A Guide for Understanding ESRD Blood Lab Values
TackneyNY
Date: 3/28/1999 00:43:56 Eastern Standard Time
From: TackneyNY
To: dial...@wugate.wustl.edu
A Guide for Understanding ESRD Blood Lab Values
http://www.aakp.org/labs.html
Blood Lab Value Comparison
Normal (non-ESRD) to Acceptable ESRD Normal
This guide was compiled by the staff of the Good Samaritan Hospital Chronic
Dialysis Center located at Bay Shore, New York.
Blood Values may vary between labs, doctors, and centers. If you have questions
regarding certain readings, inquire of the physician to assist in explaining
the importance and meaning of specific values while managing your end stage
renal disease condition.
Blood Chemistries
-1. BUN (Blood Urea Nitrogen)
-2. Calcium (Ca)
-3. Calcium Phosphate Product (Ca x PO4)
-4. Chloride (Cl)
-5. Creatinine
-6. CO2 (Bicarb)
-7. Glucose
-8. Hematocrit HCT
-9. Magnesium
10. Sodium (Na)
11. Phosphorus (PO4)
12. Potassium
Other Tests
13. Albumin
14. Australian Antigen
15. Ferritin
16. Hepatitis Antibody
17. Total Bilirubin
18. Total Protein
19. Urea Reduction Ratio (URR)
20. KT/V
Enzymes
21. Alkaline Phosphatase
22. Parathyroid Hormone (PTH)
23. SGOT
24. SGPT
1. BUN (Blood Urea Nitrogen)
Normal value = 7-25 MG/DL
Dialysis normal = 40-85 MG/DL
(values will vary depending on protein intake)
Causes of abnormal levels (refers to increases in):
eating too much protein containing food
could indicate need for more dialysis time
could indicate need for higher blood flow rate
could indicate need for a larger dialyzer
Signs and symptoms associated with abnormal levels:
fatigue
nausea
insomnia
dry and/or itchy skin
urine-like body odor and/or breath
taste and smell (senses) could be affected
Return to Blood Chemistries
2. Calcium (Ca)
Normal value = 8.5-10.8 MG/DL
Dialysis normal = (Same) 8.5-10.8 MG/DL
Level is best near upper end to avoid overactive parathyroid glands.
Causes of abnormal levels:
LOW:
eating too much high phosphorus food
not taking phosphorus binders as recommended
HIGH:
medications such as Rocaltrol and/or Calderol may cause sharp increase.
parathyroid gland removal may be indicated.
Calcium level will rise as phosphorus level decreases.
Signs and symptoms associated with abnormal levels
LOW:
muscle twitching and cramping
seizures
varying degrees of depression
hair loss
cataracts
conjunctivitus (inflammation of the mucuos membrane of inner eyelid)
HIGH:
muscle weakness
fatigue
abdominal cramps
loss of appetite
nausea and /or vomiting
constipation
possible coma if left untreated
Return to Blood Chemistries
3. Calcium Phosphate Product (Ca x PO4)
Normal value = 0-70
Dialysis normal = multiply calcium and phosphorus blood values -- should not
exceed 70.
Signs and symptoms associated with abnormal levels:
High product calcification of blood vessels including coronary arteries
Return to Blood Chemistries
4. Chloride (Cl)
Normal value = 96-109 MEQ/L
Dialysis normal = Same 96 - 109 MEQ/L
Signs and symptoms associated with abnormal levels:
excessive thirst
Try to avoid:
canned vegetables
potato chips, etc.
bacon
luncheon meats (bologna, salami, etc.)
Return to Blood Chemistries
5. Creatinine
Normal value = less than 1.5 MG/DL
Accepted dialysis normal = 10-20 MG/DL
Varies with muscle mass. Elderly may have lower creatinine due to loss of
muscle mass. Type II Diabetics have an acceptable range of 4-6 MG/DL. Should
remain about the same as at start of dialysis from treatment to treatment. Only
the most muscular of individuals should have values in the upper range.
Causes of abnormal levels:
inadequate "real" dialysis time
increase in muscle mass
Signs and symptoms associated with abnormal levels:
Non-specific symptoms, but should be closely monitored with special attention
to unsteady values. Any changes, especially increasing, should be
reported/discussed with the health care team immediately.
Return to Blood Chemistries
6. CO2 (Bicarb)
Normal value = 22-32 MEQ/L
Dialysis normal = not less than 18 MEQ/L
Causes of abnormal levels:
Eating to much protein creating a more acid blood thus lowering CO2
Signs and symptoms associated with abnormal levels:
Rapid breathing and shortness of breath
Acidosis in Type I Diabetics
Return to Blood Chemistries
7. Glucose
Normal value = 65-115 MG/DL
Accepted dialysis normal = Same 65-115 MG/DL
Causes of abnormal levels:
HIGH:
Diabetes
LOW:
persistent uremia
Will be slightly higher within 1-3 hours after eating a meal.
