The Incidence Of Kidney Disease Is Rising Screen Your Kidney Function With These Simple Blood And Urine Test
Written by Shraddha Rupavate | Updated : August 27, 2014 11:10 AM IST
Kidney problems do not develop overnight. Your kidney function naturally starts declining after you cross your 30s. And whether you will develop a kidney problem later in life is largely dependent on your lifestyle habits and diet. In most cases, kidney problems are caused as a result of a primary condition like diabetes, hypertension or high cholesterol levels. Because the symptoms of kidney diseases are not evident unless the kidneys are deteriorated to a great extent , you should regularly screen your kidney function . Here are some kidney function tests that can determine whether you are at a risk of kidney disease.
1. Blood pressure: Your kidneys perform the function of filtering blood under pressure to eliminate waste products through the urine. If your blood pressure is higher than normal it will increase the load on your kidneys and may lead to kidney disease. Alternatively, a person is suffering from kidney disease is also likely to have high blood pressure. Read more about the medication for high blood pressure.
2. Blood creatinine test: Creatinine is a waste product that is produced by your muscles. It enters the bloodstream and is filtered by the kidneys to get excreted through the urine. A blood creatinine test will measure the amount of creatinine in your blood. A higher level may indicate that the kidneys are not functioning properly.
The Kidney Profile Can Help Prevent This Scary Scenario
When it comes to annual screening for CKD, cost has never been an issue for most people. The Kidney Profiles blood and urine tests cost under $50 and are routinely covered by health insurance. They are easy to getif your primary care doctor orders both types of tests for the most complete kidney assessment.
Because the Kidney Profile streamlines and simplifies CKD testing for doctors, patients will get the benefit of more complete testing. With leading labs adopting the combination of CKD tests under the heading of Kidney Profile on request forms and electronic health records, doctors wont need to search for and order each test separatelyand they also can find the results in one place.
Lets face it: When one less click of a computer mouse or check mark on a handwritten form is needed to expedite proper care, your doctors job gets easierand the odds of effective care go up.
Important: If you have one of the risk factors , be sure to ask your doctor about getting the Kidney Profile. If its not yet available in your community, ask for the blood and urine tests to be ordered individually.
When Is A Kidney Function Test Done
A kidney function test may be requested as a routine blood test to find out about your general health. It is also requested for a variety of other more specific situations, eg:
- to assess if you have any sign of acute or chronic kidney disease
- to assess for dehydration
- to check how your kidneys are functioning before and after starting certain medicines.
Chronic kidney disease is common as you get older. It has no warning signs until too late. Therefore a kidney function test at various stages can be helpful to find problems sooner. Read more about chronic kidney disease.
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Test To Assess The Kidney Function
It is very essential to know the function of kidney and also the process of urine formation to know the rational behind these test and also to interpret the result of these test.
Glomerular Function- Clearance test
The best test to assess glomerular function is Glomerular filtration rate , which is the rate in milliliters per minute at which substances in plasma are filtered through the glomerulus in other words, the clearance of a substance from the blood. The normal GFR for an adult male is 90 to 120 mL per minute.
GFR cannot be measured directly so various substances are used to assess GFR. There are various exogenous and endogenous substances that are used for clearance test. The characteristics of an ideal marker to measure GFR are as follows:
- Constant rate of production
- Freely filterable at the glomerulus
- No tubular reabsorption
- No extrarenal elimination or metabolism
- Availability of an accurate and reliable assay
- For exogenous marker: safe, convenient, readily available, inexpensive, and does not influence GFR
Clearance is the rate at which an indicator substance is removed from plasma per unit concentration specifies a volume from which all of a substance is removed per unit time. For a substance Z cleared by renal elimination:
Cz =UzxV â Pz
Where Cz is the clearance rate of Z substance, Uz is urinary concentration of z, Pz is plasma concentration of Z, and V is urine flow rate.
Inulin Clearance Test
Creatine Clearance test
Factors affecting serum creatine are:
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.
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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.
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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Kft Test Normal Range/ Values
Kidney function test consist of a number of parameters, Each of these parameters has a specific normal range. Though usually, a KFT test report does highlight the parameters which are outside their specific range. But it is advisable to leave the result interpretation to a doctor.
Many a time, results are correlated and need to read in conjunction with some other tests. Moreover, some of the parameters can be outside the normal range due to a problem in a different organ of the body. The normal range or normal values given below are for reference.
