Re: Blood testing

[Jason]

In article <kldbck$3ai$2...@news.albasani.net>, freddy221
<fred...@hotmail.com> wrote:

> What blood tests do you routinely have to determine progression of CKD?
> And why do you have each one?
> I have more to say on this depending on replies I may or may not get.

The main one to keep track of is:

CREATININE

One other test is a urine test for protein.

If you have protein in your urine, it can indicate kidney problems.

Also look for GFR or GFR ESTIMATED. If the reading is above 60, it usually
means your kidneys are working very well. However, if the figure starts
moving downward--that can indicate your kidneys are starting to decline.

I suggest that buy and read this book:

COPING WITH KIDNEY DISEASE by Mackenzie Walser, M.D.

Chris may tell you other blood tests and urine tests that are used to
track kidney disease.

[mainframetech]

On Apr 26, 3:46 am, freddy221 <freddy...@hotmail.com> wrote:
> What blood tests do you routinely have to determine progression of CKD?
> And why do you have each one?
> I have more to say on this depending on replies I may or may not get.

Hi Freddie...:)

You should ask to have Serum creatinine readings. And from that
they derive an eGFR (estimated Glomerular Filtration Rate). These are
the main readings that diagnose loss of kidney function in Chronic
Kidney Disease (CKD). There are a few related diseases with different
names, but many of them have similar characteristics.

If the eGFR reading is below 60 for 3 months, then they diagnose it
as Chronic Kidney Disease. Here are the 5 stages of Kidney disease:

Stage 1 with normal or high GFR (GFR > 90 ml/min)
Stage 2 Mild CKD (GFR = 60-89 ml/min)
Stage 3 Moderate CKD (GFR = 30-59 ml/min)
Stage 4 Severe CKD (GFR = 15-29 ml/min)
Stage 5 End Stage CKD (GFR <15 ml/min)

Once stage 5 is reached it's time for Dialysis or a kidney
transplant in order to maintain life. It's desirable to avoid
dialysis, but there is no cure for Chronic Kidney Disease and there is
a steady progression toward the need for dialysis or transplant. The
speed of the progression of the disease varies for each person and can
be quick for some. The transplant line is long, so that you will
probably have to go into dialysis to keep you going until a transplant
is available that is a match for you. That could take years.

The reason I say that dialysis should be avoided or delayed as long
as possible is that 1 out of 4 people die in the first year of
dialysis. They don't advertise that statistic, but it's legitimate.


If we know more about your circumstances, we can help more with
information. Do you have a recent reading of serum creatinine, or an
eGFR? Have you been diagnosed with CKD?

There are various ways to avoid or delay the progression to
dialysis, each of us chooses our method.

Good Luck,
Chris

[Pendragon]

On Fri, 26 Apr 2013 07:46:35 +0000 (UTC), freddy221
<fred...@hotmail.com> wrote:

>What blood tests do you routinely have to determine progression of CKD?
>And why do you have each one?
>I have more to say on this depending on replies I may or may not get.

Depends on what the disease is and how we are progressing but most
would include all or some of these:
http://www.labtestsonline.org.uk/understanding/conditions/kidney/?show_all=1&printpreview=1

What is the urinary system?The urinary system cleanses the blood and
rids the body of excess water and waste in the form of urine. It
consists of two kidneys, two ureters (one from each kidney), tubes
that drain urine from the kidneys into the bladder (a storage sac),
and the urethra (the tube that transports the urine out of the body).
Muscles help control the release of urine from the bladder.

The kidneys, a pair of bean-shaped organs, are located at the bottom
of the ribcage in the right and left sides of the back. Although the
body is equipped with two kidneys, you can function with one
reasonably healthy kidney if the other is damaged or removed. The
kidneys receive blood from the aorta, filter it, and send it back to
the heart with the right balance of chemicals and fluid for use
throughout the body. The urine created by the kidneys is moved out of
the body via the urinary tract.

