What Level Should Your Kidney Function Be

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.

Feeling Tired Or Sluggish During The Day

Everyone has a day when they feel tired maybe you didnt get enough sleep, or ate the wrong foods, or some other temporary factors are at play. But sometimes, fatigue is caused by lack of a hormone called erythropoietin, or EPO. The main function of EPO is to stimulate the production of red blood cells, and red blood cells carry energizing oxygen to cells throughout your body.

Stressed kidneys do not produce enough EPO, thereby reducing the number of red blood cells and making you feel weak and tired out.

Why Creatinine Tests Are Done

Doctors use creatinine and creatinine clearance tests to check how well your kidneys work. This is called renal function. Testing the rate of creatinine clearance shows the kidneys’ ability to filter the blood. As renal function gets worse, creatinine clearance also goes down. Your doctor may also order a creatinine test if you have symptoms of kidney disease, including:

• Nausea

• Changes in how much you pee

• Swollen feet and ankles

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What Happens During The Creatinine Clearance Test

You will do the creatinine clearance test over 24 hours. During this time, you will collect your urine each time you urinate. This will give your healthcare provider a good idea of your creatinine levels throughout the entire day.

Make sure to follow the directions from your healthcare provider closely. These instructions will include details about how to store your urine sample and where you will take it when the test is over.

After 24 hours of collecting your urine, you will need to have your blood drawn. This second part of the test looks at the amount of creatinine in your bloodstream. This is called serum creatinine. Your results from both of these tests will be plugged into a mathematic formula that determines your creatinine clearance. This rate tells your provider just how well your kidneys are filtering waste products out of your bloodstream.

Patients On Dialysis Can Replenish Lost Nutrients With Over

Patients on dialysis need to follow a restricted diet, which may cause them to be deficient in certain nutrients. However, it is not a good idea to try to replenish those nutrients with over-the-counter vitamin and mineral supplements. Many supplements contain vitamins and minerals that can be harmful to patients on dialysis. A doctor can prescribe supplements that are appropriate.

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What Are High And Low Creatinine Levels

A high creatinine level is typically anything over 1.3 .

Certain conditions may cause a person to have higher than normal levels of creatinine.

• People with only one kidney may have a normal creatinine level of about 1.8 or 1.9.
• Creatinine levels of 2.0 or more in infants and 5.0 or more in adults may indicate severe kidney damage.
• People who are dehydrated may have elevated creatinine levels.

Low creatinine levels are often seen in patients with low muscle mass and are not usually considered a serious medical problem.

• Limit alcohol intake.

If creatinine levels are elevated from dehydration, rehydration is needed either via oral fluids or intravenously.

Medications that cause high creatinine levels may need to be changed or stopped. Talk to your doctor before altering or stopping any medications.

Other than for trying to increase muscle mass in general, low creatinine levels usually do not require treatment.

Additional Tests For Kidney Disease

If blood and urine tests indicate reduced kidney function, your doctor may recommend additional tests to help identify the cause of the problem.

Renal Imaging

Methods of renal imaging include ultrasound, computed tomography , and magnetic resonance imaging . These tools are most helpful in finding unusual growths or blockages to the flow of urine.

Renal Biopsy

Your doctor may want to see a tiny piece of your kidney tissue under a microscope. To obtain this tissue sample, the doctor will perform a renal biopsya hospital procedure in which the doctor inserts a needle through your skin and into the kidney. The needle retrieves a strand of tissue about 1/2 to 3/4 of an inch long. For the procedure, you will lie on your stomach on a table and receive local anesthetic to numb the skin. The sample tissue will help the doctor identify the cause and severity of your kidney disease.

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Who Should Be Tested For Ckd

See your GP if you have persistent symptoms of CKD, such as:

• weight loss or poor appetite
• swollen ankles, feet or hands
• peeing more than usual, particularly at night

Your GP can look for other possible causes and arrange tests if necessary.

Because CKD often has no symptoms in the early stages, some people at a higher risk should be tested regularly.

Regular testing is recommended if you have:

• diabetes
• acute kidney injury sudden damage to the kidneys that causes them to stop working properly
• cardiovascular disease conditions that affect the heart, arteries and veins, such as coronary heart disease or heart failure
• other conditions that can affect the kidneys such as kidney stones, an enlarged prostate or lupus
• a family history of advanced CKD or an inherited kidney disease
• protein or blood in your urine where there’s no known cause

You’re also more likely to develop kidney disease if you’re black or of south Asian origin.

People taking long-term medicines that can affect the kidneys, such as lithium, omeprazole or non-steroidal anti-inflammatory drugs , should also be tested regularly.

Talk to your GP if you think you may need regular testing for kidney disease.

