Chronic Kidney Failure Tests & Diagnosis

Chronic kidney failure, also known as chronic renal failure and chronic renal insufficiency, slowly gets progressively worse over time. It usually takes months or years for patients to lose the function of their kidney, which is to remove waste products and excess fluids from the body through urine. Since the process is so slow, symptoms may not be noticeable until even 10% of kidney function has been lost. By end-stage renal disease (ESRD), the kidney can no longer perform its function and dialysis (artificial removal of waste products and excess fluids from the body) or a kidney transplant is necessary for patients’ survival.

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If your general practitioner (GP) suspects that a patient has chronic kidney failure, he will refer his patient to a nephrologist, a doctor who specializes in kidney disorders. Either the GP or the nephrologist will conduct a series of tests to determine a diagnosis of kidney failure. The following is a list of diagnostic tests that may be performed:

  • Blood test to measure the levels of excess waste travelling through the bloodstream, such as urea, sodium and creatinine. Excess particles in the blood may reveal inferior functioning of the kidneys to filter the blood and remove waste.
  • Urinalysis to measure wastes in urine, such as protein and creatinine clearance, to make sure that the kidneys are properly disposing of waste from the bloodstream.
  • Kidney biopsy (removing a sample of the kidney tissue for testing) to verify and discover problems taking place with the kidney. To perform this test, patients are given local anesthetics directly into the kidney via a long needle that goes into the skin of the back and into the kidney. Once the biopsy is obtained, the sample is sent to a laboratory for testing.
  • Kidney ultrasound, which uses sound waves to reflect the shape, size and structural health of the kidney.
  • Abdominal ultrasound to determine the size of the kidneys, as diseased kidneys are usually smaller than normal (smaller than nine centimeters), unless the kidneys are diseased with polycystic kidney disease or diabetic nephropathy.
  • Nuclear medicine MAG3 scan, which measures blood flow between the right and left kidneys, and measures the respective functions of each kidney
  • DMSA scan of the kidney using radioactive imaging
  • Abdominal CT scan
  • Abdominal MRI

Once kidney disease has been diagnosed, levels of the following should be routinely checked every couple of months to monitor if there is any worsening of the disease:

  • Sodium
  • Electrolytes
  • Calcium
  • Potassium
  • Cholesterol
  • Phosphorus
  • Complete blood count (CBC)
  • Magnesium
  • Albumin

Acute renal disease is reversible, but chronic renal disease is not. It is important to distinguish between the two upon diagnostic testing and the aforementioned monitoring tests.

Most patients with kidney disease have an underlying disease or condition. A large part, therefore, of treating the kidney disease is treating the causal disorder. Most cases of CKD can be attributed to diabetes and high blood pressure. Glomerulonephritis, autoimmune diseases, kidney infections, kidney stones, birth defects impacting the kidney, reflux nephropathy, injury or trauma to the kidney, prescription pain medications and arterial complications within the kidney are some of the medical disorders that could damage kidneys and cause CKD as a result. Treating the underlying condition should help to control the kidney disease.

When the kidneys fail to adequately filter surplus waste and fluid from the body, there will be a build up of these wastes in the bloodstream. Conditions that may result from this include compromised red blood cell production, healthy vitamin D levels, bone health and healthy blood pressure.

All patients with kidney damage are diagnosed with CKD. Patients with glomerular filtration rate (GFR) that is less than 60 mL/min/1.73 m2 for a duration of three months are diagnosed as having chronic kidney disease even if there is no present kidney damage. This level of kidney function or lower is representative of a loss of at least 50% of the adult level of normal kidney function.

There are five stages of kidney disease, as follows:

Stage 1
GFR = ≥ 90 mL/min/1.73 m2
Stage 2
GFR = 60–89 mL/min/1.73 m2
Stage 3
GFR = 30–59 mL/min/1.73 m2
Stage 4
GFR = 15–29 mL/min/1.73 m2
Stage 5, ESRD
GFR = < 15 mL/min/1.73 m2

Talk to your doctor today about the appropriate and most efficient tests available for your case. Develop a treatment plan with your doctor so that you can keep your kidneys healthy and functioning.

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