Chronic kidney disease (CKD) is primarily diagnosed with blood and urine tests that detect chemical imbalances caused by the progressive loss of kidney function. The tests may be accompanied by imaging tests and biopsies used to pinpoint the exact reason for the dysfunction. Kidney function tests, also known as renal function tests, are essential for monitoring the progression of the disease and your response to therapy.
Chronic kidney disease develops when the kidneys, for whatever reason, are unable to filter waste and regulate the balance of water and acids in the body. The disease can be diagnosed by measuring certain substances, known as markers, that either rise or fall when the kidneys are impaired.
Serum creatinine (SCr) tests measure the amount of a substance called creatinine in your blood. Creatinine is a by-product of muscle metabolism that is excreted in the urine.
Glomerular filtration rate (GFR) is an estimation of how well your kidneys are functioning. Specifically, it estimates how much blood passes through the tiny filters of your kidneys, called glomeruli, each minute.
Glomeruli are components of a filtration unit called a nephron. The role of nephrons is to filter out larger cells like red blood cells and proteins so that they are not excreted. When the nephrons are damaged, protein and blood can escape and exit the body in urine.
Blood Urea Nitrogen
Blood urea nitrogen (BUN) measures the amount of a waste product in your blood, called urea nitrogen. Urea nitrogen is created when the liver breaks down protein and, like serum creatinine, is produced and excreted at a fairly consistent rate.
In addition to blood and urine tests, imaging tests can be used to identify and evaluate any damage that the kidneys may have sustained.
Ultrasound is the preferred method of imaging. It can be used to measure the size and appearance of the kidney and help locate tumors, lesions, and blockages. A newer technique called a Color Doppler can be used to identify clots, strictures (narrowing), or ruptures in the blood vessels of the kidneys.
X-rays are generally used to assess the size of kidney stones or to measure the size and shape of the kidney.
Computed tomography (CT) is a type of X-ray that can produce cross-sectional images of the kidneys. CT scans can be useful in detecting cancer, lesions, abscesses, obstructions, kidney stones, and the accumulation of fluid around the kidneys.
A kidney biopsy involves taking a tissue sample of your kidney to examine under the microscope. The biopsy may either be percutaneous (in which a needle is inserted into the kidney through your abdomen) or open (where tissue is obtained through a one- to two-inch laparoscopic surgical incision).
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