How Is A Urine Test Used To Diagnose Kidney Disease
Urinalysis, the testing of urine, may be necessary in the evaluation of kidney and urinary tract disorders. A urine sample is usually collected using the clean-catch method or another sterile method. For example, a method to obtain an uncontaminated urine sample involves passing a catheter through the urethra into the bladder.
Diabetes And Kidney Failure
Diabetes is the most common cause of kidney failure. Uncontrolled high blood sugar can damage kidneys. The damage can become worse over time.
Diabetic nephropathy, or kidney damage caused by type 1 or type 2 diabetes, cant be reversed. Managing blood sugar and blood pressure can help reduce damage. Taking medicines prescribed by your doctor is important, too.
If you have diabetes, your doctor will likely perform regular screenings to monitor for kidney failure.
Is A Kidney Transplant An Option
If kidney failure occurs and is non-reversible, kidney transplantation is an alternative option to dialysis. If the patient is an appropriate candidate, the healthcare professional and nephrologist will contact an organ transplant center to arrange evaluation to see whether the patient is suitable for this treatment. If so, the search for a donor begins. Sometimes, family members have compatible tissue types and, if they are willing, may donate a kidney. Otherwise, the patient will be placed on the organ transplant list that is maintained by the United Network of Organ Sharing.
Not all hospitals are capable of performing kidney transplants. The patient may have to travel to undergo their operation. The most successful programs are those that do many transplants every year.
While kidney transplants have become routine, they still carry some risk. The patient will need to take anti-rejection medications that reduce the ability of the immune system to fight infection. The body can try to reject the kidney or the transplanted kidney may fail to work. As with any operation, there is a risk of bleeding and infection.
Kidney transplants may provide better quality of life than dialysis. After one year, 95% of transplanted kidneys are still functioning and after five years, the number is 80%. It seems that the longer a patient is on dialysis, the shorter the life of the transplanted kidney.
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Can Kidney Failure Be Prevented
While kidney failure from chronic kidney disease cant be reversed, you can do many things to help preserve the kidney function you have today. Healthy habits and routines may slow down how quickly kidneys lose their functional abilities.
If you have chronic kidney disease or kidney failure, youll want to:
- Monitor your kidney function, with your doctors help.
- Keep your blood sugar levels under control, if you have diabetes.
- Keep your blood pressure levels in a normal range.
- Avoid smoking.
- Make healthy diet choices, such as limiting foods high in protein and sodium.
When To Get A Urine Culture During Pregnancy
Pregnant women without any symptoms are recommended to be screened with a urine culture early in their pregnancy or during the first prenatal visit for bacteria in their urine. What does the test result mean?
Its a test to check for germs or bacteria in your pee that can cause a urinary tract infection . Your urinary tract includes the kidneys, bladder, and the tubes that carry your pee . An infection usually starts in the bladder or urethra . But it can affect any part of this system.
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Test Results And Stages Of Ckd
Your test results can be used to determine how damaged your kidneys are, known as the stage of CKD.
This can help your doctor decide the best treatment for you and how often you should have tests to monitor your condition.
Your eGFR results is given as a stage from 1 of 5:
- stage 1 a normal eGFR above 90ml/min, but other tests have detected signs of kidney damage
- stage 2 a slightly reduced eGFR of 60 to 89ml/min, with other signs of kidney damage
- stage 3a an eGFR of 45 to 59ml/min
- stage 3b an eGFR of 30 to 44ml/min
- stage 4 an eGFR of 15 to 29ml/min
- stage 5 an eGFR below 15ml/min, meaning the kidneys have lost almost all of their function
Your ACR result is given as a stage from 1 to 3:
- A1 an ACR of less than 3mg/mmol
- A2 an ACR of 3 to 30mg/mmol
- A3 an ACR of more than 30mg/mmol
For both eGFR and ACR, a higher stage indicates more severe kidney disease.
Risk Factors And Medical History
Your risk of kidney disease increases as you age. Having or also raises your risk. So does having close relatives who’ve had .
Other conditions that could affect your kidneys include:
Diseases that cause inflammation or damage to the kidneys, such as
Inherited diseases, such as , which causes large cysts to form in the kidneys
Diseases that affect the immune system, such as
Conditions that cause blockages in the urinary tract, such as , tumors or an gland
If you have any of these risk factors, your doctor may routinely screen you for kidney disease. That lets your doctor find it as early as possible and slow down its progress.
