what tests are used to diagnose a kidney disease?

Answer 1

Wow Answerman!

I'm a nephrologist and that's a lot of information - I learned a lot! Basically, start simple - blood and urine test for glomerular and tubular function, and for blood and protein, respectively. An ultrasound is useful to assess any obstruction of the urinary tract, and to assess kidney size and symmetry. After that, I would focus on what seems likely, rather than 'cover all bases' many patients expect.

Answer 2

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Answer 3

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Answer 4

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Answer 5

cat scan-plain and simple or you can go w/ the novel of the answer man-way too much time on his hands

Answer 6

There are several. I have listed some here, but you really need to consult a medical specialist for better advice.

Kidney function tests are common procedures used to evaluate renal function. Refer to the following documents for details of how each test is performed:

Creatinine tests


Alternative names
Serum creatinine

Definition
Creatinine is a breakdown product of creatine, which is an important part of muscle. A serum creatinine test measures the amount of creatinine in the blood.

How the test is performed
Blood is drawn from a vein, usually from the inside of the elbow or the back of the hand. The puncture site is cleaned with antiseptic. An elastic band is placed around the upper arm to apply pressure and cause the vein to swell with blood.

A needle is inserted into the vein, and the blood is collected in an air-tight vial or a syringe. During the procedure, the band is removed to restore circulation. Once the blood has been collected, the needle is removed, and the puncture site is covered to stop any bleeding.

For an infant or young child:

The area is cleansed with antiseptic and punctured with a sharp needle or a lancet. The blood may be collected in a pipette (small glass tube), on a slide, onto a test strip, or into a small container. A bandage may be applied to the puncture site if there is any bleeding.

How to prepare for the test
The health care provider may tell you to stop taking certain drugs that may affect the test.

How the test will feel
When the needle is inserted to draw blood, some people feel moderate pain, while others feel only a prick or stinging sensation. Afterward, there may be some throbbing.

Why the test is performed
The test is performed to evaluate kidney function. If kidney function is abnormal, creatinine levels will increase in the blood, due to decreased excretion of creatinine in the urine. Creatinine levels also vary according to a person's size and muscle mass.

Normal Values
A normal (usual) value is 0.8 to 1.4 mg/dl. Normal value ranges may vary slightly among different laboratories.

Females have a lower creatinine than males, because they have less muscle mass.

Note: mg/dl = milligrams per deciliter

What abnormal results mean
For abnormal results, the following applies:

Higher-than-normal levels may indicate:

Acute tubular necrosis
Dehydration
Diabetic nephropathy
Eclampsia (a condition of pregnancy that includes seizures)
Glomerulonephritis
Muscular dystrophy
Pre-eclampsia (pregnancy-induced hypertension)
Pyelonephritis
Reduced renal blood flow (shock, congestive heart failure)
Renal failure
Rhabdomyolysis
Urinary tract obstruction
Lower-than-normal levels may indicate:

Muscular dystrophy (late stage)
Myasthenia gravis
Additional conditions under which the test may be performed:

Acute nephritic syndrome
Alport syndrome
Atheroembolic renal disease
Chronic renal failure
Complicated UTI (pyelonephritis)
Cushing's syndrome
Dementia due to metabolic causes
Dermatomyositis
Digitalis toxicity
Ectopic Cushing's syndrome
End-stage renal disease
Epilepsy
Generalized tonic-clonic seizure
Goodpasture's syndrome
Hemolytic-uremic syndrome (HUS)
Hepatorenal syndrome
IgM mesangial proliferative glomerulonephritis
Interstitial nephritis
Lupus nephritis
Malignant hypertension (arteriolar nephrosclerosis)
Medullary cystic disease
Membranoproliferative GN I
Membranoproliferative GN II
Type 2 diabetes
Polymyositis (adult)
Prerenal azotemia
Primary amyloid
Rapidly progressive (crescentic) glomerulonephritis
Secondary systemic amyloid
Thrombotic thrombocytopenic purpura
Wilms' tumor

What the risks are
Excessive bleeding
Fainting or feeling light-headed
Hematoma (blood accumulating under the skin)
Infection (a slight risk any time the skin is broken)
Multiple punctures to locate veins
Why is the test performed:

A measurement of the serum creatinine level is used to evaluate kidney function.

