Chronic Kidney Disease (CKD) is often diagnosed through routine blood and urine tests. In many instances, these tests, initially conducted for other health concerns, reveal underlying kidney issues that might otherwise go unnoticed. Early Diagnosis Of Kidney Disease is crucial for effective management and to slow disease progression.
Who Should Be Tested for Kidney Disease?
It’s important to consult with a healthcare professional if you experience persistent symptoms that may indicate CKD. These symptoms can include:
- Unexplained weight loss or a noticeable decrease in appetite
- Swelling in the ankles, feet, or hands (edema)
- Shortness of breath
- Persistent fatigue or unusual tiredness
- Blood in your urine
- Increased frequency of urination, especially at night
These symptoms warrant a visit to a General Practitioner (GP) who can investigate potential causes and arrange necessary tests to assess kidney function.
Given that CKD frequently progresses without noticeable symptoms in its early stages, regular testing is particularly recommended for individuals at higher risk. You should consider regular kidney function testing if you fall into any of these categories:
- Individuals with a family history of kidney disease
- People diagnosed with diabetes
- Individuals with high blood pressure (hypertension)
- Older adults
- People of Black or South Asian origin, as these ethnicities have a higher predisposition to kidney disease.
- Children and young adults with only one functioning kidney.
- Individuals on long-term medications known to potentially affect kidney function, such as lithium, omeprazole, or non-steroidal anti-inflammatory drugs (NSAIDs).
If you believe you might benefit from regular kidney disease testing due to any of these risk factors, it’s essential to discuss this with your GP.
Essential Tests for Kidney Disease Diagnosis
Diagnosing kidney disease primarily involves blood and urine tests. These tests provide critical insights into how well your kidneys are functioning.
Blood Test: Measuring Kidney Function with eGFR
The cornerstone of kidney disease diagnosis is a blood test. This test measures creatinine levels in your blood, a waste product that healthy kidneys efficiently filter out.
From your blood test results, along with factors like your age, body size, and gender, doctors calculate your estimated glomerular filtration rate (eGFR). eGFR represents the volume of waste your kidneys are capable of filtering per minute.
A healthy eGFR is typically 90 ml/min or higher. An eGFR below 90 ml/min may indicate CKD, with lower values suggesting more advanced stages of kidney disease.
Urine Test: Assessing Albumin and Other Indicators
A urine test is also a vital component of kidney disease diagnosis. It serves several important purposes:
- Albumin:Creatinine Ratio (ACR): The urine test measures the levels of albumin and creatinine in your urine to calculate the ACR. Albumin is a protein, and its presence in urine can be an early sign of kidney damage.
- Detection of Blood or Protein: The urine test also checks for the presence of blood or protein, further indicators of potential kidney problems.
Combined with your eGFR, urine tests provide a more comprehensive assessment of your kidney health and function, aiding in a more accurate diagnosis.
Other Diagnostic Tests
In certain situations, additional tests may be employed to gain a more detailed understanding of kidney damage. These might include imaging tests like ultrasound or CT scans, or a kidney biopsy in specific cases. However, blood and urine tests remain the primary diagnostic tools for CKD.
Understanding Your Test Results and CKD Stages
Your blood and urine test results are crucial in determining the extent of kidney damage, known as the stage of CKD. Staging helps doctors determine the most appropriate treatment plan and the frequency of monitoring required for your condition.
The eGFR result categorizes CKD into five stages, from 1 to 5:
- Stage 1 (G1): eGFR is normal (above 90ml/min), but other tests indicate signs of kidney damage.
- Stage 2 (G2): eGFR is mildly reduced (60 to 89ml/min), with other signs of kidney damage present.
- Stage 3a (G3a): eGFR is moderately reduced (45 to 59ml/min).
- Stage 3b (G3b): eGFR is moderately reduced to severely reduced (30 to 44ml/min).
- Stage 4 (G4): eGFR is severely reduced (15 to 29ml/min).
- Stage 5 (G5): eGFR is very severely reduced (below 15ml/min), indicating kidney failure or end-stage renal disease.
The ACR result is staged from A1 to A3:
- A1: ACR is less than 3mg/mmol (normal to mildly increased albuminuria).
- A2: ACR is 3 to 30mg/mmol (moderately increased albuminuria).
- A3: ACR is greater than 30mg/mmol (severely increased albuminuria).
For both eGFR and ACR staging, a higher stage number signifies more advanced and severe kidney disease. Understanding your CKD stage is a vital step in managing your kidney health and working with your healthcare provider to develop a personalized treatment strategy.