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Tips For Managing End
There are several different ways you can help a loved one manage their end-stage kidney failure symptoms. Perhaps the most valuable thing you can do is listen to your loved one and try as best you can to address their issues. However, if at any time you are unsure of how you can help, or if the patient is unable to communicate effectively, we recommend contacting their primary care physician.
The Effects Of Kidney Disease
Over time, high blood sugar levels can damage tiny blood vessels in your kidneys, which means they cannot filter your blood properly.
As a result, tiny particles of protein spill into the urine this is called microalbuminuria. As kidney disease progresses, larger amounts of protein spill into the urine this condition is called proteinuria.
As kidney disease progresses, waste products start to build up in your blood because your body can’t get rid of them. If left untreated, your kidneys will eventually fail and dialysis or a kidney transplant will be required.
Diabetes can also affect the nerves that tell you when your bladder is full. The pressure from a full bladder can damage the kidneys. If urine remains in the bladder for a long time, it can increase your risk of developing a urinary tract infection, which can spread to the bladder.
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Causes Of Kidney Failure
Some of the causes of kidney failure include:
- diabetes even if it is well managed, diabetes can cause kidney damage
- glomerulonephritis swelling or inflammation of the tiny filtering units in the kidney. Also known as nephritis
- polycystic kidney disease an inherited condition that causes thousands of cysts to form in the kidneys
- urinary reflux a bladder-valve problem that allows urine to flow back into the kidneys, causing scarring
- medications some drugs such as lithium and cyclosporin can cause kidney failure. Continued misuse of compound analgesic preparations was once a common cause of permanent kidney damage. Non-steroidal anti-inflammatory drugs , taken in normal therapeutic doses, may occasionally cause acute kidney failure
- medullary cystic kidney disease an inherited kidney disease that leads to the kidneys gradually losing their ability to work properly due to cysts in the centre of the kidneys.
What Is Kidney Failure
The kidneys are designed to maintain proper fluid balance in the body, remove waste and eliminate toxins from the blood. The kidneys make urine, which carries away those products of elimination and excess fluid. They also make hormones, which stimulate the making of red blood cells in the bone marrow and strengthen the bones. The term kidney failure describes a situation in which the kidneys have lost the ability to effectively carry out these functions. A build-up of waste levels can cause a chemical imbalance in the blood, which can be fatal if left untreated. Patients with renal failure may develop a low blood count or weak bones over time. Chronic renal failure can be caused by a variety of diseases and means failure of kidney function over time.
Other conditions can result in acute kidney failure, such as a drop in blood flow to the kidneys, blockage of urine flow, or damage from infections, certain medications or contrast materials used in imaging. Acute kidney failure can occur quickly and may leave the kidneys with permanent damage. In many cases, it occurs in patients who are already critically ill and require intensive care.
Symptoms may include:
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Detection And Evaluation Of Chronic Kidney Disease
SUSAN SNYDER, M.D., and BERNADETTE PENDERGRAPH, M.D., Harbor-University of California, Los Angeles Medical Center, Torrance, California
Am Fam Physician. 2005 Nov 1 72:1723-1732.
Patient information: See related handout on chronic kidney disease, written by the authors of this article.
SORT: KEY RECOMMENDATIONS FOR PRACTICE
All adults with risk factors for chronic kidney disease should be screened with a serum creatinine determination for GFR estimation and analysis of a random urine sample for proteinuria.
|Clinical recommendation||Evidence rating||References|
Instead of a timed urine collection, a random urine sample for the microalbumin-creatinine or protein-creatinine ratio should be used to quantify proteinuria.
Interventions proved to slow the progression of chronic kidney disease include blood pressure control, glycemic control, and reduction of proteinuria with an angiotensin-converting enzyme inhibitor or angiotensin-II receptor blocker.
A low-density lipoprotein goal of less than 100 mg per dL is recommended for patients with chronic kidney disease, because these patients are statistically at highest risk for cardiovascular disease.
A blood pressure goal of 130/80 mm Hg is recommended in patients with normal urinary albumin concentrations, and a blood pressure goal of 125/75 mm Hg is recommended in patients with proteinuria equal to or greater than 1 g per 24 hours.
GFR = glomerular filtration rate.