Creatinine is a breakdown product of creatine, which is an important component of muscle. Creatinine can be converted to the ATP molecule, which is a high-energy source. The daily production of creatine and subsequently creatinine, depends on muscle mass, which fluctuates very little.

Creatinine is excreted from the body entirely by the kidneys. With normal renal excretory function, the serum creatinine level should remain constant and normal.

Special considerations
Drugs that can increase creatinine measurements include aminoglycosides (for example, gentamicin), Bactrim, cimetidine, heavy metal chemotherapeutic agents (for example, Cisplatin), and nephrotoxic drugs -- such as cephalosporins (for example, cefoxitin).


Urine creatinine - spot collection
Definition
The creatinine urine test measures the amount of creatinine in urine.

How the test is performed
Spot collection: obtain a sample of urine by urinating and saving part of the urine in a container.

A 24-hour urine sample is needed. The health care provider will instruct you, if necessary, to discontinue drugs that may interfere with the test.

On day 1, urinate into the toilet when you get up in the morning.
Afterwards, collect all urine in a special container for the next 24 hours.
On day 2, urinate into the container when you get up in the morning.
Cap the container. Keep it in the refrigerator or a cool place during the collection period. Label the container with your name, the date, the time of completion, and return it as instructed.
For an infant:

Thoroughly wash the area around the urethra. Open a urine collection bag (a plastic bag with an adhesive paper on one end), and place it on the infant. For boys, the entire penis can be placed in the bag and the adhesive attached to the skin. For girls the bag is placed over the labia. Diaper as usual over the secured bag.

This procedure may take a couple of attempts -- lively infants can displace the bag. The infant should be checked frequently and the bag changed after the infant has urinated into the bag. The urine is drained into the container for transport to the laboratory.

Deliver it to the laboratory or your health care provider as soon as possible upon completion.

How to prepare for the test
No special preparation is necessary for this test, but if the collection is being taken from an infant, a couple of extra collection bags may be necessary.

How the test will feel
The test involves only normal urination, and there is no discomfort.

Why the test is performed
A measurement of the serum creatinine level is used to evaluate kidney function. Urine creatinine levels can be used as a screening test to evaluate kidney function, or as part of the creatinine clearance test.

Creatinine is a breakdown product of creatine, which is an important part of muscle. By far, the most important source of energy inside cells is the ATP molecule, with its high-energy phosphate bonds.

When one of these bonds is broken, energy is released, and ATP becomes ADP. Creatine phosphate represents a backup energy source for ATP because it can quickly re-convert ADP back to ATP.

Over time, the creatine molecule gradually degrades to creatinine. Creatinine is a waste product, that is, it cannot be used by cells for any constructive purpose. The daily production of creatine, and subsequently creatinine, depends on muscle mass, which fluctuates little in most normal people over long periods of time.

Creatinine is excreted from the body entirely by the kidneys. With normal kidney function, the serum (blood) creatinine level should remain constant and normal.

Normal Values
Normal values are highly dependent on the age and lean body mass of the person the urine is being collected from. Normal value ranges may vary slightly among different laboratories. Urine creatine (24-hour sample) values may therefore be quite variable and can range from 500 mg/day to 2000 mg/day.

What abnormal results mean
Abnormal results of urine creatinine and creatinine clearance are often non-specific, but may include the following conditions:

Glomerulonephritis
Pyelonephritis
Reduced renal blood flow (as in shock or congestive heart failure)
Renal failure
Rhabdomyolysis
Urinary tract obstruction
Muscular dystrophy (late stage)
Myasthenia gravis
High meat diet
Additional conditions under which the test may be performed:
Complicated UTI (pyelonephritis)
Prerenal azotemia

What the risks are
There are essentially no risks.

Special considerations
Drugs that can increase creatinine measurements include: aminoglycosides (gentamicin), cimetidine, heavy metal chemotherapeutic agents (Cisplatin), and nephrotoxic drugs, such as cephalosporins (cefoxitin).


Alternative names

Blood urea nitrogen
Definition
BUN (blood urea nitrogen) is a test that measures the amount of urea nitrogen (a breakdown product of protein metabolism) in the blood.

How the test is performed
Blood is drawn from a vein, usually from the inside of the elbow or the back of the hand. The puncture site is cleaned with antiseptic, and a tourniquet is placed around the upper arm to apply pressure and restrict blood flow through the vein. This causes veins below the tourniquet to fill with blood.

