Category Archives: Blood/Urine Testing For Kidney Disease

my question is about my stage 4 chronic kidney disease, doctor when I breathe I feel a strong pain in the under the lungs is how a very hard squeeze. Doctor I do not have fluid retention, I do not have hypertension the pth is in 263.90 with very small kidneys less than half of the normal of an adult, I am not on dialysis or pre-dialysis what can I test can you recommend to see what is affecting my Kidneys, my nephrologist does not recommend a biopsy because the kidneys are very small and can bleed. I don’t know what is causing my kidney disease. Can you give me a concept Doctor a hug and blessings.

I am not able to make a specific diagnosis based on the information that you present.  Your symptoms could be consistent with chronic kidney disease (CKD) but you indicate that you do not have fluid overload.  Your blood pressure should … Continue reading

Posted in Ask the Doctor, Blood/Urine Testing For Kidney Disease, Chronic Kidney Disease, Hypertension/High Blood Pressure, Kidney-Related Health Questions, Laboratory Testing, Symptoms and Side Effects

I have biopsied IgA Nephropathy. My recent blood and urine tests show that among other out of range values my BUN has increased to over 30. In addition, I show small reductions in my red blood count and hematocrit which are now out of range. I have been on Coumadin for 10 years and wonder if it has contributed to these recent developments. There has been a recent study which shows that all of the various blood thinners contribute to worsening kidney function if one already has impaired function. My current gfr is 42 whereas a year ago it was 49.

Coumadin (warfarin) can cause episodes of acute kidney injury (AKI) in patients with underlying chronic kidney disease (CKD). This happens when the dose of Coumadin is excessive and the blood become too thin.  I am not aware of any studies … Continue reading

Posted in Acute Kidney Injury, Ask the Doctor, Blood/Urine Testing For Kidney Disease, Chronic Kidney Disease, Kidney-Related Health Questions

The criteria for determining CKD is very confusing to me. As you know, the Merck Manual lists 5 stages of CKD. From reading some of your past posts it appears that you consider eGFR 60 or above to be normal. I have read that one of the following must be present for > or = three months to be CKD: GFR 29, or other markers of kidney damage. According to this criteria, it appears to me that stages 1 & 2 of CKD as defined in the Merck Manuel are completely ignored. Please explain.The other question I have is that the National Kidney Foundation website states that 37, 000, 000 adults have CKD in the US. There is no explanation as to what that number includes. That seems to be a lot of people to be in stages 3,4, & 5 so does that number include stages 1 & 2?

There are 5 Stages of chronic kidney disease (CKD) that have been proposed by the National Kidney Foundation (NKF). The estimating equation that we use to calculate the estimated glomerular filtration rate (eGFR) is most accurate and consistent when the … Continue reading

Posted in Ask the Doctor, Blood/Urine Testing For Kidney Disease, Chronic Kidney Disease, GFR, Kidney Biopsy, Kidney-Related Health Questions, Polycystic Kidney Disease

I am a 47 yr old Asian/American female. Recently got my labs done and saw that my GFR was 59. Last year it was 68. I am not familiar with all this but my friend who is a nurse said I should be concerned. I did not have a urine test done. I did speak with my PCP and she said that she does not look at me a think kidney disease after looking at my labs. Should I consult with a Nephrologist?

I do suggest that you have a urine test for blood, protein and infection as part of a complete screening test for kidney disease.  Asian/Americans do have an increased incidence of chronic kidney disease compared to Caucasian/Americans.  It may be … Continue reading

Posted in Ask the Doctor, Blood/Urine Testing For Kidney Disease, Chronic Kidney Disease, GFR, Kidney-Related Health Questions, Nephrologist, Serum Creatinine

I’m a healthy 41 year old, I do competitive CrossFit year round. I had a physical recently that showed an elevated creatinine of 1.3 with GFR of 46. It appears one year ago my creatinine was 1.1 and GFR was 55. My doctor is not recommending any further tests. I do not take creatine or any other supplements. I take Prilosec daily. I drink 60oz water daily. Would you recommend any other tests?

I am not able to make a specific diagnosis based on the information that you present.  Additional testing should at least include a urine test for blood, protein and infection. It is possible that this represents early Stage 3 chronic … Continue reading

Posted in Ask the Doctor, Blood/Urine Testing For Kidney Disease, Chronic Kidney Disease, GFR, Kidney-Related Health Questions, Laboratory Testing, Nephrologist, Serum Creatinine

I recently got blood work done at a Quest Diagnostics lab. My creatinine level came in at 1.18. I’m a non-african-american male who is 36 years old. The eGFR non-african american number showed up on the results as 59. Every eGFR calculator I find online shows that this number should be a lot higher than 59 based on my age, gender, creatinine level, and race. Is it possible that Quest could’ve miscalculated this or is there another equation of calculation that they could potentially use?