SORT: KEY RECOMMENDATIONS FOR PRACTICE
How Is A Renal Panel Test Different From An Estimated Glomerular Filtration Rate Test
The renal panel is a broader test than an estimated glomerular filtration rate test, and in some cases, a renal panel involves eGFR.
The estimated glomerular filtration rate is a common method of evaluating kidney function. It can be calculated in several different ways and reflects how much blood is being filtered by the kidneys every minute.
The eGFR is usually determined with a mathematical formula based primarily on the amount of creatinine in the blood. Because creatinine is measured in most renal panels, the test report may also list eGFR. However, the renal panel also measures electrolytes, minerals, and other substances that can reflect the status of the kidneys.
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Acute Intrinsic Kidney Failure
Acute intrinsic kidney failure can result from direct trauma to the kidneys, such as physical impact or an accident. Causes also include toxin overload and ischemia, which is a lack of oxygen to the kidneys.
The following may cause ischemia:
- severe bleeding
There are several tests your doctor can use to diagnose kidney failure.
What Can I Expect If I Have Kidney Disease
If you have kidney disease you can still live a productive home and work life and enjoy time with your family and friends. To have the best outcome possible, its important for you to become an active member of your treatment team.
Early detection and appropriate treatment are important in slowing the disease process, with the goal of preventing or delaying kidney failure. You will need to keep your medical appointments, take your medications as prescribed, stick to a healthy diet and monitor your blood pressure and blood sugar.
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When Should I Call The Doctor
A nephrologist receives special training in kidney evaluation and treatment. You may benefit from a kidney specialists expert opinion if:
- You have trouble keeping your blood pressure levels in a normal range, even with medication.
- Your blood sugar levels fluctuate widely.
Last reviewed by a Cleveland Clinic medical professional on 01/11/2018.
What Does The Test Measure
A renal panel includes multiple measurements. However, not all renal panel tests are exactly the same. The components can depend on the laboratory or the measurements requested by the doctor prescribing the test.
The most common components tested in most renal panels include:
Other measurements that may also included in a renal panel include:
- Anion gap: The anion gap is a comparison of different electrolytes. Specific electrolytes can be positively or negatively charged, and this test assesses the balance between the two types. This measurement helps determine if you have too much or too little acid in your blood.
- Estimated glomerular filtration rate : The eGFR is an evaluation of kidney function. Glomeruli are tiny filters in the kidneys, and the eGFR is a calculation of how much blood they are filtering every minute. There are different ways to calculate eGFR, but most tests use a special formula based on your creatinine level.
- Total protein: There are several kinds of proteins that can be found in the blood, and total protein is a count of all of them. These proteins include albumin and multiple types of globulins, which are made by the immune system.
- BUN-to-creatinine ratio: In some cases, comparing the amounts of the waste products BUN and creatinine can provide information about whether abnormal levels are being caused by problems in the kidneys or another part of the body..
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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.
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.”
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How To Get Rid Of Swollen Feet In Kidney Failure
A kidney failure patient becomes a target of various health complications and symptoms that makes it more critical for the patient to survive the disease. Symptoms and complications of kidney failure complicate the journey of the renal failure patient to procure good health and vitality of the kidneys.
One of the common symptoms that occur in episodes of every kidney harming disease is Edema. Edema is a condition that depicts swelling within any part of the human body. When kidney failure occurs, kidneys become unable to filter liquid waste out of the body due to insufficient filtration. Excess fluids accumulate in the body tissues leading to pain and inflammation in various parts of the body.
According to Ayurveda, the human body is a combination of three vital doshas- Vata, pitta, and Kapha. Edema is known as Shotha in Ayurveda, and it is stated as a Kapha type of disorder.
Kidney failure treatment in Ayurveda can help reduce the inflammation in the body using natural healing capabilities. The amalgamation of authentic kidney-friendly herbs reduces the rate of accumulation of excess fluids in the tissues.
However, underlying ayurvedic herbal medicines provided in kidney failure treatment in Ayurveda can help reduce swelling in the affected parts of the body.
How Is Urine Concentration Measured In Kidney Failure
The kidneys lose their capacity to concentrate urine at an early stage of a disorder that leads to kidney failure. In one special test, a person drinks no water or other fluids for 12 to 14 hours. In another test, a person receives an injection of vasopressin . Afterward, urine concentration is measured.
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