The kidneys control the quantity and quality of fluids within the
body. They also produce hormones and vitamins that direct cell
activities in many organs; the hormone renin, for example, helps
control blood pressure. When the kidneys are not working properly,
waste products and fluid can build up to dangerous levels, creating a
life-threatening situation. Among the important substances the kidneys
help to control are sodium, potassium, chloride, bicarbonate, pH,
calcium, phosphate, and magnesium.

Diseases and conditions affecting the kidneyAny diseases that affect
the blood vessels, including diabetes, high blood pressure, and
atherosclerosis (hardening of the arteries), can impair the kidneys’
ability to filter blood and regulate fluids in the body. Disease and
infection in other parts of the body can also trigger a kidney
disorder. Because kidney impairment can be life-threatening, disorders
and diseases that may affect the kidney deserve prompt attention.
Kidney disease often causes no symptoms until late in its course and
can lead to end-stage kidney failure, which is fatal unless a dialysis
machine is used or a kidney transplant is performed. There are more
than 100 disorders, diseases, and conditions that can lead to
progressive destruction of the kidneys. Some of the more common
problems are described here. Warning signs that should not be ignored
are also listed below.

Obstruction –The urinary tract can become partially obstructed (for
example, by a kidney stone, tumour, expanding uterus during pregnancy,
or enlarged prostate gland). The build-up of pressure can lead to
infection and injury of the kidney. With a kidney stone, often the
blockage is painful. Other obstructions may produce no symptoms and be
detected only when a blood or urine test is abnormal or an imaging
procedure, such as an x-ray or ultrasound, detects it.

Infection –Urinary tract infections, such as cystitis (an infection of
the bladder), can lead to more serious infections further up the
urinary tract. Symptoms include fever, frequent urination, sudden and
urgent need to urinate, and pain or a burning feeling during
urination. There is often pressure or pain in the lower abdomen or
back. Sometimes the urine has a strong or foul odour or is bloody.
Pyelonephritis is an infection of kidney tissue; most often, it is the
result of cystitis that has spread to the kidney. An obstruction in
the urinary tract can make a kidney infection more likely. Infections
elsewhere in the body, including, for example, streptococcal
infections, the skin infection impetigo, or a bacterial infection in
the heart can also be carried through the bloodstream to the kidney
and cause a problem there.

Glomerular diseases –Glomerular diseases are those that attack the
blood filtering units of the kidneys. Diabetes and high blood pressure
can lead to glomerular disease. Diseases of this type cause more cases
of chronic kidney failure than any other cause. The blood is
continually filtered through microscopic clusters of looping blood
vessels, called glomeruli. Attached to each glomerulus is a tiny tube
(tubule) that collects the waste that has been filtered out. The
filtering unit (glomerulus and tubule) is called a nephron.

Often, a glomerular disease is triggered by an abnormal reaction of
the immune system. In this case, the body’s own infection fighters
mistakenly attack the kidney tissues. Sometimes, an autoimmune
disorder such as systemic lupus erythematosus or Goodpasture syndrome
is the cause. The attack on the glomerulus may also be the result of
an inherited condition. An attack on the glomerulus may also occur
after a bacterial infection in another part of the body, such as a
strep infection of the throat or skin, the skin infection impetigo, or
an infection inside the heart. Viruses, such as the HIV virus that
leads to AIDS, can also trigger glomerular disease.

In diseases and conditions classified as glomerulonephritis (also
called nephritis), the glomeruli become inflamed. As blood filtering
becomes impaired, urine output decreases, water and waste products
accumulate in the blood, and blood appears in the urine. Because the
blood cells break down, urine often becomes brown instead of red.
Certain body tissues swell with the excess water (a condition called
oedema). Outcomes can vary: the condition may go away in a few weeks,
permanently reduce kidney function, or progress to end-stage kidney
failure.

In nephrotic syndrome, the blood loses protein to the urine because of
damage to the membrane between the glomeruli and tubules. As the
amount of albumin (a major protein) decreases in the blood, parts of
the body swell with fluid (often around the eyes or in the belly or
legs). Other diseases and illnesses may lead to this syndrome, and
complications such as blood clots and high cholesterol may develop.
Childhood nephrotic syndrome usually responds well to treatment and
does not usually result in permanent kidney damage.

