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:
- 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.
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.
Blood Tests That Measure Diabetes Control
A blood glucose test measures the amount of a type of sugar in your blood. Glucose is your blood sugar. It is measured to make sure your body is able to digest and utilize sugar and carbohydrates correctly. If your blood sugar is too high, it may mean you have diabetes.
Normal Fasting Glucose levels:
- No known diabetes: less than 100 mg/dl
- Above 125 mg/dl can indicate diabetes
- Diabetics: 70-130 mg/dl is within target range
- No known diabetes: less than 140 mg/dl
- Diabetics: less than 180 mg/dl
A glycosylated hemoglobin A1C reading reveals your average blood glucose level over the past three months and can be used to monitor your diabetic control and to predict your risk for diabetic complications. How does it do that? Your body actually memorizes the trail that sugar leaves in your body. When blood glucose is high, the sugar molecules attach themselves to red blood cells. The red blood cells store the sugar information for about four months. A blood test can then retrieve your average blood glucose results in the format of a percentage. The greater your A1C value, the higher your risk for diabetic complications. For the diabetic with CKD, good control of your blood sugar can slow the worsening of kidney function. Ask your doctor what your result should be. For most people, the result should be less than 7%.
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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.
What Happens If My Test Results Show I May Have Chronic Kidney Disease
- A eGFR below 60 for three months or more or a eGFR above 60 with kidney damage indicates chronic kidney disease. Your doctor will want to investigate the cause of your kidney disease and continue to check your kidney function to help plan your treatment.
- Typically, a simple urine test will also be done to check for blood or albumin in the urine. When you have albumin in your urine it is called albuminuria. Blood or protein in the urine can be an early sign of kidney disease.
- People with a high amount of albumin in their urine are at an increased risk of having chronic kidney disease progress to kidney failure.
Your doctor may also suggest further testing, if necessary, such as:
- Imaging tests such as an ultrasound or CT scan to get a picture of your kidneys and urinary tract. This tells your doctor whether your kidneys are too large or too small, whether you have a problem like a kidney stone or tumor and whether there are any problems in the structure of your kidneys and urinary tract.
- A kidney biopsy, which is done in some cases to check for a specific type of kidney disease, see how much kidney damage has occurred and help plan treatment. To do a biopsy, the doctor removes small pieces of kidney tissue and looks at them under a microscope.
Your doctor may also ask you to see a kidney specialist called a nephrologist who will consult on your case and help manage your care.
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How Does High Blood Pressure Hurt The Kidneys
High blood pressure makes the heart work harder and, over time, can damage blood vessels throughout the body. If the blood vessels in the kidneys are damaged, they may stop removing wastes and extra fluid from the body. The extra fluid in the blood vessels may then raise blood pressure even more. It’s a dangerous cycle.
High blood pressure is one of the leading causes of kidney failure, also called end-stage renal disease . People with kidney failure must either receive a kidney transplant or have regular blood-cleansing treatments called dialysis. Every year, high blood pressure causes more than 25,000 new cases of kidney failure in the United States.1
1United States Renal Data System. USRDS 2007 Annual Data Report. Bethesda, MD: National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, U.S. Department of Health and Human Services 2007.
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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What Is Kidney Disease
In simple terms, kidney disease means your kidneys have become damaged and can no longer perform their key functions properly. Its a serious condition and its important to receive immediate medical care.
There are two forms of kidney disease:
Acute kidney disease is known to occur pretty suddenly and over a short period of time, its sometimes referred to as acute kidney injury.
Chronic kidney disease is a long-term condition which can get worse over time, sometimes developing into chronic kidney failure,
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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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.
How To Treat Low Kidney Function
Although there is no cure for chronic kidney disease , your doctor can work with you to treat and manage your existing symptoms, reduce underlying issues, and find ways to slow down disease progression. Some of the treatments are universal, while others depend upon the stage of CKD you are in.
A healthy diet and lifestyle combined with appropriate medications for symptom control is the most common treatment for kidney disease in its early stages. Renal replacement therapy, such as dialysis or a kidney transplant, is reserved for end-stage kidney disease .
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Become Your Own Expert
Many kidney patients choose to take an active role in their care and treatment. You can too by logging on to the PatientView website, where you may be able to keep track of all your medications, test results, scans and medical letters. You may also be able to see your medical history and get information about a wide range of tests .
You need to be referred to Patient View by your kidney unit so make sure you ask them to do this.
- For more ways to take control of your kidney disease visit our How can I help myself? section.
And for further information about kidney tests visit:
Experimental Treatments For Ckd
Research is ongoing to find new treatments and interventions that will someday soon render dialysis and kidney donation unnecessary. The Harvard Stem Cell Institute is just one of many institutions exploring a wide variety of options, such as experimental treatments.
