Services
Mercy Dialysis Center
Understanding Dialysis Lab Values
BUN | Creatinine | Sodium | Potassium | Albumin | Calcium
Phosphorus | Hematocrit/Hemoglobin | KT/V
and URR
BUN
BUN stands for blood urea nitrogen. When a protein food is eaten, the waste
(nitrogen) circulates in the blood until it is removed by the kidney or by
dialysis. The the BUN is low (under 40) it means you are not eating enough
protein. If the BUN is high (over 80) it means you may need to decrease protein
intake. A high BUN also could mean you are not getting good dialysis.
Goal: 40 - 80 mg/dl
CREATININE
Creatinine is the waste product of muscles. The normal for each person is different.
Small people are less muscular and therefore make less creatinine waste.
Larger people and men have more muscles, therefore make more creatinine waste.
Creatinine levels should stay about the same each month. If it starts to
rise, it may mean you are not getting good dialysis.
Goal: Varies for each person
SODIUM
A high sodium level may mean you are dehydrated. Your dry weight may need to
be adjusted. A low sodium may mean you are holding extra fluid. The fluid
then dilutes the salt so that blood sodium looks low on labs. In summary,
a low sodium level means you probably took in too much fluid and probably
too much salt. A high sodium level may mean you are dehydrated. Your dry
weight may need to be adjusted.
Goal: 135 - 145 mEq/L
POTASSIUM
Potassium is an electrolyte, which helps regulate the function of muscles and
the heart. A low potassium (under 3.5) or a high potassium (over 5.5) can
be very dangerous as it can lead to a heart attack.
- Hemodialysis patients need to watch their potassium levels closely and know what their dietary potassium allowance is. In addition, the dialysis machine has different settings for clearing potassium – ask the staff to explain about your “potassium bath.”
- Peritoneal dialysis patients may need to eat extra potassium foods as peritoneal dialysis cleans potassium very well.
Goal: 3.5 – 5.5 mEq/L
ALBUMIN
Albumin measure your protein stores. Protein is needed by the body to build
cells and to build antibodies to fight infection. A low albumin (less than
3.5) is risky. It means your body will not be able to fight off infection
as easily and you may not heal as quickly. Try to eat more protein foods.
An albumin of 4.0 is recommended.
Goal: Over 3.5 g/dl
CALCIUM
Calcium is needed for bones and teeth, and circulates in the blood for other
functions. If your blood calcium is low (less than 8) you may start pulling
calcium out of your bones to supply the blood. This can lead to brittle,
weak bones. A high calcium level may lead to the deposit of calium in blood
vessels, joints, and other soft tissues.
Goal: 8 – 9.5 mg/dl
PHOSPHORUS
Phosphorus is a mineral that works with calcium. A high phosphorus level (over
5.5) causes an imbalance with calcium that also can affect your bones. If
your phosphorus is high, cut back on high phosphorus foods. Also, take your
phosphate binders (PhosLo or Renagel). These binders, taken with food, bind
to phosphorus in the digestive tract and are excreted through the colon.
A high phosphorus level also can start the process of depositing calcium
in the vessels, joints and soft tissues.
Goal: 3.5 - -.5 mg/dl
HEMATOCRIT/HEMOGLOBIN
Hematocrit and hemoglobin measure your red blood count. If these tests are
low, the red blood count is low. Red blood cells carry oxygen. A low hematocrit
or hemoglobin leaves you tired, weak and short of breath. If a patient has
a low hematocrit or hemoglobin, he/she will receive “EPO” at
dialysis to help build blood. EPO, which is a hormone produced by healthy
kidneys, now is available in a synthetic form and can be given at dialysis.
Peritoneal dialysis patients may receive a weekly EPO shot. Iron also is
needed to build blood. Most patients receive iron pills or IV iron to help
keep up their iron stores.
Goal: Hematocrit: 33 – 36 %;
Hemoglobin: 11 – 12 g/dl
KT/V and URR (Dialysis Adequacy)
KT/V and URR are formulas that tell if you are getting good dialysis treatments.
If KT/V and URR are low, you will not feel as well and a change will be made
in your treatment plan.
Goal: URR – 65 % or greater
KT/V – Hemodialysis
(not diabetic) 1.2 or greater
(diabetic)
1.4 or greater
CCPD – 2.2 or greater
CAPD – 2.0 or greater