A needle is inserted into the vein, and the blood is collected in an air-tight vial or a syringe. During the procedure, the tourniquet is removed to restore circulation. Once the blood has been collected, the needle is removed, and the puncture site is covered to stop any bleeding.

Infant or young child:

The area is cleaned with antiseptic and punctured with a sharp needle or a lancet. The blood may be collected in a pipette (small glass tube), on a slide, onto a test strip, or into a small container. A bandage may be applied to the puncture site if there is any continued bleeding.

How to prepare for the test
There are no special preparations.

How the test will feel
When the needle is inserted to draw blood, some people feel moderate pain, while others feel only a prick or stinging sensation. Afterward, there may be some throbbing.

Why the test is performed
The BUN test is a somewhat routine test used primarily to evaluate renal (kidney) function. The test is often performed on patients with many different diseases.

Urea is formed in the liver as the end product of protein metabolism. During digestion, protein is broken down to amino acids. Amino acids contain nitrogen, which is removed as NH4+ (ammonium ion), while the rest of the molecule is used to produce energy or other substances needed by the cell. The ammonia is combined with other small molecules to produce urea. The urea makes its way into the blood and it is ultimately eliminated in the urine by the kidneys.

Most renal diseases affect urea excretion so that BUN levels increase in the blood. Patients with dehydration or bleeding into the stomach and/or intestines may also have abnormal BUN levels. Numerous drugs also affect BUN by competing with it for elimination by the kidneys.

Normal Values
7 - 20 mg/dl. Note that normal values may vary among different laboratories.

What abnormal results mean
Greater-than-normal levels may indicate:

Congestive heart failure
Excessive protein catabolism (possibly due to starvation)
Excessive protein ingestion
Gastrointestinal bleeding
Hypovolemia (possibly due to burns or dehydration)
Myocardial infarction (heart attack)
Renal disease (for example, glomerulonephritis, pyelonephritis, and acute tubular necrosis)
Renal failure
Shock
Urinary tract obstruction (for example, tumor, stones, and prostatic hypertrophy)
Lower-than-normal levels may indicate:
Liver failure
Low protein diet
Malnutrition
Over-hydration
Additional conditions under which the test may be performed:
Acute nephritic syndrome
Alport syndrome
Atheroembolic renal disease
Chronic renal failure
Complicated UTI (pyelonephritis)
Dementia due to metabolic causes
Diabetic nephropathy/sclerosis
Digitalis toxicity
End-stage renal disease
Epilepsy
Generalized tonic-clonic seizure
Goodpasture's syndrome
Hemolytic-uremic syndrome (HUS)
Hepatorenal syndrome
IgM mesangial proliferative glomerulonephritis
Interstitial nephritis
Lupus nephritis
Malignant hypertension (arteriolar nephrosclerosis)
Medullary cystic disease
Membranoproliferative GN I
Membranoproliferative GN II
Type 2 diabetes
Prerenal azotemia
Primary amyloid
Rapidly progressive (crescentic) glomerulonephritis
Secondary systemic amyloid
Wilms' tumor
What the risks are

Excessive bleeding
Fainting or feeling light-headed
Hematoma (blood accumulating under the skin)
Infection (a slight risk any time the skin is broken)
Multiple punctures to locate veins
Special considerations

For people with liver disease, the BUN level may be low even if the kidneys are normal.

Some drugs affect BUN levels. Before having this test, make sure the health care provider knows which medications you are taking.

Drugs that can increase BUN measurements include allopurinol, aminoglycosides, cephalosporins, chloral hydrate, cisplatin, furosemide, guanethidine, indomethacin, methotrexate, methyldopa, nephrotoxic drugs (for example, high-dose aspirin, amphotericin B, bacitracin, carbamazepine, colistin, gentamicin, methicillin, neomycin, penicillamine, polymyxin B, probenecid, vancomycin), propranolol, rifampin, spironolactone, tetracyclines, thiazide diuretics, and triamterene.

Drugs that can decrease BUN measurements include chloramphenicol and streptomycin.

Veins and arteries vary in size from one patient to another and from one side of the body to the other. Obtaining a blood sample from some people may be more difficult than from others.