What Do The Results Of My Kidney Function Test Mean
Kidney function test results can tell you whether your kidneys are functioning typically or not. Most function tests look for two measurements:
- GFR of less than 60 could indicate kidney disease.
- Urine albumin-to-creatinine ratio of more than 30 milligrams per gram could be a warning sign of kidney disease.
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What Is The Functional And Structural Unit Of A Kidney
The structural and functional unit of the kidney is called nephron. It consists of two main parts viz. the glomerulus and the tubular system. The glomerulus is composed of Bowmans capsule and a tuft of leaky blood vessels encapsulated by the Bowmans capsule. The primary purpose of the glomerulus is filtration. The leaky vessels filter into the glomerulus almost all the water, electrolytes, small proteins, nutrients such as sugar etc and excretory products such as urea etc. The filtration are dependent on the size and charge of the particles. The average pore size is 8 mm and hence particles of only smaller size will pass through. Also, the basement membrane carries a negative charge, hence preventing negatively charged particles from passing through. The tubular system is responsible for reabsorption of most of the water, electrolytes, nutrients as well as excretion of the remaining nutrients by means of secretion into the tubules. These tubules are responsible for the concentration of urine.
What Causes Kidney Problems
There are several kidney problems including kidney failure, chronic kidney disease or even a kidney infection.
Chronic Kidney disease may be caused by:
- Type 1 or Type 2 diabetes
- High blood pressure
- Prolonged obstruction of the urinary tract
- Vesicoureteral reflux
- Shortness of breath
- High blood pressure
Symptoms of Kidney Problems are often not specific which means having these symptoms cannot establish a proper diagnosis. However, if you have these symptoms of kidney problems, you should see your doctor to get a kidney test done.
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Blood Tests For Diagnosing Kidney Disease
Following are a variety of blood tests that help determine whether or not you have kidney disease:
- CBC complete blood count of your red blood cells, white blood cells, and plateletslow CBC level can mean kidney function is reduced.
- Creatinine waste product of muscles that is normally eliminated by the kidneys, may be elevated when kidney function is reduced.
- Creatinine clearance measure of how well creatinine is removed by the kidneys over a 24-hour period of urine collection. When kidney function is reduced, clearance may be low.
- Blood electrolyte tests also known as chemistries. Electrolytes are filtered out of the blood by the kidneys. Abnormal levels may indicate reduced kidney function.
- Hemoglobin A1C measures how well blood sugar is controlled during three months before testing. Elevation indicates blood sugar is not well-controlled and may be causing reduced kidney function.
- Blood urea nitrogen also a waste product that is eliminated by the kidneys. BUN is elevated when kidney function is reduced.
- Glomerular filtration rate the best measure of kidney function and also determines the stage or progression of the disease. The higher the numbers of the GFR, the better the kidneys are working.
Is Kidney Disease The Same As A Kidney Infection
Kidney disease is not the same as a kidney infection. Kidney disease happens when you have a genetic or congenital issueone you were born withthat causes damage to your kidneys, or when you acquire a disease or your lifestyle choices limit your kidney function. Diabetes, heart disease, alcohol, and drug use, and other conditions can all impact your kidneyseven the medications you take. Chronic kidney disease is the result of long-term problems that lower the ability of your kidneys to process and excrete waste fluids and solutes, regulate blood pressure, and maintain the bodys fluid balance.
A kidney infection occurs when bacteria, most commonly Escherichia coli, travels from the urethra up through the bladder and ureter into one or both of your kidneys. You can also have a kidney injuryoften caused by sudden illness or certain medicationsthat can resolve in time with little permanent damage.
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How Much Do At
At-home kidney tests range in cost from about $20 to several hundred dollars. More affordable tests typically have limited results and use a fingerstick or urine sample. The renal system is complicated, so the more accurate tests require larger blood samples, and you may have to supplement a urine sample with a trip to a lab. These tests are usually more expensive, but you can still have them done without seeing your doctor and still have your tests interpreted by a clinician and receive comprehensive information about your kidney function.
