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Why Is Kidney Function Low

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Assessing Kidney Function: Glomerular Filtration Rate (GFR): Nephrology| Lecturio

Stephen H Hahn, MD, FDA Commissioner

Unfortunately, in times of uncertainty, there are people who look to prey upon those who are vulnerable. The US Food and Drug Administration reports there are unscrupulous companies and individuals looking to fraudulently profit by scamming people who want to prevent and/or treat COVID-19.

Beware of false promises

Products that claim to cure, mitigate, treat, or prevent disease, but are not proven safe and effective for those purposes, defraud consumers of money and can place consumers at risk for serious harm. Fraudulent COVID-19 products may come in many varieties, including dietary supplements, such as vitamins and minerals, foods , as well as questionable products purporting to be drugs, herbal remedies, immune boosters, or medical devices. Using these products may lead to delays in getting proper diagnosis and treatment for COVID-19.

The FDA urges consumers and patients to talk to their healthcare providers and to follow the advice from federal public health agencies about how to prevent the spread and treatment options for people with COVID-19.

About Normal Ranges And Interpreting The Numbers

When you look at a printout of your lab results, youll find the normal ranges for each blood test next to your personal results. For example, if your routine blood work includes a test for calcium in the blood, your lab may list the normal range for calcium as 8.3 to 9.9 milligrams per deciliter . If your result is a 9.1 mg/dL, right in the middle, you can feel confident that your calcium level is normal.

But what if a blood test result is at the very low or high end of normal, or even slightly outside the normal range? Is that a red flag? Dont jump to conclusions, warns Dr. Salamon. Blood test results can vary a little bit, depending on the lab. And many people are consistently on one side or the other of the normal range, and for them, thats healthy, says Dr. Salamon.

Take, for example, a routine measure of blood urea nitrogen , a waste product created as your body breaks down the protein in your diet. Excess urea is removed from the blood by the kidneys, so high levels of BUN in the blood can indicate that kidney function is declining. So, what does it mean if your BUN level is at the very high end of the normal range? If I see that its borderline high, I might ignore it, says Dr. Salamon. Its common for BUN to go up if you dont drink enough, and that can happen when someone is fasting before having blood drawn.

Minor fluctuations in test results may also reflect

  • recent infections

Correction Of Phosphate Balance

If you have stage four or five kidney disease, you can get a build-up of phosphate in your body because your kidneys cannot get rid of it. Phosphate is a mineral that, with calcium, makes up most of your bones. Phosphate is obtained through diet, mainly dairy foods. The kidneys usually filter out excess phosphate. If phosphate levels rise too much, it can upset the normal calcium balance of the body. This can lead to thinning of the bones and furring of the arteries.

You may be asked to limit the amount of phosphate in your diet. Foods high in phosphate include red meat, dairy produce, eggs and fish. Your GP or dietitian should be able to advise you about how much phosphate you can eat. However, there is no advantage in reducing your intake of these foods unless you have a raised phosphate level. Always ask a healthcare professional before changing your diet.

If reducing the amount of phosphate in your diet does not lower your phosphate level enough, you may be given medicines called phosphate binders. These medicines bind to the phosphate in the food inside your stomach and stop it from being absorbed into your body.

To work properly, phosphate binders must be taken just before meals. The most commonly used phosphate binder is calcium carbonate, but there are also alternatives that may be more suitable for you.

The side effects of phosphate binders are uncommon but include:

  • nausea
  • itchy skin

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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.

Kidney Failure Definition And Facts

Reduced kidney function can improve with lifestyle modification
  • Kidneys are the organs that filter waste products from the blood. They are also involved in regulating blood pressure, electrolyte balance, and red blood cell production in the body.
  • Symptoms of kidney failure are due to the build-up of waste products and excess fluid in the body that may cause weakness, shortness of breath, lethargy, swelling, and confusion. Inability to remove potassium from the bloodstream may lead to abnormal heart rhythms and sudden death. Initially, kidney failure may cause no symptoms.
  • There are numerous causes of kidney failure, and treatment of the underlying disease may be the first step in correcting the kidney abnormality.
  • Some causes of kidney failure are treatable and the kidney function may return to normal. Unfortunately, kidney failure may be progressive in other situations and may be irreversible.
  • The diagnosis of kidney failure usually is made by blood tests measuring BUN, creatinine, and glomerular filtration rate .
  • Treatment of the underlying cause of kidney failure may return kidney function to normal. Lifelong efforts to control blood pressure and diabetes may be the best way to prevent chronic kidney disease and its progression to kidney failure. As we age, kidney function gradually decreases over time.
  • If the kidneys fail completely, the only treatment options available may be dialysis or transplant.

