The Amount Of Urine I Produce Has Not Decreased Doesnt That Mean My Kidneys Are Functioning Alright
The kidneys still produce the same amount of urine up to â and even after â a patient with kidney failure first starts dialysis. Kidney function is described using the term âglomerular filtration rate,â or GFR. The GFR in a person with normal kidney function is 120 milliliters per minute. This means that each minute 120 milliliters is filtered from the blood into the kidneys. After three minutes, the amount filtered by the kidneys from the blood is about the same amount of fluid as in a can of soda. Over a 24-hour period, the total fluid filtered by the kidneys from the blood in a patient with normal kidney function is roughly 50 gallons! Of course, people do not produce 50 gallons of urine per day. That is because the kidneys reclaim over 99% of the water and minerals filtered by the kidney into roughly two quarts of urine. Therefore, a patient with kidney function that is 20% of normal will still filter 10 gallons of fluid from the blood per day. That person still produces two quarts of urine just like someone with normal kidney function, but only eliminates 20% of the kidney poisons in the urine compared to a person with normal kidney function.
Counting Blood Cells And Components
Problems such as anaemia and infection can be detected by counting amounts of these blood components in a blood sample:
- haemoglobin normal levels are approximately 110-180 grams/litre in men and 115-165 grams/litre in women
- white blood cells a normal count is approximately 4-11 thousand million per litre
- platelets a normal count is approximately 150-350 thousand million per litre
- albumin normal levels are 35-45g/litre.
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Blood Urea Nitrogen Test
The blood urea nitrogen test checks for other waste products in the blood, such as urea nitrogen.
Urea nitrogen occurs as proteins from food break down, and elevated levels may be a sign that the kidney is not filtering these waste products effectively.
A typical BUN level falls between 7 and 20 milligrams per deciliter. Higher values could be a sign of an underlying condition affecting the kidneys.
With that said, many other things can affect BUN levels, such as medications or antibiotics. A diet that is very high in protein diet may also affect levels.
Doctors will typically compare these results to the results of a creatine test to get a better understanding of how well the kidney is filtering this waste.
Imaging tests may help doctors identify any physical changes to the kidneys, such as injuries or kidney stones.
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Take Care Of Your Kidneys
Not all people with kidney disease progress to kidney failure. Follow these tips to help lower your risk for developing kidney failure:
- Keep your blood pressure below 140/90 .
- If you have diabetes, stay in your blood sugar range as much as possible.
- Work with your health care team to monitor your kidney health.
- Take medicines as prescribed.
- Work with a dietitian to develop a kidney-healthy eating plan. If you have diabetes, find tips on how to eat well to manage both diabetes and CKD.
- Get activephysical activity helps control blood pressure and blood sugar levels. Learn about the many benefits of physical activity.
Why Might I Need A Kidney Function Test
Some conditions, such as diabetes or high blood pressure , affect how well the kidneys work. If you have one of these conditions, your healthcare provider may use kidney function tests to help monitor these conditions.
You may also need a kidney function test if you have symptoms that indicate possible kidney problems. These symptoms might include:
- Blood in your urine .
- Problems with starting to pee.
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How Is Estimating Gfr Different From Measuring Gfr
There are different ways to assess the glomerular filtration rate, and estimating GFR is distinct from directly measuring GFR.
Measuring GFR is possible by infusing a substance, such as a compound called inulin or certain radioisotopes, into the blood and seeing how quickly it is cleared by the kidneys. While more accurate, this type of testing is expensive and requires more specialization, reducing its ability to serve as a widespread method of assessing kidney function.
Accordingly, direct GFR measurement is reserved for particular situations, and tests that estimate GFR based on creatinine or cystatin C are much more frequently used.
What Do Abnormal Creatinine Levels Mean
So, you went to the doctor, did the tests, and the results are in: You have high creatinine levels. Now what? Step onedont panic. Elevated creatinine doesnt necessarily mean your kidneys are in a downward spiral. Anything outside the normal range may cause a healthcare provider to investigate further, but doesnt always spell danger. Numerous factors can influence your test results. Here are just a few:
- Increased exercise: Have you been on a fitness kick? In the gym every day? This spike in muscle breakdown will increase the production of creatinine.