What Are The Warning Signs Of Chronic Kidney Disease
Symptoms of chronic kidney disease may not appear until late in the course of the disease, but there can be warning signs:
- Difficulty concentrating and sleeping
- Poor appetite, nausea or vomiting
- Fatigue/loss of energy
- Family history of Kidney Disease
- Race and ethnicity: African Americans, Hispanics, Asians, American Indians and Pacific Islanders
- Hereditary factors such as polycystic kidney disease
- Abnormally elevated creatinine levels or decreasing glomerular filtration rates
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Estimated Glomerular Filtration Rate
Normal Lab Value 90-120 ml/minute, 60 ml/minute or less indicates kidney damage may be present
Kidneys can filter up to 150 quarts of blood each day in the body of the average adult. The Estimated Glomerular Filtration Rate is a way of estimating the ability of the kidneys to filter blood. Using a formula that includes creatinine level, a lab can estimate the number of liters of blood the kidneys are filtering.
Chronic Kidney Disease Stages
Risk factors for kidney disease include diabetes, high blood pressure, family history, older age, ethnic group and smoking.For most patients, a GFR over 60 / is adequate. But significant decline of the GFR from a previous test result can be an early indicator of kidney disease requiring medical intervention. The sooner kidney dysfunction is diagnosed and treated the greater odds of preserving remaining nephrons, and preventing the need for dialysis.
| CKD stage | |
|---|---|
| Stage 5 | < 15 |
The severity of chronic kidney disease is described by six stages the most severe three are defined by the MDRD-eGFR value, and first three also depend on whether there is other evidence of kidney disease :
- 0) Normal kidney function â GFR above 90 / and no proteinuria
- 1) CKD1 â GFR above 90 / with evidence of kidney damage
- 2) CKD2 â GFR of 60 to 89 / with evidence of kidney damage
- 3) CKD3 â GFR of 30 to 59 /
- 4) CKD4 â GFR of 15 to 29 /
- 5) CKD5 kidney failure â GFR less than 15 / Some people add CKD5D for those stage 5 patients requiring dialysis many patients in CKD5 are not yet on dialysis.
Note: others add a “T” to patients who have had a transplant regardless of stage.
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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.
Kft Test Cost In India
The KFT test cost in India varies depending on the lab and location. As most labs include different numbers of parameters in kidney function test, so this also becomes a factor for variable cost. However, in general, cost range from Rs 400 to Rs 1100. For example, KFT test cost Rs 780 in Lal path lab whereas it cost Rs 730 in SRL Diagnostics. Some labs also have packages wherein cost of LFT and KFT is combined to provide a discount on both the tests.
However, most of the time a doctor prescribe a number of tests related to different organs in the body. Many of these tests may also be part of some health package which can reduce the cost significantly. Thyrocare Aarogyam packages are one such example which can save a lot of healthcare cost.
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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.
How Do You Test For Kidney Disease
Comparing testing for kidney disease is difficult because there are many different methods of collecting and analyzing samples that test kidney function. The most basic criterion for diagnosing kidney disease is a decreased glomerular filtration rate value. Glomeruli are the tiny filters in the kidneys, and GFR is a measurement that can tell you how well these filters are working.
It is cumbersome to measure GFR directly, but it can be estimated using creatinine levels in blood or urine samples. Urine tests typically check for protein in your urine. This happens in early kidney damage, as the kidney begins to leak protein. If there is protein present, your doctor would order a second urine test to check your albumin-to-creatinine ratio , which shows how much albumin and how much creatinine is in your urine after it has passed through the kidneys. Blood tests can provide an estimated GFR.
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Kidney Function In Disease
A decreased renal function can be caused by many types of kidney disease. Upon presentation of decreased renal function, it is recommended to perform a history and physical examination, as well as performing a renal ultrasound and a urinalysis. The most relevant items in the history are medications, edema, nocturia, gross hematuria, family history of kidney disease, diabetes and polyuria. The most important items in a physical examination are signs of vasculitis, lupus erythematosus, diabetes, endocarditis and hypertension.
A urinalysis is helpful even when not showing any pathology, as this finding suggests an extrarenal etiology. Proteinuria and/or urinary sediment usually indicates the presence of glomerular disease. Hematuria may be caused by glomerular disease or by a disease along the urinary tract.
The most relevant assessments in a renal ultrasound are renal sizes, echogenicity and any signs of hydronephrosis. Renal enlargement usually indicates diabetic nephropathy, focal segmental glomerular sclerosis or myeloma. Renal atrophy suggests longstanding chronic renal disease.