Signs and symptoms associated with high levels:
Excessive thirst
Return to Blood Chemistries
8. Hematocrit (Hct)
Normal value: % of total blood volume made up of red blood cells
Males = 40% - 54%
Females = 37% - 47%
Dialysis normal (following Medicare guideline)
30% - 36% (gender non-specific)
Causes of abnormal levels:
decreased production of red blood cells
blood loss during or after dialysis
shortened survival time of red blood cells
Signs and symptoms associated with abnormal levels:
Fatigue
shortness of breath
chest pain on exertion (if underlying heart disease is present)
Return to Blood Chemistries
9. Magnesium (Mg)
Normal value = 1.7 - 2.3 MG/DL
Dialysis normal = Same 1.7 - 2.3 MG/DL
Causes of abnormal levels:
elevated due to taking phosphate binder containing magnesium
ingesting medication such as milk of magnesia or citrate of magnesium
Signs and symptoms associated with abnormal levels:
decreased mental function ranging from drowsiness to coma in severe states
decreased tendon reflex leading to paralysis
Nausea / vomiting
hypotension due to dilated blood vessels
Return to Blood Chemistries
10. Sodium (Na)
Normal value = 135 - 147 MEQ/L
Dialysis normal = Same 135 -147 MEQ/L
Causes of abnormal levels:
eating too much salt
(found mainly in canned vegetables, potato chips, bacon, etc.)
Signs and symptoms associated with abnormal levels:
thirst - leads to drinking more fluids and results in fluid weight gain
elevated blood pressure (hypertension)
shortness of breath
Return to | Blood Chemistries | Use the Na-K-Phos Counter <nakphos.html> |
11.Phosphorus (PO4)
Normal value = 2.5 - 4.5 MG/DL
Dialysis normal = 3.5 - 5.5 MG/DL
Causes of abnormal levels:
LOW:
taking too much phosphate binder
HIGH:
not taking phosphate binders
eating high phosphorus foods such as milk, beans, cheese, and organ meats
Signs and symptoms associated with abnormal levels:
causes elevated parathyroid hormone by lowering Calcium (Ca)
itchy skin
Return to | Blood Chemistries | Use the Na-K-Phos Counter <nakphos.html> |
12. Potassium
Normal value = 3.5 - 5.4 MEQ/L
Dialysis normal = 4.00 - 6.5 MEQ/L
Causes of abnormal levels:
HIGH:
eating too many foods high in potassium
(bananas, replacement cooking/table salt)
Signs and symptoms associated with abnormal levels:
HIGH:
above 7.0 MEQ/L, extreme weakness (usually) prior to cardiac arrest
Return to | Blood Chemistries | Use the Na-K-Phos Counter <nakphos.html> |
12. Albumin
Normal value = 3.5 - 5.5 G/DL
Dialysis normal = Above 3.8 G/DL
Reason for test:
Measure of nutritional adequacy
Return to | Other Tests | Blood Chemistries |
14. Australian Antigen
Normal value = Negative
Dialysis normal = Same
Reason for test:
test for serum Hepatitis (Hepatitis B)
Return to | Other Tests | Blood Chemistries |
15. Ferritin
Normal value = 10 - 350 NG/ML
Dialysis normal = 200 - 500 NG/ML
Reason for test:
a measure of "stored" iron
Return to | Other Tests | Blood Chemistries |
16. Hepatitis Antibody
Normal value = Negative
Dialysis normal = Same
Reason for test:
Antibody test to determine if one has ever had Hepatitis. Past episodes of
Hepatitis would register a "positive" result
Return to | Other Tests | Blood Chemistries |
17. Total Bilirubin
Normal value = 0.2 - 1.2 MG/DL
Dialysis normal = Same
Reason for test:
elevated level indicates liver damage possibly from Hepatitis or obstructed
bile ducts
Return to | Other Tests | Blood Chemistries |
18. Total Protein
Normal value = 6 - 8.5 GM/DL
Dialysis normal = Same
Reason for test:
observed for detecting abnormally low levels when increased intake of protein
foods have been initiated
Return to | Other Tests | Blood Chemistries |
19. Urea Reduction Ratio (URR)
Dialysis normal = greater than 65%
Reason for test:
determines dialysis efficiency
Return to | Other Tests | Blood Chemistries |
20. KT/V
Dialysis normal:
Hemodialysis = 1.3 or higher
Peritoneal Dialysis = 2.0 or higher
Reason for test:
checks dialysis efficiency
Return to | Other Tests | Blood Chemistries |
21. Alkaline Phosphatase
Normal value = 30 -115 U/ML
Dialysis normal = Same Alkaline Phosphatase is derived from bone or liver.
Causes of high levels:
BONE
a marker for the severity of parathyroid caused bone disease
LIVER
a marker for diseases involving the liver or gall bladder
Signs and symptoms associated with abnormal levels:
painful joints
weakened bones which could lead to severe pain and/or deterioration requiring
surgery (hyperparathyroidism)
Return to | Enzymes | Other Tests | Blood Chemistries |
22. Parathyroid Hormone (PTH)
Normal value = Check "normals" for your lab
Dialysis normal = Same
Causes of abnormal levels:
long term imbalance of calcium and phosphorus
Signs and symptoms associated with abnormal levels:
HIGH
not taking phosphate binders
eating high phosphorus foods such as milk, beans, cheese, and organ meats
Return to | Enzymes | Other Tests | Blood Chemistries |
23. SGOT
Normal value = 10 - 50 U/ML
Dialysis normal = Same
Causes of abnormal levels:
Hepatitis
Signs and symptoms associated with abnormal levels:
sometimes, no symptoms are displayed
nausea and vomiting
abdominal cramping
fatigue (if severe liver damage is present)
Return to | Enzymes | Other Tests | Blood Chemistries |
24. SGPT
Normal value = 7 - 33
Dialysis normal = Same
Causes of abnormal levels:
Hepatitis
Signs and symptoms associated with abnormal levels:
sometimes, no symptoms are displayed
nausea and vomiting
abdominal cramping
fatigue (if severe liver damage is present)
Return to | Enzymes | Other Tests | Blood Chemistries |
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