Harvards current kidney disease research path has three tiers:
- Short-term: This research is intended to repair damaged kidneys by using regenerative medicineor cell replacement therapyusing mesenchymal stem cells . These cells are our bodys natural defense against kidney damage.
- Medium-term: This involves identifying the types of kidney cells most susceptible to damage in order to target the specific cell types with appropriate medications.
- Long-term: The long-term goal is to use stem cells and nanotechnology to create an artificial kidney that can be used in transplant surgerieseliminating the need to rely solely on human kidneys. Thus far, scientists have created a rat kidney that is being tested on lab animals.
Clinical trials are also being run by the National Institutes of Health and the National Institute of Diabetes and Digestive and Kidney Diseases to test the effectiveness and safety of pirfenidone in the treatment of diabetic nephropathy.
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Anemia Of Chronic Kidney Disease
Hemoglobin is the protein in red blood cells that carry oxygen to tissue in our body. Low level of hemoglobin is called anemia and can occur at any stage of kidney disease. The risk of developing anemia increases as kidney disease worsens. The kidney normally secretes a glycoprotein called erythropoietin. Erythropoietin stimulates cells in the bone marrow to form into red blood cells. In patients with chronic kidney disease, the production of erythropoietin is lower which can lead to anemia. Anemia can manifest itself as weakness, shortness of breath, chronic fatigue, poor appetite, difficulty sleeping, dizziness, depression but can also be asymptomatic. Iron deficiency, vitamin deficiency, poor nutrition or inflammation can all contribute to anemia. Patients might benefit from administration of erythropoietin in injection form together with iron and vitamin supplements to stimulate red blood cell production and treat anemia related symptoms.
Stage 5gfr Of 15 Ml/min Or Less
Patients at Stage 5 have chronic CKD. They have a GFR of 15 mL/min or less and have End Stage Renal Disease .The kidneys have lost almost all ability to function effectively at this stage. They will need dialysis or a kidney transplant to live.
Our kidney specialists can work with you to provide individualized evaluation and treatment, taking into consideration your GFR and other factors. To learn more or schedule an appointment at one of our clinics call 412-802-3043 or toll free 1-800-533-UPMC .
You should discuss this result with your kidney specialist.
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Procedures And Low Kidney Function
Diet modification and medications can help delay the progression of chronic kidney disease, especially in the early stages. If the disease progresses, however, other forms of treatment may become necessary.
Other forms of treatment may include:
- Blood transfusions: Hormone and iron supplements are not always enough to manage the symptoms of anemia. In those cases, your doctor may order one or more blood transfusions.
- Dialysis: Dialysis is an artificial method of removing wastes, toxins, and excess fluids from your blood when your kidneys cease to function. There are two types of dialysis: hemodialysis and peritoneal dialysis.
- With hemodialysis, your blood is filtered through a machine to be cleansed of impurities and then returned to your body.
- With peritoneal dialysis, a thin tube is inserted into your abdomen, which you fill with a solution that absorbs wastes and extra fluids. After a specified period of time, the solution is drained, and the wastes are removed.
What Do Your Kidneys Do
You have two kidneys. They are bean-shaped organs that are located toward your back, on either side of your spine, just underneath the rib cage. Each kidney is about the size of your fist.
Your kidneys have many jobs, but their main job is to filter your blood, getting rid of toxins and excess salt and water as urine. If your kidneys are damaged and dont work as they should, wastes can build up in your blood and can make you sick. Your kidneys also balance the amount of salts and minerals in your body, make hormones that control blood pressure, make red blood cells and keep your bones strong.
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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.
How Is It Tested
As part of standard blood tests, your doctor can check the creatinine level to assess kidney function. Creatinine is released from muscle cells into the blood stream.
Creatinine is one of the things that the kidneys filter from the blood. If the kidneys start to lose some function, blood creatinine level rises. The creatinine level is used to calculate an estimate of the GFR and provide an estimate of your kidney function.
Most people who have a minor reduction in kidney function can take steps to not keep the kidneys from getting worse. If the function is somewhat low but stable, you may need to see your doctor only once per year. If the GFR is declining or it is already under 50, it’s best to see a kidney doctor, if for no other reason than to become educated.
How high blood pressure damages the kidneys
High blood pressure can cause tiny cracks in the lining of arteries, which provide a breeding ground for fatty deposits that hamper blood flow. As the arteries that feed blood to the kidneys narrow, the body produces renin, a hormone that makes small arteries narrow further. This worsens high blood pressure, causing even more kidney damage. Over time, restricted blood flow can damage or destroy the nephrons, the tiny filtering units inside your kidneys.
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