Kidney Health testing procedures

• Kidneys are tested to let know of how well or efficiently they work 
• There are various test to determine them of them ranging from basic blood examination to advanced imaging techniques
• Few basic tests include blood analysis, urinalysis where in specifically speaking urine test are done by a process known as Dip urine test and it also used to measure urine albumin to creatinine ratio or in short also known as UACR
• Blood tests are done to determine the serum creatinine levels, glomerular filtration rate and blood urea nitrogen or (BUN)
• Where as other test include Imaging procedures such as CT,kidney ultrasound,kidney biopsies etc 

1. Urine tests

Dipstick urine test 

• It is an urinalysis procedure where a thin strip made of plastic embedded with chemicals is dipped in to the collected patients urine sample 
• If the color change is noticed then there are substances present in urine which might probably the problem associated with kidneys 

• It is usually indicated to know the acidity or pH of the urine, Concentration, protein,ketones,Blood, infections,Sugar levels ,bilirubin levels etc .
• They help to diagnose kidney diseases,urinary tract infections and also diabetes mellitus 
• In renal patients this is indicated to evaluate the protein/blood in urine infection.
• As a part of the analysis the collected samples of urine is further analyzed in microscope 

• For White blood cells ,red blood cells ,WBC /RBC casts ,bacteria or yeast /viral/fungal microorganisms
• Urinalysis doesn’t completely determine the desired results it should be used an base test to further investigate the patient .It is because there might be an manual error by lab technician by over diluting it or not at all diluting the urine or way too early for an investigation to start before the actual disease 

Urine albumin to creatinine (UCAR)

• It is also known as urine microalbumin 
• This Is to be done as soon as the patient diagnosed with diabetes 
• Regular testing is considered
• The values is shown depending upon the stage of chronic kidney disease 
• If the values are too high it indicates the severe kidney problem 
• If the values are slightly raised then it indicates the early disease
• If values are normal or very less it indicates the healthy kidneys 

Note:If the diabetes is noticed priorly with good maintenance or control it is earlier to have lower values 

Blood tests

Serum creatinine

• The normal levels of serum creatinine may vary according to the age ,sex and few other factors such as muscle mass

• For males,it ranges from 0.7-1.3 mg/dL
• For females,it ranges from 0.6-1.1mg/dL

• If the serum creatinine is more than the above mentioned levels then the patient is considered to have a renal disease 
• This serum creatinine levels are used to estimate  eGFR Values ,BUN and also can be compared with their results 

Estimated Glomerular filtration rate(eGFR)

• Glomerular filtration rates provide the information regarding the functioning of kidneys 
• It provide the information by measuring the serum creatinine levels in the blood 
• It depends on the age,sex,race and weight of the patient
• The normal eGFR Is 60 or more 
• For stage 1 renal disease,eGFR is >or 90 with little less protein In urine 
• For stage 2 renal disease,eGFR is about 60-89, with mild loss in kidney function and signs of kidney damage is know with presence of protein in the urine
• For stage 3 renal disease,eGFR is about 30-59 with moderate damage and symptoms of swelling,as usual proteinuria
• For stage 4 renal disease,eGFR is 15-29 with severe kidney damage, anemia and increased blood pressure
• For stage 5 renal disease,eGFR <15 which indicates the renal Faure and might be life threatening damage too

Blood urea nitrogen 

• This is used to measure or estimate the urea nitrogen in the blood 
• It depends on the age ,weight of the patient
• The normal ranges from 7-20 mg/dL
• More than the normal levels indicate the kidney disease or failure 

Kidney ultrasound 

• The kidney ultrasound is indicated to see the  size and shape of the kidneys with use of sound waves which make the radiolucent and radiopaque images
• Apart for the size and shape it is also used to know the blood flow ,damage or injury to kidneys , presence of stone or cysts and even tumors 
• This can be indicated during biopsies or after the Transplantation of kidneys 
• This is done by running a probe over the belly near the renal area where that system detects the waves and produce images 
• Pre-procedural restriction of liquids or food for 3 hours before the procedure  is indicated 

Renal biopsy

• This investigational procedures is indicated very rarely until and unless the diagnosis is hard to made from the above mentioned procedures 
• This is very much useful when the patients are presented with renal cancers Or abnormal swellings
• Other than these this can be utilized in few other conditions where the cause is unknown, Inflammatory Kidney disease, renal transplantation etc 
• They are of 2 major types of renal biopsies namely percutaneous and laparoscopic
• The former is advised in Transplantation cases which is rather the common biopsy procedure 
• The later is advised in when the bleeding or clotting is uncontrolled ,done under anesthesia
• Before the start of the process patient is advised to temporarily stop certain medications that may further increases the bleeding and to avoid drinking or eating for about 8 hours before the start of process 
• They include possible risks of bleeding,infections,clots,damage to surrounding organs ,severe pain near the site 

Frequently asked questions