National Kidney And Urologic Diseases Information Clearinghouse

3 Information Way Phone: 18008915390 Fax: 7037384929 Internet: www.kidney.niddk.nih.gov/ The National Kidney and Urologic Diseases Information Clearinghouse is a service of the National Institute of Diabetes and Digestive and Kidney Diseases . The NIDDK is part of the National Institutes of Health of the U.S. Department of Health and Human Services. Established in 1987, the Clearinghouse provides information about diseases of the kidneys and urologic system to people with kidney and urologic disorders and to their families, health care professionals, and the public. The NKUDIC answers inquiries, develops and distributes publications, and works closely with professional and patient organizations and Government agencies to coordinate resources about kidney and urologic diseases. Publications produced by the Clearinghouse are carefully reviewed by both NIDDK scientists and outside experts. This publication was reviewed by Akinlolu Ojo, M.D., Ph.D., University of Michigan. This publication is not copyrighted. The Clearinghouse encourages users of this publication to duplicate and distribute as many copies as desired.

NIH Publication No. 075390 July 2007

Kidney & Urology Foundation of America104 West 40th Street, Suite 500 | New York NY 10018 | 212.629.977063 West Main Street, Suite G | Freehold, NJ 07728 | 732.866.44441.800.633.6628Kidney & Urology Foundation of America is a national, 501 c not-for-profit organization.©

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Symptoms You Could Experience With Elevated Creatinine And Urea Levels

High creatinine levels can cause you to feel confused, be extremely tired, have difficulty breathing or be dehydrated. High urea levels can produce fatigue, nausea, insomnia, dry skin and body odor. High levels of urea are generally not toxic, but high levels of both of these can indicate that the functioning of your kidneys is poor. If you feel you are having these symptoms, the best way to know if you are having any trouble with your kidneys is to see your doctor so they can test out your kidney function numbers with renal function labs.

Estimating Kidney Function In The Aging Adult

Srinivas Subramanian, MD, Sunil Dhar, MD, Francia Rojas-Delgado, MD, Madhu Kandarpa, MD, Kiran Samindla, MD, and Eric Bloom, MD

Citation:Subramanian S, Dhar S, Rojas-Delgado F, Kandarpa M, Samindla K, Bloom E. Estimating kidney function in the aging adult. Clin Geriatr. 2009 17.

Introduction

It is expected that 1 in 5 persons will be elderly by the year 2030.1 Chronic kidney disease is an important problem in the elderly and is associated with a high risk of kidney failure, cardiovascular disease, and death.2 Among persons age 60-69 years, approximately 18% have albuminuria and 7% have an estimated glomerular filtration rate of less than 60 mL/min/1.73 m2. In persons age 70 years or older, those percentages increase to 30% and 26%, respectively.3 The severity of CKD can be classified according to the level of the GFR, regardless of the cause, as follows3:

Stage 1: Kidney damage with a normal or increased GFRStage 2: Kidney damage with a mild decrease in GFRStage 3: A moderate decrease in GFRStage 4: A severe decrease in GFRStage 5: Kidney failure

According to the National Kidney Foundation, the average estimated GFR in different age groups is3:

• Age 20-29: 116 mL/min/1.73 m2
• Age 30-39: 107 mL/min/1.73 m2
• Age 40-49: 99 mL/min/1.73 m2
• Age 50-59: 93 mL/min/1.73 m2
• Age 60-69: 85 mL/min/1.73 m2
• Age 70 years and older: 75 mL/min/1.73 m2

—–The following case reveals the dilemma that clinicians face when attempting to accurately estimate kidney function in the elderly patient.

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Kidneys Have Lots Of Reserve But Getting Ahead Of Small Decreases In Function Prevents Later Damage

You often hear older people say I have weak kidneys. That doesn’t mean they can’t do their job or are destined to fail. But it does indicate you have some form of chronic kidney disease. The kidneysthe body’s blood-filtering urine factoryhave less capacity to filter toxins from the blood and excrete them in the urine.

Half of U.S. adults over 75 may have below-normal kidney function. Most of them will never get sick from it, unless they have other conditions such as diabetes or uncontrolled hypertension, or take medications that can injure the kidney.

Rhabdomyolysis Symptoms And Causes

What are the symptoms of rhabdomyolysis?

The muscle damage causes inflammation leading to tenderness, swelling, and weakness of the affected muscles. The dark urine color is due to myoglobin being excreted in the urine by the kidney as it tries to rid the body of the muscle breakdown products.

Symptoms related to the expected complications of rhabdomyolysis include:

• symptoms of kidney failure, which may include swelling of the hands and feet
• shortness of breath as excess fluid builds up in the lungs,
• lethargy
• weakness
• symptoms of hyperkalemia such as weakness, nausea, lightheadedness, and palpitations due to heart rhythm disturbances) and
• disseminated intravascular coagulation, a disruption of the normal blood clotting process, may occur as unexplained bleeding.