- Increased protein consumption: Cooked meats contain creatinine, so if youre feasting on steak and roast chicken every night, you could see higher levels.
- Urinary tract blockage: If you cant urinate, your body cant eliminate creatinine, so kidney stones and other urinary disruptions will allow it to remain in your bloodstream.
- Certain medications: Sometimes, drugs can be the culprit. The antibiotic trimethoprim and Cimetidine, a stomach ulcer and heartburn medication, can inhibit creatinine secretion. Sometimes, non-steroidal anti-inflammatory drugs , such as ibuprofen, can also be a cause.
- High blood pressure:Studies have also shown that hypertension, heart failure, and other heart conditions can cause increased creatinine levels.
Likewise, low creatinine isnt always dangerous. It could be the result of low muscle mass , pregnancy, a low-protein diet, or certain liver conditions.
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How Does The Egfr Number Relate To Kidney Disease
Your provider may diagnose chronic kidney disease when your eGFR stays below 60 for three months in a row.
There are five stages:
- Stage 1 indicates mild kidney damage, but your kidneys are working well.
- Stage 2 indicates an increase in kidney damage from stage 1, but the kidneys continue to function well.
- Stage 3 means you have decreased kidney function and may experience symptoms.
- Stage 4 is poor kidney function, with moderate to severe kidney damage.
- Stage 5 is a sign of kidney failure. It means you have less than 15% kidney function. This stage is the most serious and can be life-threatening. You will need dialysis or a kidney transplant.
Stage 3a & 3b Kidney Disease
Moderate decrease in GFR
GFR LEVEL: 30 TO 59 mL/min
Stage 3 CKD, a moderate decrease in kidney function, is divided into 3A and 3B . The following can occur when someone is in stage 3 of CKD:
- Waste products build up in the blood.
- Symptoms include fatigue, too much fluid, urination changes, sleep problems and kidney pain.
- You can often manage stage 3 by changing to a kidney-friendly diet plan as well as managing high blood pressure and diabetes.
- Visit your doctor or nephrologist to help manage kidney disease through kidney-friendly living habits and possibly with prescription medication.
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Calculating Your Glomerular Filtration Rate
What Stage Am I In?
There are five stages of kidney disease. Your glomerular filtration rate considered by medical professionals to be the best measure of kidney functionlets kidney care experts figure out your stage of kidney disease. Understanding it can help you learn how to take control and make any change to certain lifestyle habits in order to possibly slow the progression of your condition. Determining your GFR levels requires a simple blood test. Use this GFR Calculator tool to help you determine which stage of kidney disease you are in currently.
What Your GFR Result Means
Completely healthy kidney function is measured at a glomerular filtration rate of around 100, which means that the kidneys are working at 100 percent. Your kidney function is still considered normal if the GFR number is 90 or greater. If your GFR is 45, you know that your kidneys are working at approximately 45 percent of the normal rate.
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Can Anything Else Impact My Gfr
It is possible to slow the progression of kidney disease by taking good care of yourself by following a healthy diet and exercising. However, for some people, their kidney disease gets worse despite their best efforts at a healthy lifestyle. It is important to know the cause of your kidney disease. For example, if you have diabetes, the most important thing you can do to protect your remaining kidney function is to keep your blood sugar under control. The same is true for high blood pressure. If you eat well and exercise but do not keep healthy blood sugar or blood pressure levels then your GFR may continue to decline.
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What Is A Creatinine Test
A creatinine test, also called a serum creatinine test, is a way for doctors to measure how well your kidneys are working. Creatinine is a waste product from the normal breakdown of muscle tissue. As your body makes it, it’s filtered through your kidneys and expelled in urine. Your kidneys‘ ability to handle creatinine is called the creatinine clearance rate, and this helps estimate how fast blood is moving through your kidneys, called the glomerular filtration rate .
Why The Test Is Performed
Creatinine is a chemical waste product of creatine. Creatine is a chemical made by the body and is used to supply energy mainly to muscles.
This test is done to see how well your kidneys work. Creatinine is removed from the body entirely by the kidneys. If kidney function is not normal, the creatinine level in your blood will increase. This is because less creatinine is excreted through your urine.
