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Mostly, there are no symptoms produced by early kidney disease thus, the only way to diagnose or to rule out chronic kidney disease is to do tests to check for kidney functioning.
A person should get himself checked for kidney disease if he or she has the following:
• A family history of kidney failure
A person having diabetes, should get kidney function checked every year.
A person with high blood pressure, heart disease, or a family history of kidney failure, should consult with the doctor to know how often they should get tested. The earlier a person gets to know about kidney disease, the sooner he or she can get treatment to help protect from further kidney damage.
Chronic Kidney Disease Diagnosis is done with two simple tests:
1. Urine test for protein (albumin)– the presence of protein in urine is a sign of kidney damage.
2.Blood test for creatinine which is in turn used to estimate glomerular filtration rate (GFR) which suggests the degree of functioning of the kidneys.
Even if these tests come out to be normal they should be repeated in the future, especially if there are risk factors present for kidney disease.
GFR or to be precise eGFR means an estimated glomerular filtration rate which is a term used to denote how much blood is passing through the glomeruli each minute. Glomeruli are the tiny filters in the kidney which removes waste products from the blood.
Estimating the rate of blood flow through glomeruli gives us an idea about the functioning of the kidney.
GFR is considered the best test to measure the level of kidney function and to determine the stage of kidney disease
A blood sample is taken and sent to a lab to measure the creatinine level in the blood. Creatinine is a waste product of creatine which is a chemical the body makes to supply energy, mainly to muscles.
The obtained creatinine level is combined with several other factors to estimate GFR. Different formulae are used for adults and children which includes some or all of the following:
• Blood creatinine measurement
Another test called creatinine clearance test can also be used to estimate kidney function. This involves a 24-hour urine collection.
According to the National Kidney Foundation, the normal value of GFR ranges from 90 to 120 mL/min/1.73 m2. The GFR declines normally with age, even in people without kidney disease. Given below are the average estimated GFR based on age.
|Age (years)||Average estimated eGFR|
The GFR of a person can’t be raised but can be kept from getting lower.
Levels less than 60 mL/min/1.73 m2 for 3 or more months are a sign of chronic kidney disease diagnosis. A GFR lower than 15 mL/min/1.73 m2 is a suggests kidney failure and requires immediate medical attention.
Calculate your GFR (for adults- above 18 years of age).
Urine Test for Albumin: is done to find out the kidney damage. This based on the fact that a healthy kidney doesn’t let albumin pass into urine. Albumin is a protein found in the blood. The presence of albumin in urine called albuminuria suggests kidney damage. The less albumin in urine, the better it is.
A health care provider can estimate albumin in the urine in two ways:
Dipstick test for albumin: A chemically treated paper, called a dipstick, is put into the collected urine sample to check for albumin. The presence of albumin changes the color of the dipstick.
Urine albumin-to-creatinine ratio (UACR): measures and compares the amount of albumin with the amount of creatinine in the given urine sample.
A urine albumin result of 30 mg/g or less is normal.
Urine albumin level of more than 30 mg/g may be a sign of kidney disease
In kidney disease, measuring the albumin in your urine helps to decide which treatment is best for a patient.
A urine albumin level staying the same or falling may suggest a response to the treatment given.
Stages of Kidney Disease
There are 5 stages of kidney disease which grade the kidney disease on the basis of the presence of kidney damage and the value of glomerular filtration rate (GFR). The treatment is based on these stages of kidney disease which are as follows:
|STAGES OF CHRONIC KIDNEY DISEASE||GFR*||% OF KIDNEY DISEASE|
|Stage 1- Kidney damage with normal kidney function||90 or higher||90-100%|
|Stage 2- Kidney damage with mild loss of kidney function||89 to 60||89-60%|
|Stage 3a- Mild to moderate loss of kidney function||59 to 45||59-45%|
|Stage 3b- Moderate to severe loss of kidney function||44 to 30||44-30%|
|Stage 4- Severe loss of kidney function||29 to 15||29-15%|
|Stage 5- Kidney failure||Less than 15||Less than 15%|
* Your GFR number tells you how kidney function you have. As kidney disease gets worse, the GFR number goes down
A person can know if the treatment is working for him or her if:
GFR value remains the same
Urine albumin stays the same or becomes less.
Worsening of the above values suggest worsening of the disease
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