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About Chronic Kidney Disease

CKD is a condition in which the kidneys are damaged and cannot filter blood as well as they should. Because of this, excess fluid and waste from blood remain in the body and may cause other health problems, such as heart disease and stroke.

15% of US adults are estimated to have chronic kidney disease, that is about 37 million people.

Some other health consequences of CKD include:

  • Anemia or low number of red blood cells
  • Increased occurrence of infections
  • Low calcium levels, high potassium levels, and high phosphorus levels in the blood
  • Loss of appetite or eating less
  • Depression or lower quality of life

CKD has varying levels of seriousness. It usually gets worse over time though treatment has been shown to slow progression. If left untreated, CKD can progress to kidney failure and early cardiovascular disease. When the kidneys stop working, dialysis or kidney transplant is needed for survival. Kidney failure treated with dialysis or kidney transplant is called end-stage renal disease . Learn more about ESRD.

Not all patients with kidney disease progress to kidney failure. To help prevent CKD and lower the risk for kidney failure, control risk factors for CKD, get tested yearly, make lifestyle changes, take medicine as needed, and see your health care team regularly.

Symptoms Of Kidney Disease

Kidney disease is called a silent disease as there are often few or no symptoms. In fact, you can lose up to 90 per cent of your kidneys functionality before experiencing any symptoms. Some signs and symptoms include:

  • a change in the frequency and quantity of urine you pass, especially at night
  • blood in your urine
  • changes in the appearance of your urine
  • puffiness around your legs and ankles
  • pain in your back
  • pain or burning when you pass urine
  • high blood pressure.

If your kidneys begin to fail, waste products and extra fluid build up in your blood. This, and other problems, gradually leads to:

  • tiredness and inability to concentrate
  • generally feeling unwell
  • bad breath and a metallic taste in the mouth.

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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.

What Is Kidney Disease

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Having kidney disease means that there is damage to your kidneys and they arent working as well as they should. Kidney disease is called chronic because kidney function slowly gets worse over time. Kidney disease leads to kidney failure, which is also called end-stage kidney disease. At this point, youll need dialysis or a kidney transplant.

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How Is Chronic Kidney Failure Diagnosed

There are two basic tests for kidney function: a complete urinalysis and a blood chemistry analysis.

A urinalysis is needed to evaluate kidney function. A low urine specific gravity is the earliest indication of kidney failure. An increase in protein in the urine also indicates decreased kidney function.

A blood biochemistry analysis assesses the function of various internal organs. Measuring the level of two waste products in the blood, namely blood urea nitrogen and blood creatinine , indicates decreased kidney function. Tests to measure the blood levels of other substances such as albumin, globulin, potassium, sodium, phosphorus, and calcium, as well as the red and white blood cell counts are important in order to determine the extent of failure and the best course of treatment.

A recently developed blood test to assess levels of SDMA has been used to determine if early renal failure is occurring. SDMA concentrations increase above the normal reference interval well before serum creatinine becomes elevated. This will help your veterinarian provide treatment for your dog at a much earlier stage in the disease.

“SDMA concentrations increase above the normal reference interval well before serum creatinine becomes elevated.”

A dog diagnosed with low urine specific gravity as well as elevated BUN and CREA is said to be azotemic.

What Is Normal Kidney Function

Since many of those living with kidney disease dont experience signs or symptoms until the disease has progressed, understanding normal kidney function is vital to understanding your kidney health.

From the filtering of waste products to the water balance in the body – the kidneys perform many crucial functions. Some of the kidneys key functions include:

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How Much Potassium Is Safe

Its recommended that healthy men and women over the age of 19 consume at least 3,400 mg and 2,600 mg of potassium per day, respectively.

However, people with kidney disease who are on potassium-restricted diets usually need to keep their potassium intake below 2,000 mg per day.

If you have kidney disease, you should have your potassium checked by your doctor. Theyll do this with a simple blood test. The blood test will determine your monthly level of potassium millimoles per liter of blood .

