DIAGNOSIS OF RENAL FAILURE

The diagnosis of renal failure can be done through the observation of a combination of symptoms ,physical examination and elevated the build up of waste products in the blood such as blood urea nitrogen (BUN),creatinine (Cr) levels, serum potassium, Glomerular filtration rate  and urinalysis. 

Urinalysis

Test to measure the amount of protein, detect the presence of abnormal blood cells, or measure the concentration of electrolytes.

•  Abnormalities of protein concentration in urine can act as indicator that the damage to the kidney has occurred. The most accurate method is  protein to creatinine ratio. Normal(200 mg/gm or less per day).Another test ,albumin to creatinine ratio which normal reading(30 mg/gm per day).More than 30 mg/gm per day or higher is sign of early kidney disease
•  The present of anaemia also related with kidney disease where abnormal aggregations of RBC can be seen in urine.Kidney disease disrupts blood cell production and shortens the survival  the red blood cell count and hemoglobin may be low (anemia)
• Comparing the concentrations of electrolytes in the blood and urine can help decide whether the kidneys are able to appropriately monitor and filter blood. Kidney dysfunction causes imbalances in electrolytes,such hyperkalemia, hypocalcemia (Decreased production of the active form of vitamin D), Hyperphosphatemia (Inability of failing kidneys to excrete phosphorus)

 Glomerular filtration rate  

Estimated from results of a serum (or blood)creatinine test. The GFR show the effciency of kidney to remove wastes from your blood. A serum (or blood) creatinine test alone should not be used to check kidney function. GFR is calculated using the serum creatinine and other factors such as age and gender.(refer GFR table)

A blood urea nitrogen (BUN) test

Measuring the amount of nitrogen in the blood that comes from the waste product urea.. BUN level rises when the kidneys aren't working well enough to remove urea from the blood.

Serum creatinine and creatinine clearance tests

Tests  that measure the level of waste,creatinine in blood & urine.It(creatine) formed when food converted into energy through a process of metabolism. Creatine broken further into creatinine that taken out of your blood by the kidney.

Types of tests on creatinine

Ø  Blood creatinine level

T A high creatinine level may mean your kidneys are not working properly.

Ø  Creatinine clearance test

A creatinine clearance test measures how well creatinine is removed from your blood by your kidneys. A creatinine clearance test is done on both a blood sample and on a sample of urine collected over 24 hours (24-hour urine sample).

Ø  Blood urea nitrogen-to-creatinine ratio (BUN:creatinine)

The levels of blood creatinine and blood urea nitrogen can be used to find the BUN-to-creatinine ratio. A blood urea nitrogen (BUN) test measures the amount of urea in blood.

Other related tests

• Abdominal ultrasound (check size or any obstruction exists)
• Kidney biopsy (tissues of kidney examine under microscope)
• Duplex Dropper study(check restricted of blood flow such renal artery stenosis)