DIAGNOSIS OF CKD

CKD develops over time. If a patient has diabetes, hypertension, and certain anemias or possess a hereditary predisposition to kidney disease, their primary care physician will carefully monitor them for abnormal kidney function. Otherwise, testing for CKD begins when some sign of kidney abnormality is detected. A doctor will screen for CKD by measuring a patient's blood pressure and testing for substances that should not normally be in the urine and the blood.

Some blood tests used to determine kidney function:

Urine Albumin: This test checks for a specific protein, albumin, in the urine. Proteins, necessary for the building and repair of tissues in the body, leak into the urine when the kidney is damaged. “Proteinuria” is the clinical term for having too much protein in the urine.

Serum creatinine: This test measures how well the kidneys are removing creatinine from the body by calculating the levels of creatinine in the blood according to a patient's weight, age and gender.

Creatinine clearance (CrCl): This test measures the removal of creatinine from the body by calculating the levels of creatinine in the blood with a patient's weight, age and gender. Creatinine clearance can give an estimation of glomerular filtration rate (GFR), the major indicator of kidney function.

Glomerular Filtration Rate (GFR): The GFR gives a doctor the most accurate assessment of overall kidney function.

Blood Urea Nitrogen (BUN): The BUN measures levels of urea. If it is high, it is another indication of possible kidney disease.

Images can tell their own story. Sometimes doctors will order scans to visually examine the appearance of the kidneys. The health of the kidneys may also be evaluated by testing the actual tissue.

Ultrasound or CT scan: Such screenings may be used to determine abnormalities in kidney size and/or placement, to estimate residual urine, or to pinpoint abnormalities like kidney stones.

Kidney biopsy: This involves removing small pieces of kidney tissue with a long, thin needle and examining them under a microscope.

In most cases, a nephrologist is called in when moderate kidney damage is apparent. However, if a patient has pre-existing, poorly managed diabetes or hypertension they may be referred to a specialist earlier.

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