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What Are Kidney Numbers
The two numbers youll need to become familiar with to assess your kidney health are your albumin to creatinine ratio and your estimated glomerular filtration rate . Well refer to these as your kidney numbers.
The ACR measures how much of the protein albumin is present in your urine. This protein is not bad your body needs it. But it should be in your blood, not your urine. If too much of it is present, that could indicate one or both of your kidneys are not functioning properly. Your ACR can be assessed through a simple urine sample.
The eGFR measures the amount of creatinine in your blood, then plugs that number into a formula that takes into account your age, gender, and body size. The resulting number is your eGFR. As you may remember, creatinine is a waste product that should be in the urine, not the blood, if your kidneys are functioning properly. With a simple finger prick blood test, a doctor can evaluate the amount of creatinine in your blood and estimate your GFR.
Note: Your actual GFR number is more complicated to determine and requires experienced personnel, so it is typically only performed in research settings and transplant centers. The eGFR is recommended as a sufficient measure of kidney health by the National Kidney Foundation. The eGFR is typically a reliable indicator of kidney health but in some cases could be inaccurate and require further testing, particularly if you have had a limb amputated, are malnourished, or highly obese.
Why Kidney Function Tests Are Performed
Kidney function tests are performed for a variety of reasons, including something as simple as a yearly checkup, or a urinary tract infection is suspected. They may also be performed if an individual is ill and a diagnosis has not been made, as a screening test for a patient planning or recovering from surgery, or as a way to track kidney disease. Urinary tract infections are common after surgery, and some patients experience kidney dysfunction after a procedure, so these tests are frequently performed on patients recovering from surgery.
Kidney function tests are a reliable way of testing the kidneys, but it is important to remember that they can also change dramatically with illness or dehydration. Many individuals can have an acute problem with the kidneys that resolves after receiving fluids or other treatment.
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Food Choices Can Affect Kidney Health
- Avoid processed foods and choose fresh fruits and vegetables instead.
- Follow a low-salt diet. Salt should be limited especially if you have high blood pressure, protein in your urine, or swelling, or difficulty breathing. Eating less than 2000 mg a day of sodium is recommended.
- Limit protein if you have moderate-to-advanced kidney disease . A high-protein diet, which is popular for losing weight, maybe safe for people with normal kidneys but can put a strain on poorly functioning kidneys to rid the bodys protein waste. However, a diet too low in protein can cause loss of muscle and make you frail.
Many healthcare professionals recommend the Dash Diet, however, it is important to discuss your individual nutrition needs with your healthcare professional or dietitian before starting a diet.
How Does Eating Diet And Nutrition Affect A Solitary Kidney
If you have a solitary kidney, you do not need to eat a special diet. However, you can keep your kidneys healthy by staying well hydrated, not taking too much salt, and not gaining excessive weight. If you have reduced kidney function, you may need to make changes to your diet to slow your kidney disease progression. Work with your health care professional or a registered dietitian to develop a meal plan that includes foods you enjoy eating while maintaining your kidney health.
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More On Your Kidney Function Numbers
The normal range for kidney function numbers is between 80 and 129. Anything below 80 is generally quite bad. This will vary between men and women and it is dependent on muscle mass. Petite people without much muscle mass will likely have a low kidney number. It is important for you to know your kidney number, as a lot of people do not know this or even what one is, and therefore they dont wind up getting to their doctor until their kidney function is so low that they will require dialysis or kidney replacement.
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.
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Do I Need To Fast Beforehand
Your doctor will instruct you on whether or not you need to fast. This is generally not required for the kidney function test, but could be ordered for other lab testing you may also be getting at the same time.
To fast before a blood test, you do not eat any food for the 8 to 12 hours before the appointment time. Its important you still drink plenty of water before as dehydration can negatively affect your renal function test results.
How Is An Egfr Test Different From A Basic Or Comprehensive Metabolic Panel Test
Both the basic metabolic panel and comprehensive metabolic panel are blood tests that help to assess how well the kidneys are working however, the standard version of these tests do not include a calculation of eGFR.
That said, the BMP and CMP involve a measurement of creatinine, so these tests may enable the lab or your doctor to estimate GFR.
In addition, the BMP and CMP include assessments of more than just kidney function. For example, these tests measure blood sugar and levels of electrolytes that facilitate many important processes in the body.
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