Chronic Kidney Disease (CKD)

Diagnosis

CKD usually causes no symptoms in its early stages and anyone who is at increased risk should perform lab tests to detect the disease. These include urinalysis, blood and x-ray tests.

Urinalysis : Urinalysis examine the sample of the urine for color, clarity, odor, concentration, and acidity. It also checks for abnormal levels of protein, sugar, and blood cells or other substances found in the urine. The presence of protein in the urine indicates kidney damage.
Dipstick test is the first step of urinalysis. It has reagents that check the urine for the presence of various normal and abnormal constituents including protein. Urine is then examined under a microscope to look for red and white blood cells, presence of casts and crystals. In another test, the urine for 24 consecutive hours are collected and analyzed for protein and waste products. The amount of creatinine and urea excreted in the urine can be used to calculate amount of kidney function and the glomerular filtration rate (GFR).   

Glomerular filtration rate is the standard means of expressing overall kidney function. The normal GFR is about 100-140 mL/min in men and 85-115 mL/min in women. As kidney disease progresses, GFR falls. It decreases in most people with age. GFR is estimated using calculations that include the serum creatinine, blood urea nitrogen and serum albumin, as well as your age, race, and sex.

Blood Tests :
The level of urea and creatinine rises in the blood as kidney function worsens. Urea is the waste product of breakdown of protein. Creatinine is a breakdown product of normal muscle breakdown. 

Blood urea nitrogen (BUN) test - This test measures the amount of nitrogen in your blood that comes from the waste product urea. A BUN test is done to estimate the functioning of kidney. The BUN level increases, if the kidneys are not able to remove urea from the blood. Heart failure, dehydration, certain medicines, intestinal bleeding can also increase the BUN level. Liver disease or damage can decrease the BUN level

Serum creatinine - This test measure the level of the waste product creatinine in the blood and urine. If the kidneys are damaged and cannot function normally, the amount of creatinine in the urine decreases while the amount of creatinine in the blood increases.

Complete blood count (CBC) - A CBC provides important information about the red blood cells, white blood cells, and platelets. It can be used to check for diseases or infections that could be causing renal failure.

Ultrasound : Ultrasound is a noninvasive type test used in the diagnosis of kidney disease. It is also used to diagnose presence of urinary obstruction, kidney stones and also to assess the blood flow into the kidneys.

Biopsy : If the kidney disease is unclear, a biopsy is required. In biopsy, a sample of the kidney tissue is collected by introducing a special needle through the skin into the kidney. The sample is observed under a microscope for the cause of the inflammation.