kidney and urinary tract disorders
Chronic Kidney Disease
Diagnosis of Chronic Kidney Disease
Blood and urine tests Ultrasonography Sometimes biopsy Blood and urine tests are essential. They confirm the decline in kidney function. When loss of kidney function reaches a certain level in chronic kidney disease, the levels of chemicals in the blood typically become abnormal. Ureaand creatinine, metabolic waste products that are normally filtered out by the kidneys, are increased. Blood becomes moderately acidic. Potassium in the blood is often normal or only slightly increased but can become dangerously high. Calcium andcalcitriolin the blood decrease. Phosphate andparathyroid hormonelevels increase. Hemoglobin is usually lower (which means the person has some degree of anemia). Doctors measure kidney function by using the level of creatinine in the blood, sex, and body weight in a formula called the estimated glomerular filtration rate (eGFR). Some of these formulas used race to assess whether kidney function was abnormal. However, doing so increased health care disparities between races in diagnosis and treatment of kidney disease. Thus, including race in such assessments is no longer recommended. Measuring the blood level of potassium is important, because it can become dangerously high when kidney failure reaches an advanced stage or if people ingest large amounts of potassium or take a medication that prevents the kidneys from excreting the potassium. Analysis of the urine may detect many abnormalities, including protein and abnormal cells. Ultrasonography is often done to rule out obstruction and check the size of the kidneys. Small, scarred kidneys often indicate that loss of kidney function is chronic. Determining a precise cause becomes increasingly difficult as chronic kidney disease reaches an advanced stage. Removing a sample of tissue from a kidney for examination (kidney biopsy) may be the most accurate test, but it is not recommended if results of an ultrasound examination show that the kidneys are already small and scarred. 