The three levels are:

  • Safe zone: 3.5 to 5.0 mmol/L
  • Caution zone: 5.1 to 6.0 mmol/L
  • Danger zone: 6.0 mmol/L or higher

Your doctor can work with you to determine how much potassium you should ingest daily, while also maintaining the highest level of nutrition possible. Theyll also monitor your levels to ensure that youre staying within a safe range.

People with high potassium levels do not always have symptoms, so being monitored is important. If you do have symptoms, they may include:

  • fatigue

Treatment For Kidney Disease

Your Kidneys and Uric Acid

If detected early enough, the progress of kidney disease can be slowed and sometimes even prevented. In the early stages, changes to diet and medication can help to increase the life of your kidneys.

If kidney function is reduced to less than 10 per cent of normal, the loss of function must be replaced by dialysis or a kidney transplant. Dialysis is a treatment for kidney failure that removes waste products and extra water from the blood by filtering it through a special membrane .

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Glomerular Filtration Rate Based On Creatinine Measurement

GFR is a calculation of how efficiently the kidneys are filtering wastes from the blood. A traditional GFR calculation requires an injection into the bloodstream of a substance that is later measured in a 24-hour urine collection. Recently, scientists found they could calculate GFR without an injection or urine collection. The new calculation requires only a measurement of the creatinine in a blood sample.

Creatinine is a waste product in the blood created by the normal breakdown of muscle cells during activity. Healthy kidneys take creatinine out of the blood and put it into the urine to leave the body. When kidneys are not working well, creatinine builds up in the blood.

In the lab, your blood will be tested to see how many milligrams of creatinine are in one deciliter of blood . Creatinine levels in the blood can vary, and each laboratory has its own normal range, usually 0.6 to 1.2 mg/dL. If your creatinine level is only slightly above this range, you probably will not feel sick, but the elevation is a sign that your kidneys are not working at full strength.

One formula for estimating kidney function equates a creatinine level of 1.7 mg/dL for most men and 1.4 mg/dL for most women to 50 percent of normal kidney function. But because creatinine values are so variable and can be affected by diet, a GFR calculation is more accurate for determining whether a person has reduced kidney function.

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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Common Tests To Help Diagnose Kidney Disease

Lab work, urine samples, and other tests may be completed as you undergo diagnosis and treatment for renal failure. The test results will be used to assist the healthcare team in evaluating your kidney function and determining the best care plan for you.Remember, you are in control and you are your own best healthcare advocate, so it is essential for you to understand what these tests mean. Note that there can be some differences in these values from one lab to another, so make sure you learn the normal values for your lab. Lets get started.

Are All Renal Panel Tests The Same

Itchy Skin & Chronic Kidney Disease – A sign of low kidney function & high phosphorus

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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Questions For Your Doctor About Test Results

When your test results are ready, you can learn more about their significance by discussing them with your doctor. Some questions that you can ask include:

  • Were there any abnormal findings on my renal panel test? If so, what were they?
  • For any abnormal findings, can you explain what might be the cause?
  • Are there any follow-up tests that are warranted based on my renal panel test?
  • Should I take this test again? If so, when?

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What Causes Low Blood Pressure

There are a number of things that can cause your blood pressure to lower to dangerous levels. Those things include:

  • Taking certain medications
  • Inflammation
  • Shock or trauma

Shock or trauma is often the most common cause of lower blood pressure. Shock or trauma can be caused by experiencing a certain event, undergoing surgery, or certain health problems.

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Preventing Chronic Kidney Disease

The main way to reduce the chances of CKD developing is to ensure any existing conditions, such as diabetes and high blood pressure, are carefully managed.

Some lifestyle changes can also reduce the risk of CKD developing, these include:

  • having a healthy diet
  • avoiding drinking excessive amounts of alcohol
  • exercising regularly

Will Kidney Failure Affect My Sex Life

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Kidney failure will affect your emotions, nerves, hormones, and energy levels, all of which may change your sexual relationships. Taking good care of yourself by managing your kidney disease and controlling your blood pressure and blood glucose levels can help prevent some sexual problems, such as erectile dysfunction. Getting counseling may help with some emotional problems, such as anxiety and depression, which can get in the way of having satisfying sex.

You may feel shy asking questions about your sex life, but your health care team has heard the same questions from other people. Your provider is trained to help you address concerns about your sex life.

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