Other factors –Any situation in which there is severe blood loss or
reduced blood flow may prevent the kidneys from working correctly.
Severe dehydration, some aortic and heart surgeries, a severe
infection in the blood or heart, and severe heart failure are examples
of events that can lead to sudden kidney problems. The damage is
usually reversible; although with shock or severe infection, the
damage may be permanent. Some medications and diagnostic agents can
have toxic effects. In some cases, non-steroidal anti-inflammatory
drugs (NSAIDS, such as over-the-counter ibuprofen and various
prescription drugs), x-ray dye, ACE inhibitors, and certain
antibiotics can damage the kidneys. Acute (sudden) kidney failure may
result, a condition that requires emergency medical treatment to
prevent death.

Cancers involving the urinary system are not as common as those in
other parts of the body. Kidney cancers are of two main types. One
called Wilm's tumour occurs in young children and is often detected as
a firm swelling in the belly. Renal cell carcinoma, which occurs in
middle-aged to older adults, can cause blood in the urine but is often
not detected until it has spread to other parts of the body. Bladder
cancers are more common, and often present with painless, bloody
urine. In many cases, the blood is only detected when a urinalysis is
performed. Because bladder cancers can be controlled when detected
early, any urine bleeding in adults (except during a woman’s menstrual
period) should be checked by your doctor.

Signs and symptomsKidney disease often proceeds silently over many
years, with no signs or symptoms the patient can recognize or with
signs that are too general for the patient to suspect kidney trouble.
For that reason, routine blood and urine tests are especially
important; they detect blood or protein in the urine and abnormal
levels of chemicals in the blood, such as creatinine and urea, early
signs of kidney disorder and failure. The following problems may,
however, be warning signs of kidney disease and should not be ignored.
Prompt medical attention is required when any of these conditions are
present.

Swelling or puffiness, particularly around the eyes or in the face,
wrists, abdomen, thighs or ankles
Urine that is foamy, bloody, or coffee-coloured
A decrease in the amount of urine
Problems urinating, such as a burning feeling or abnormal discharge
during urination, or a change in the frequency of urination,
especially at night
Mid-back pain (flank), below the ribs, near where the kidneys are
located
High blood pressure
TestsTests performed on samples of your blood and urine are the first
step in the investigation of kidney problems. Tests of these types can
show how well the kidneys are removing excess fluids and waste. When
changes in the shape or size of the kidney, bladder or urinary tract
are suspected, a variety of imaging tests can be used. A sample of
kidney tissue, a biopsy, is sometimes helpful in diagnosing the
specific cause of the problem.

Tests commonly used for screening and diagnosis –There are several
tests commonly used to help the healthcare professional recognize if
you have kidney or urinary disease. A blood sample can be analysed for
creatinine (and estimated glomerular filtration rate [EGFR]) and urea.
The level of these waste products in the blood increases as kidney
filtration declines. Abnormal results are usually the first sign that
kidney disease is present. A urine sample is typically also examined
and analysed (urinalysis) as part of routine screening. This set of
tests looks for indicators of kidney and urinary disease such as red
blood cells, white blood cells (WBCs or leukocytes), and protein in
the urine. If you have diabetes or high blood pressure, the amount of
protein in your urine should be checked at least yearly to detect
kidney disease in its early stages. Often a particular protein called
albumin is measured: increased amounts of albumin in the urine are
referred to as microalbuminuria. When you have symptoms suggesting
infection, a urine culture can confirm the presence of a bacterial
infection.