I suggest that you go to our web site and use your vital information to calculate your estimated glomerular filtration rate (eGFR).  You can use our CKD-EPI formula to calculate your eGFR at:  https://www.kidney.org/professionals/KDOQI/gfr_calculator I suspect that a data entry … Continue reading

Posted in Ask the Doctor, Blood/Urine Testing For Kidney Disease, Chronic Kidney Disease, GFR, Kidney-Related Health Questions, Serum Creatinine

Hi there. I got some test results in today and the note said to come here. GFR MDRD Af Amer 99 See Note See Note. GFR is estimated using Creatinine, age, gender and race. Patient’s values should be interpreted as a trend. Below 90 ml/min/1.73m2, the patient may have renal disease.

The result mentioned is that your estimated glomerular filtration rate (eGFR) is 99 milliliters per minute per 1.73 meters squared if you are African American and 81 milliliters per minute per 1.73 meters squared if you are non-African American. In … Continue reading

Posted in Ask the Doctor, Blood/Urine Testing For Kidney Disease, Chronic Kidney Disease, GFR, Kidney-Related Health Questions, Laboratory Testing, Urinary Tract Infection/Pyelonephritis

I am 62 year old white female. 5’2” 124 pounds. HTN x 30 years well controlled with Atenolol, Losartan and HCTZ. Type 2 diabetes x 5 years, well controlled with metformin. 6 months ago I adopted 45 minute brisk walk daily and cut out breads, grains, sugar and starchy vegetables. Eating primarily lower carb foods. 20 pound weight loss and able to stop metformin. Recently at well visit with PCP labs were ordered. A1C 5.8. Basic metabolic panel results: Glucose 90. BUN 16mg/dt, Creatinine 0.55 mg/dL, BUN/Crea ratio value 29, Estimated GFR value 112/mL/min/1.73m^2. Urinalysis, macro/micro: protein-negative, ketones 1+. 24 hour urine: creatinine timed urine 30.60 mg/dL (standard range 100.00-200.00 mg/dL), creatinine specimen value 1,178 mg/specimen. Protein timed urine 12mg/dL (standard range 42-225 mg/dL, protein/specimen 462 mg/specimen (standard range 42-225 mg/specimen). Microalbumin/Creatinine ratio results: creatinine random urine 116 mg/dL, microalbumin random urine 1.4mg/dL, microalbumin/creatinine ratio random urine 12.1 mg/g (standard range 0.0-30.0 mg/g). Due to protein in 24 hour urine my PCP ordered at ultrasound of kidney and CT of abdomen and pelvis. Both US and CT are normal. Please help me interpret these lab tests to determine if there is concern for kidney damage/disease and if further testing is needed. Reported is high protein in the 24 hour urine. Thank you.

All of the testing that you quote appears to be normal except for your 24 hour urine protein test.  Normal for this is commonly quoted at less than 150 or 200 milligrams per day.  The normal that you quote is … Continue reading

Posted in Ask the Doctor, Blood/Urine Testing For Kidney Disease, Chronic Kidney Disease, GFR, Kidney-Related Health Questions, Laboratory Testing

I have observed that, total urinary protein, urinary creatinine and urinary microalbumin are commonly measured in laboratory tests for kidney disease patients. It is my understanding that the protein creatinine ratio (P/C) is the ratio of the total urinary protein, which consists of the measurable amount of microalbumin in that test and other proteins, to urinary creatinine. Also calculated in laboratory tests is the urinary microalbumin to urinary creatinine ratio (A/C). I understand that the microalbumin test is more sensitive in order to measure this parameter more accurately but why is it necessary to measure this parameter in the first place and determine the A/C when the P/C also seems to consider the microalbumin? What does the amount of microalbumin in the total protein tell you?

The urinary albumin to creatinine ratio (also commonly called the microalbumin to creatinine ratio) is a much more sensitive test.  The lower limit of detection for the urine albumin to creatinine ratio is commonly in the range of 3-5 micrograms … Continue reading

Posted in Ask the Doctor, Blood/Urine Testing For Kidney Disease, Chronic Kidney Disease, GFR, Kidney-Related Health Questions, Laboratory Testing, Microalbuminuria

Will you kindly tell me whether I am developing CKD? What are the steps for me to follow in the future? May I consult a nephrologist?

The information that you present appears normal to me.  In order to screen for chronic kidney disease (CKD), you should also have urine testing for blood, protein, and infection.  

Posted in Ask the Doctor, Blood/Urine Testing For Kidney Disease, Chronic Kidney Disease, Kidney-Related Health Questions, Nephrologist