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Medical Tests of Kidney Function

Blood tests

Serum creatinine. 

 

Synonym: Cr

Specimen : Serum 

Reference Value : 0.6 - 1.2 

Method :  Spectrophotometer 


Description

Creatinine (kree-AT-uh-nin) is a waste product that comes from meat protein in the diet and from the normal wear and tear on muscles of the body. Creatinine levels in the blood can vary, and each laboratory has its own normal range. In many labs the normal range is 0.6 to 1.2 mg/dL. Higher levels may be a sign that the kidneys are not working properly. As kidney disease progresses, the level of creatinine in the blood increases. 

Indications

Evaluated known or suspected impairment of renal function ( decrease glomerular filtration rate (GFR)

 

Interpretation 

 

Increase in : 

- Renal disease , acute and chronic renal failure .

- Congestive heart failure .

- Dehydration .

- Acute myositis.

- Hyperthyroidism .

- Shock .

Decrease in : 

- Decrease muscle mass owing to debilitating disease or increasing age . 

- Inadeque protein intake .

- Liver disease ( sever) due to decreasing creatine production  .

- Muscular dystrophy .  

 

Blood urea nitrogen (BUN). 

 

Synonym : BUN 

Specimen : Serum or Plasma 

Reference Value : 8 - 20 mg/dL

Method :  Spectrophotometer 

Description

 Urea nitrogen (yoo-REE-uh NY-truh-jen) also is produced from the breakdown of food protein. A normal BUN level is between 7 and 20 mg/dL. As kidney function decreases, the BUN level increases.

Indications : 

- Evaluated renal function

- Evaluated liver function 

- Evaluated hydration 

Interpretation 

Increase in 

- Acute renal failure . 

- Chronic glomerulonephritis 

- Congestive heart failure.

- Decrease renal perfusion 

- Diabetes .

- Increase protein catabolism 

- Excessive protein ingestion 

- Gastrointestinal bleeding .

- Hypovolemia 

- Nephrotoxic agents 

- Pyelonephritis 

- Shock 

- Urinary tract obstruction .

- Increase production of urea . 

-  Early prerenal azotemia

Decrease in : 

- Inadequate dietary protein 

- Low- protein / high - carbohydrates diet

- Malabsorption syndromes 

- Sever liver disease 

- Polyuria . 

 

Urine Tests


Some urine tests require only a few ounces of urine. But some tests require collection of all urine produced for a full 24 hours. A 24-hour urine test shows how much urine your kidneys produce in 1 day. The test is sometimes used to measure how much protein leaks from the kidney into the urine in 1 day. However, protein leakage can also be accurately determined in a small sample of urine by measuring its protein and creatinine concentration. 


Creatinine Clearance

 

Specimen : Urine (5 mL ) from an unpressed random or timed specimen collected in a clean plastic collection container . 

Reference value : Adults 90 - 130 mL/min/1.73m2

Method : Spectrophotometer 

A creatinine clearance test compares the creatinine in a 24-hour sample of urine to the creatinine level in the blood, to show how many milliliters of blood the kidneys are filtering out each minute (mL/min). The creatinine clearance can also be estimated accurately from the serum creatinine alone using well established prediction equations. 

Indications

- Determination the extent of nephron damage in known renal disease . 

- Determination renal function before administering nephro toxic drugs . 

- Evaluated glomerular functions 

- Monitor effectivenessof treatment in renal  disease . 

Interpretation

Increase in 

- High cardiac output . 

- Exercise 

- Acromegaly 

- Diabetes mellitus ( early stage ) 

- Infections , 

- Hypothyroidism 

 Decrease in 

- Acute or chronic glomerulonephrities .

- Acute or chronic renal failure 

- Decrease renal blood flow ( shock , hemorrhage, dehydration , CHF ) 

- Drugs : nephrotoxic drugs 

- Muscle wasting disease .

- Urinary tract obstruction ( e.g , from calcuii )

Comments

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