until all of the tests are completed.
Sometimes a lab will only release results to your doctor, who reviews them and then releases them to you.
How Is A Normal Blood Test Done
A blood test is usually done in a lab or doctors office and only takes a few minutes. To perform a blood test, nurse or laboratory technician:
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High Blood Pressure And Kidney Disease
High blood pressure is increased pressure inside the arteries that carry blood from your heart to all parts of your body. Untreated, high blood pressure can damage your kidneys.
Also, high blood pressure can develop as a result of kidney disease or renal artery stenosis . Your kidneys control the amount of fluid in your blood vessels and produce a hormone called renin that helps to control blood pressure.
A Negative Test Result Is Usually Good News
Negative is not the same as bad when it comes to blood tests. A negative result means that the test did not detect what it was seeking, whether it was a disease marker or a risk factor for a health condition. When youve had a blood test to check for an infectious disease an interferon gamma release assay for tuberculosis, for example getting back a negative result is good news it means the test found no evidence of an infection.
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What Might These Tests Indicate If My Pet Has Kidney Disease
A) A complete blood count involves the evaluation of the red blood cells, the white blood cells and the platelet components of a single blood sample. A hematology analyzer will provide your veterinarian with the total numbers of these cells, and evaluation of a blood smear will allow a look at the physical characteristics of these cells.
The kidneys produce a substance called erythropoietin that is necessary for proper red blood cell production within the bone marrow. With kidney disease, the amount of erythropoietin produced may be decreased, causing a decrease in red blood cell production. This shows up in the CBC as anemia.
The white blood cell numbers may be increased if the underlying cause of the kidney disease is due to an infection or inflammation.
Rarely, platelet numbers may be reduced if a clotting problem has occurred as a result of the underlying kidney disease.
B) The serum biochemistry profile requires a separate blood sample from which the serum is separated from the cellular portion of blood. Serum contains many substances including enzymes, proteins, lipids , glucose and metabolic waste products.
Of most importance in the diagnosis of kidney disease are the determination of the levels of two substances, namely blood urea nitrogen and creatinine.
Increases in BUN and creatinine may be seen with kidney disease, as well as with dehydration and other causes of reduced blood flow to the kidneys.
“Severe increases in potassium may cause cardiac arrhythmias.”
How Is A Renal Panel Test Different From A Creatinine Clearance Test
A creatinine clearance test includes both a blood and urine sample. The amount of creatinine is measured in each sample, and then the two figures are compared. This comparison provides a method for estimating the glomerular filtration rate and evaluating kidney function.
In contrast, a renal panel uses only a blood sample. While a standard renal panel measures creatinine in the blood, it does not include a urine collection or comparative measurement.
The renal panel also includes a more diverse set of measurements, including proteins, minerals, and electrolytes, than a creatinine clearance test.
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Four Key Concepts And Talking Points
1. Talk to patients about their kidneys, CKD, and their risk.
What is CKD? CKD means the kidneys are damaged and may no longer filter blood well. This damage happens over many years. As more damage occurs, the kidneys are unable to keep the body healthy – then dialysis or a kidney transplant may be needed to maintain health.
How can I lower my risk for CKD? The steps you take to manage your diabetes and high blood pressure also help protect your kidneys. Choosing healthy foods, quitting smoking, and being more physically active are all important steps.
2. Communicate the importance of testing and how CKD is diagnosed.
What are the symptoms of CKD? Most people with CKD have no symptoms until their kidneys are about to fail. The only way to know if you have kidney disease is to get tested. The sooner kidney disease is found, the sooner you can take steps to begin treatment and keep your kidneys healthier longer.
How do you check for CKD? A blood test and a urine test are used to find kidney disease. Because you are at risk, you should get these tests regularly:
- GFR – A blood test measures how much blood your kidneys filter each minute, which is known as your glomerular filtration rate .
- Urine Albumin – A urine test checks for albumin in your urine. Albumin is a protein that can pass into the urine when the filters in the kidneys are damaged.
3. Explain the progressive nature of CKD and the basics of treatment.
4. Begin to speak about dialysis and transplantation.
Imaging Tests To Look For Kidney Cancer
Imaging tests use x-rays, magnetic fields, sound waves, or radioactive substances to create pictures of the inside of your body. Imaging tests are done for a number of reasons, such as:
- To look at suspicious areas that might be cancer
- To learn how far cancer might have spread
- To help determine if treatment is working
- To look for possible signs of cancer coming back after treatment
Unlike most other cancers, doctors can often diagnose kidney cancer with fair certainty based on imaging tests without doing a biopsy . Some patients, however, may need a biopsy.
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Signs Of Kidney Disease
Questions For Your Doctor About Test Results
When your test results are ready, you can learn more about their significance by discussing them with your doctor. Some questions that you can ask include:
- Were there any abnormal findings on my renal panel test? If so, what were they?
- For any abnormal findings, can you explain what might be the cause?
- Are there any follow-up tests that are warranted based on my renal panel test?
- Should I take this test again? If so, when?
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