Who to screen for kidney disease?
Those patients with high risk should be screened for CKD. It is not cost-effective to screen everyone.
If you have the following, you should be screened:
- Diabetes mellitus
- Age ? 65 years
- Family history of CKD and hereditary kidney disease
- Urinary tract abnormalities, kidney stones or prostatic hypertrophy
- Chronic use of non-steroidal anti-inflammatory drugs or agents damaging the kidney
- Cardiovascular disease
- Multisystem disease such as systemic lupus erythematosus
How to screen for kidney disease?
Various tests are required to detect CKD. These tests can be divided into urine analysis, blood biochemistry and radiology imaging. Some of these tests are basic tests and some are more specific. Further tests may be required to determine the cause of the CKD.
- Urine Analysis
A sample of your urine is checked for the amount of protein, blood (red blood cells and white blood cells) and other abnormalities. Protein and red and white blood cells are not normally found in the urine. Finding these abnormalities in a sample of urine requires a doctor’s attention.
- Blood tests
- Is measured by a blood test, and is routinely used to measure kidney function
- Is a breakdown product of muscle which is normally cleared from the blood by the kidneys
- Increases when the kidneys are not working well and not filtering as much blood as normal
- Is affected by various conditions like age, gender, consumption of a high protein diet, increased muscle mass etc.
- Begins to rise only when an individual loses about 50% of kidney function.Therefore, it should not be used alone to measure kidney function
- Is required to calculate the estimated glomerular filtration rate which is a better method of measuring kidney function
Estimated glomerular filtration rate (eGFR)
- is calculated from a mathematical formula based on parameters such as age, race, gender. It signifies the amount of blood that is purified by the kidneys in a period of time. It is the best test to determine the health of your kidneys. Currently, there are many mathematical formulae available for the calculation of eGFR. Some are simple and can be used at the bedside, others are more complicated hence requiring software.
Individuals at high risk for kidney disease (for example diabetic patients and hypertensive patients) should have this test done at regular intervals.
How to interpret eGFR results?
An individual with normal kidney function would have a GFR ? 90mls/min/1.73m2.
- A reduction in GFR from the first measurement of eGFR indicates progression of the underlying kidney disease
- An increase in GFR indicates improvement in kidney function
- A stable GFR indicates stable disease
eGFR results can vary slightly during your regular visits to your doctor. What is more important is the trend of the eGFR over time.
|3 May 2016
|Dr. Anita Bhajan Manocha
|Dr. Sunita Bavanandan