Diagnosing Chronic Kidney Disease

What is chronic kidney disease?

Chronic kidney disease (CKD), also known as chronic kidney failure, is a term used to encompass damage to the kidneys that is caused by various conditions. It involves the gradual loss of kidney function that develops over months or years. As the kidneys lose the ability to filter the blood and remove waste and extra fluids from the body, a buildup of fluids, electrolytes, and wastes occurs.

Diagnosing chronic kidney disease

A correct diagnosis of chronic kidney disease is essential in obtaining appropriate treatments to slow the progression of the disease and contribute to higher kidney function. The diagnostic process typically begins by evaluating a medical history and is followed by performing a physical examination. Certain testing includes blood test, urinalysis, imaging, and possibly a biopsy.

Medical history

A health care professional will gather a health history that includes other conditions, such as high blood pressure or diabetes, and any current medications. Personal and family medical history will also be reviewed. Symptoms, such as changes in urination, fatigue, or loss of appetite, should be detailed.

Physical examination

A physical exam normally includes reviewing vital signs and blood pressure, identifying any problems with the heart or blood vessels, and conducting a neurological exam. Based on the medical history and physical exam, additional testing or imaging may be required.

Blood tests

Blood tests are commonly used in the diagnosis of CKD to review the glomerular filtration rate (GFR) and the level of creatinine in the blood. The GFR indicates how efficiently the kidneys are filtering blood. Creatinine is a waste product that the kidneys have difficulty removing when they are damaged. A decreased GFR or high level of creatinine may suggest CKD.

Urine tests

A urine sample will be collected to help diagnose CKD and identify the cause. An urinalysis includes testing for traces of blood and a protein called albumin. The presence of either may support a diagnosis of CKD.

Imaging

Imaging tests may include ultrasound, magnetic resonance imaging (MRI), or computerized topography (CT) scans. They can examine the size of the kidneys and identify any structural problems.

Biopsy

In certain situations, a small sample of kidney tissue is obtained and sent to a lab. This can identify the cause of CKD. A kidney biopsy is performed using anesthesia and a thin, long needle that goes through the skin and into the kidney.