Choice and assessment of clinical laboratory parameters in renal diseases – basic, extended and specialized analysis.
The routine blood and urine tests listed below may provide the first indication of a kidney problem or may be ordered if chronic kidney disease (CKD) is suspected due to a person's signs and symptoms. These tests reflect how well the kidneys are removing excess fluids and wastes.
Basic Analysis
- Hematology: Hb, HCT, Erys, Lks, Thr, differential count, ESR
- Urine: color, transparency, odor, рН, protein, glucose, bacteriuria, sediment
- Blood serum: creatinin, urea, total protein, Alb, glucose
- Hemostasis: in micro bleedings
Tests commonly used for screening and diagnosis
- Urine protein—a few different tests may be used to screen for protein in the urine: The measurement of proteinuria is obligatory in renal pathology. Reference range <150 mg/24h (+) protein in urine >150 mg/24h or below 10 years of age >100 mg/24h (>40 mg/m²/24h) Significant proteinuria >300 mg/24h, Possible parenchymal renal disease >1g/24h
- Urine albumin— done on a 24-hour urine sample, or both urine albumin and creatinine can be measured in a random urine sample and the albumin/creatinine ratio (ACR) can be calculated.
- Urinalysis—this is a routine test that can detect protein in the urine as well as red blood cells and white blood cells. These are not normally found in the urine and, if present, may indicate kidney disease.
- Urine total protein or urine protein to creatinine ratio (UP/CR)—detects not just albumin, but all types of proteins that may be present in the urine. While urinalysis and urine total protein are not as sensitive as urine albumin for detecting kidney damage, these tests give fewer false signals of kidney damage.
- Estimated glomerular filtration rate (eGFR)—a blood creatinine test. GFR refers to the amount of blood that is filtered by the glomeruli per minute.
- Urea (urea nitrogen or BUN)—the level of this waste product in the blood increases as kidney filtration declines. Increased BUN levels suggest impaired kidney function, although they can also be elevated due to a condition that results in decreased blood flow to the kidneys, such as congestive heart failure, heart attack, or shock.
- Creatinine clearance test—(1.33-3.00 ml/s) measures creatinine levels in both a sample of blood and a sample of urine from a 24-hour urine collection. Results = the amount of creatinine cleared from the blood and passed to urine. This calculation allows for a general evaluation of the amount of blood that is being filtered by the kidneys in a 24-hour time period.