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Mercy Dialysis Center
Warning Signs of Kidney Disease
What Are the Warning Signs of Kidney Disease?
People in the early stages of kidney disease may not feel
sick at all. The first signs that you are sick may be general: frequent headaches
or feeling tired or itchy all over your body. The six warning signs of kidney
disease include:
- Burning or difficulty during urination
- A significant increase or decrease in the frequency of urination
- Blood in the urine
- Puffiness around eyes, swelling of the hands and/or feet
- Pain in the small of the back just below the ribs
- High blood pressure
If your kidney disease gets worse, you may lose your appetite or experience nausea and vomiting. Your hands or feet may swell or feel numb. You may get drowsy or have trouble concentrating. Your skin may darken. You may have muscle cramps.
How Will May Doctor Detect Kidney Disease?
Creatinine | Proteinuria | Creatinine Clearance
Renal imaging | Blood Urea Nitrogen (BUN) | Renal biopsy
First, your doctor probably will send blood and urine samples to a lab to test for substances that should not be there. If the blood contains too much creatinine or urea nitrogen and the urine contains protein, your kidneys may not be functioning properly.
Creatinine
Creatinine is a waste product in the blood created by the normal breakdown of muscle during activity. Healthy kidneys take creatinine out of the blood and put it in the urine to leave the body. When kidneys are not working well, creatinine builds up in the blood.
In the lab, your blood will be tested to see how many milligrams of creatinine are in one deciliter of blood (mg/dl). Creatinine levels in the blood can vary, and each laboratory has its own normal range. In many labs, the normal creatinine range is 0.6 to 1.2 mg/dl. If your creatinine level is only slightly above this normal range, you probably will not feel sick, but the elevation is a sign that your kidneys are not working at full strength. One formula for estimating kidney function equates a creatinine level of 2.0 mg/dl to 50 percent of normal kidney function and 4.- mg/dl to 25 percent. But because creatinine values are so variable and can be affected by diet, you may need to have your creatinine measured regularly to see whether your kidney function is decreasing.
The doctor may refer to the measure of creatinine in your blood as your serum creatinine. Do not confuse your serum creatinine number with your creatinine clearance number.
Creatinine Clearance
A creatinine clearance test shows how fast your kidneys remove creatinine from the blood. Clearance is measured in milliliter per minute (ml/min).
To measure your creatinine clearance, you will need to collect urine for 24 hours. Your doctor or nurse will give you a container to collect urine and special instructions for timing the 24-hour collection.
When you take the collected urine to your doctor or laboratory, you also will give a blood sample at that time. Your doctor will measure your creatinine clearance comparing the amount of creatinine in your urine to the amount of creatinine in your blood.
For men, a normal creatinine clearance rate is 91 to 137 ml/min. For women, the normal rate is 88 to 128 ml/min. If your number is below this normal range, your kidneys are not working at full strength.
Blood Urea Nitrogen (BUN)
Blood carries protein for use by cells throughout the body. After the cells use the protein, the remaining waste product is returned to the blood as urea, a compound containing nitrogen. Healthy kidneys take urea out of the blood and send it to the bladder in the urine. If your kidneys are not working well, the urea will stay in the blood.
Normal blood contains 7 to 20 milligrams of urea per deciliter of blood. If your BUN is more than 20 mg/dl, your kidneys may not be working at full strength. Other possible causes of an elevated BUN include dehydration and heart failure.
Proteinuria
Healthy kidneys take wastes out of the blood but leave in protein. Impaired kidneys may fail to separate the protein from the wastes. Proteinuria means protein in the urine, and it is a sign of poor kidney function. If your urine makes foam in the toilet, it may contain high levels of protein. Your doctor may test for protein using a dipstick in a small sample of your urine taken in the doctor’s office. The color of the dipstick indicates the presence or absence of proteinuria. For a more precise measurement, you may need to collect urine for 24 hours.
Renal imaging
If blood and urine tests indicate reduced kidney function, your doctor may recommend additional tests to help identify the cause of the problem. Renal imaging (taking pictures of the kidneys) methods include ultrasound, computed tomography (CAT scan), and magnetic resonance imaging (MRI). These tools are most helpful in finding unusual growths or blockages to the flow of urine.
Renal biopsy
Your doctor may want to see a tiny piece of your kidney tissue under a microscope. To obtain this tissue sample, the doctor will perform a renal biopsy – a hospital procedure in which the doctor inserts a needle through your skin into the back of the kidney. The needle retrieves a strand of tissue about ½ to ¾ inch long. You will lie prone (on your stomach) on a table and will receive a local anesthetic to numb the skin. The sample tissue will help the doctor identify problems at the cellular level.
