June 26, 2022

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What indicators need to be checked to diagnose kidney failure?

What indicators need to be checked to diagnose kidney failure?

 

What indicators need to be checked to diagnose kidney failure? If kidney failure is suspected, just check the kidney function. If you want to treat it properly, you must check at least these 8 items.

When you doubt whether you are kidney failure, it is not that complicated and difficult. You only need to do a simple laboratory test.

Many patients read an article on the Internet or feel that they are not feeling well. They wonder if they are suffering from kidney failure and start to worry.   Patients who have been suffering from kidney disease for many years will deliberately avoid and dare not face it, and are afraid or unwilling to go to the hospital for further examination.

Sometimes People are afraid of kidney failure and uremia while  daring not check and face it head-on.   As a result, some patients miss the best treatment opportunity. There are so many painful lessons. In the end, we can only embark on the path of dialysis or kidney transplantation.


When you suspect that you are kidney failure, it is not that complicated and difficult. You only need to do a simple laboratory test, that is, a blood test for renal function. The small items include urea nitrogen (Bun) and blood creatinine (SCr). And glomerular filtration rate (GFR) or creatinine clearance rate (CCr) and other indicators.


However, the above tests related to renal function can only be used as a preliminary examination for the diagnosis of renal failure. After clarifying renal failure, it is important to determine the cause of diagnosis and how to take further treatment measures.

Therefore, in addition to checking kidney function, patients with kidney disease also need to check at least the following eight items.


1. Kidney ultrasound

A clear diagnosis of renal failure may be acute kidney injury or chronic renal insufficiency. Color Doppler ultrasound examination of the kidney can distinguish acute or chronic through changes in the size and structure of the kidney. Color ultrasound of the kidneys showed enlarged kidneys, mostly acute kidney injury or acute renal failure; color ultrasound of the kidneys showed shrinkage and structural disorders of the kidneys, mostly chronic renal insufficiency or chronic renal failure. This is also a necessary inspection item for diagnosis and treatment.


2. Urinalysis

For the diagnosis of renal failure, urinalysis (i.e. urine routine) is one of the items that must be checked. This is also a screening test for further diagnosis. There are many small items in the urine routine, such as urine specific gravity, urine pH, urine protein + number, urine red blood cell number, urine white blood cell number, urine sugar + number, etc. can assist in diagnosis. Among them, it can be easily distinguished whether renal failure is related to glomerulonephritis, tubulointerstitial nephritis, and urinary tract infectious diseases.

 


3. Blood cell analysis

Patients with renal failure may also have abnormal changes in blood cell analysis, which are manifested in blood routines, such as leukopenia, anemia, or thrombocytopenia, or a decrease in all of the “three lines”. The reduction of anemia and “three lines” is related to renal anemia in patients with renal failure and affecting blood cell function. The discovery of renal anemia can provide a treatment basis for the use of erythropoietin.


4. Urine protein quantification

After the diagnosis of renal failure, a 24-hour urine protein quantitative test is needed to see whether the patient’s urine protein excretion is small, medium, or large. The occurrence of a moderate amount of proteinuria exceeding 1.0 g or a large amount of proteinuria exceeding 3.5 g in 24 hours is mostly caused by renal failure caused by glomerulonephritis. The addition of protein-lowering drugs should be considered, and the acute case may be reversed (completely cured) For chronic patients, there is hope to delay (long-term stability).

 

5. Urine protein analysis

Urine protein analysis is also one of the items that must be checked for patients with renal failure. The increase of microalbumin in urine protein analysis is more concerned with renal failure caused by glomerulonephritis, which is more related to immune inflammation; the increase of microglobulin and NAG in urine protein analysis, more consideration is given to tubulointerstitial nephritis Kidney failure caused by it is more related to factors such as drugs, poisons and infections. Based on this, targeted treatment measures can be taken.


6. Blood biochemical examination

Patients with renal failure also need to do blood biochemical examination, which includes many small items, abnormal liver function needs to exclude hepatitis B-related nephritis, plasma albumin is as low as 30g/L, then consider whether it is nephrotic syndrome complicated renal failure, Elevated blood lipids may also be related to renal failure caused by nephrotic syndrome. Hyperkalemia and hyperphosphatemia are mostly complications of patients with renal failure that require active treatment. If the carbon dioxide binding capacity is found to be significantly low, consider combining with renal failure. Metabolic acidosis that requires acid correction, etc., is also a very important inspection item.

 

7. Blood uric acid level

One of the items that patients with renal failure cannot fail to check is the blood uric acid level, which is closely related to diagnosis and treatment. If the blood uric acid is high, the diagnosis cannot ignore the renal failure caused by primary hyperuricemia, and more consideration is the hyperuricemia secondary to chronic renal failure. No matter what the situation is, uric acid-lowering treatment is needed for hyperuricemia. Therefore, this item is a must-check item for the diagnosis and treatment of patients with renal failure.

 


8. Immunoglobulin and complement

Patients with renal failure should also not forget to check plasma immunoglobulin and complement, which is also very helpful for further confirming the diagnosis and formulating treatment plans.

Elevated blood IgG may be caused by connective tissue disease including lupus nephritis; renal failure may be caused by connective tissue diseases; decreased IgG may be idiopathic acute renal failure caused by primary glomerulonephritis; IgA may be significantly increased, Or renal failure caused by IgA nephropathy or Henoch-Schonlein purpura nephritis; decreased blood C3, or renal failure caused by lupus nephritis, acute nephritis or membranous proliferative nephritis. And so on, all these indicators can be changed to provide a basis for diagnosis and treatment.

 

 

 

Do the kidney patients understand? Diagnosing renal failure is not difficult, but to further clarify the diagnosis and formulate a good treatment plan, the above eight examinations are very important and must be checked. In special circumstances, other items may be checked, which requires a decision based on the specific condition.

 

 

(source:internet, reference only)


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