• Rhabdomyolysis may not cause any symptoms at all.
• Muscle aches and pain , stiffness, and muscle weakness can occur with rhabdomyolysis, and is especially common with severe muscle damage.
• Rhabdomyolysis may cause a darkening of the urine color.
• Myoglobin is released from the muscles when they break down and is excreted into the urine. This can cause a red or cola color of the urine.

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What Is Kidney Glomerular Filtration Rate

Kidney glomerular filtration rate is a test performed by a simple blood test and used to check how well your kidneys are working by estimating how much blood passes through the glomeruli, tiny filters in the kidneys that filter waste from the blood. per minute. Kidney Glomerular Filtration Rate number is considered by medical professionals to be the best measure of your kidney function and it is a key indicator of renal function.

Besides the blood test result other factors are factored in to determine your GFR number. These factors include:

• Age
• Blood Creatinine
• Creatinine Clearance Test

The creatinine clearance test involves urine collection over a 24 hour period and can also provide an estimate of your kidney function. The creatinine clearance test requires a urine sample as well as a blood sample. You collect all your urine for 24 hours and then have a blood test done.

Stages Of Chronic Kidney Disease

About chronic kidney disease

With chronic kidney disease, the kidneys dont usually fail all at once. Instead, kidney disease often progresses slowly years. If caught early, medicines and lifestyle changes may help slow or prevent CKD progression.

Five stages of chronic kidney disease

The National Kidney Foundation divided kidney disease into five stages. This helps doctors provide the best care, as each stage calls for different tests and treatments.

Doctors determine the stage of kidney disease using the glomerular filtration rate , a math formula using a person’s age, gender, and their serum creatinine level . Creatinine, a waste product that comes from muscle activity, is a key indicator of kidney function. When kidneys are working well they remove creatinine from the blood but as kidney function slows, blood levels of creatinine rise.

Use the links below to learn about each stage of kidney disease:

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Should You Check Your Kidney Function

If youre concerned about symptoms that youre experiencing, its important to make a trip to your doctor for a check-up.

If you simply want to know a bit more about your kidney health, you have the option to take a kidney function test from the comfort of your own home. With LetsGetCheckeds Kidney Function Test you can monitor your kidney function and performance and receive your online results within 5 days.

You should consider taking a Kidney Function Test if any of the below are applicable to you:

• You suffer from high blood pressure
• You suffer from diabetes

Understanding Your Lab Values

People who develop chronic kidney disease may have some or all of the following tests and measurements. If you have kidney disease ask your doctor which tests you will have and how often they will be done. Speak to your doctor about your results. If your numbers are not in the normal range, ask how to improve them.

Serum Creatinine: Creatinine is a waste product in your blood that comes from muscle activity. It is normally removed from your blood by your kidneys, but when kidney function slows down, the creatinine level rises. Your doctor should use the results of your serum creatinine test to calculate your GFR.

Glomerular Filtration Rate : Your GFR tells how much kidney function you have. It may be estimated from your blood level of creatinine. If your GFR falls below 30 you will need to see a kidney disease specialist . A GFR below 15 indicates that you need to start a treatment for kidney failure. Your kidney disease specialist will speak to you about treatments for kidney failure, such as dialysis or kidney transplant.

Blood Urea Nitrogen : Urea nitrogen is a normal waste product in your blood that comes from the breakdown of protein from the foods you eat and from your body metabolism. It is normally removed from your blood by your kidneys, but when kidney function slows down, the BUN level rises. BUN can also rise if you eat more protein, and it can fall if you eat less protein.

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What Is Creatinine And Creatinine Clearance

Creatinine is a waste product that your body constantly makes during normal muscle breakdown. Your kidneys filter creatinine from the blood into the urine and reabsorb almost none of it.

The amount of blood the kidneys can make creatinine-free each minute is called the creatinine clearance. Creatinine clearance in a healthy young person is about 95 milliliters per minute for women and 120 mL per minute for men. This means each minute, that person’s kidneys clear 95 to 120 mL of blood free of creatinine. The GFR can vary depending on age, sex, and size. Generally, the creatinine clearance is a good estimation of the glomerular filtration rate.

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 Lab Values Indicate A Need For Concern When Contrast Material Is Injected

Historically serum creatinine was the lab value used to assess kidney function. A better and more accurate measure is a lab result called estimated glomerular filtration rate . eGFR takes into account the serum creatinine value and also patient age, race and gender which affect kidney function results. At UCSF we use this very accurate blood test to assess kidney function and it can be obtained quickly, right before a scan. For CT, eGFR > 45 indicates no increased risk of kidney damage from contrast material. eGFR > 30, but less than 45 indicates that while it is safe to get contrast material, there is a small risk of causing kidney damage. In that situation, we will inject additional fluid into the patients vein before and after the contrast material injection. This hydration is effective to prevent any renal damage. For MRI, it is safe to give a regular dose of contrast material as long as the patients eGFR is > 30.