Tests to monitor kidney function –If you have been diagnosed with a
kidney disease, your health care provider will request laboratory
tests to help monitor kidney function. Blood levels of urea and
creatinine are measured from time to time to see if the kidney disease
is getting worse. The amount of calcium and phosphate in the blood and
the balance of serum and urine electrolytes can also be measured, as
these are often affected by kidney disease. Haemoglobin, measured as
part of a full blood count (FBC) may be measured (the kidneys make a
hormone, erythropoietin, that controls red blood cell production).
Urine total protein or albumin can be used to test the effects of
treatment in diabetes and nephrotic syndrome (a condition where the
kidneys leak large amounts of protein into the urine). Parathyroid
hormone, which controls calcium levels, is often increased in kidney
disease and it may be checked to see if bone damage is developing that
requires treatment.


Condition Tests Used in Diagnosis Tests Used to Follow Chronic kidney
disease (chronic renal failure)
Blood urea, creatinine, estimated GFR, urinalysis Urea, creatinine,
estimated GFR, electrolytes, calcium, phosphate, alkaline
phosphatase, parathyroid hormone, FBC

Urinary tract infections
Urinalysis, urine culture Urinalysis, urine culture

Kidney stones Imaging (see below),
urinalysis Urine sodium, calcium, phosphate, citrate, oxalate, uric
acid

Nephrotic syndrome
Urinalysis; serum albumin, total protein, cholesterol; urine total
protein; antinuclear antibody (ANA) test, hepatitis B test, hepatitis
C test; complement levels Urine total protein, serum cholesterol,
urea, creatinine, estimated GFR

Nephritis Urinalysis,
serum urea, creatinine, estimated GFR, serum albumin, urine total
protein, antinuclear antibody (ANA) test, antistreptolysin O,
antiglomerular basement membrane antibody, antineutrophil cytoplasmic
antibodies Urea, creatinine, estimated GFR, urinalysis

Kidney disease due to diabetes or high blood pressure
Microalbumin Microalbumin, urine total protein, urea, creatinine,
estimated GFR

note:
Imaging techniques –If blockage to the flow of urine or kidney damage
which might alter the shape or size of the kidney or urinary tract is
suspected, a picture of the kidneys can be helpful. Imaging techniques
such as an ultrasound, CT scan (computed tomography), isotope scan, or
intravenous pyelogram (IVP) may be used. Various x-ray procedures can
also be employed, such as an intravenous urogram, micturating
cystogram (picture whilst passing urine), or renal arteriogram (which
looks af the flow of blood in the kidney.

Kidney biopsy –A biopsy can determine the cause of protein or blood in
the urine. Analysing a small piece of kidney tissue can reveal the
nature and extent of structural damage to a kidney. A biopsy, obtained
using a biopsy needle and diagnostic imaging equipment, is often
useful when disease of the glomerular filter is suspected.

[mainframetech]

On Apr 27, 4:36 pm, freddy221 <freddy...@hotmail.com> wrote:
> Pendragon <nom...@hereplease.com> wrote innews:d12ln8961fluvc1vn...@4ax.com:
>
> >http://www.labtestsonline.org.uk/understanding/conditions/kidney/?show_
> > all=1&printpreview=1
>
> Your reply was the only one that attempted to answer the question and was
> a good reply. That is why when you have questions I attempt to answer
> them Putting together a list for the lab for my next visit, it's going to
> be expensive :-(

We might do better if we had answers to some of our questions.
What led you to look around about kidney disease?

If you've had any blood testing in the recent past many states now
have laws that the patient must have access to their records, so that
asking for the records may be no cost to you.

Good Luck,
Chris

[Pendragon]

On Sat, 27 Apr 2013 20:36:05 +0000 (UTC), freddy221
<fred...@hotmail.com> wrote:

>Pendragon <nom...@hereplease.com> wrote in

>news:d12ln8961fluvc1vn...@4ax.com:
>
>> http://www.labtestsonline.org.uk/understanding/conditions/kidney/?show_
>> all=1&printpreview=1
>>
>
>Your reply was the only one that attempted to answer the question and was
>a good reply. That is why when you have questions I attempt to answer
>them Putting together a list for the lab for my next visit, it's going to
>be expensive :-(

What is you condition currently, and when did you last have bloods?
Hopefully you are under a good nephrologist who will request the most
important bloods for you.