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KIDNEY DISEASE

TESTS &
PROCEDURES

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Peoplewithkidneydiseaseoftenundergoalot
ofmedicaltestsandprocedures.Theyareneeded
toconfirmadiagnosis,plantreatmentorcheck
progress.Someofthemostcommonlyusedtests
forpeoplewithkidneydiseaseareoutlinedinthis
factsheet.

Youmayfinditusefultobuyafolderandkeep
recordsofyourhealthappointments,testresults,
andproceduresdetails.Thiswayyoucanfollow
thedevelopmentsofyourtestsyourself.Youmay
alsoliketousesomegraphpapertoplotyourtest
results(seeexample).

TESTS FOR KIDNEY FUNCTION AND DAMAGE


Bloodtests
EstimatedGlomerularFiltrationRate(eGFR)Thebestmeasureofyourkidneyfunction.
Itshowshowwellyourkidneysarecleaningtheblood.YoureGFRisusuallyestimated
fromtheresultsofthecreatininebloodtest.eGFRisreportedinmillilitresperminute
per1.73m2(mL/min/1.73m2).AneGFRof100mL/min/1.73m2isinthenormalrange,so
itisusefultosaythat100mL/min/1.73m2isequalto100%kidneyfunction.An
eGFRof50mL/min/1.73m2couldbecalled50%kidneyfunction.

CreatinineAwasteproductmadebythemuscles.Itisusuallyremovedfromtheblood
bythekidneysandpassesoutintheurine.Whenthekidneysarentworkingwell,
creatininestaysintheblood.Creatininevarieswithage,genderandbodyweight,soits
levelisnotanaccuratewayofmeasuringoverallkidneyfunction.Whenondialysis,
creatininelevelsarealwayshigh.

UreaAwasteproductmadeasthebodybreaksdownprotein.Highurealevels
suggestdecreasedkidneyfunction.

Urinetests
Albumin:CreatinineRatio(ACR)Usedtomeasuretheamountofalbumin(akindof
protein)thatleaksintoyoururinewhenyourkidneysaredamaged.Asmallormicro
amountofalbuminintheurineiscalledmicroalbuminuria,andalarger,macro,amount
iscalledmacroalbuminuria.

UrinalysisAnexaminationofaurinesampletodetectmedicalconditionslikekidney
andliverdisease,diabetesandurinarytractinfections.Thiscanbeavisualexaminationfor
colourandclearness.Forexample,bloodintheurine(haematuria)maymakeurineredor
aninfectioncanmakeitcloudy.Achemicallytreatedstripordipstick
isusedtotestforpH,sugar(glucose),blood,bacteria,orwasteproducts.Aurine
samplecanbesenttoalaboratoryforanexaminationunderamicroscopeortogrowa
cultureifaninfectionissuspected.

KidneyDiseaseTests&Procedures

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TESTS FOR DIABETES

GlucoseBloodglucosemonitoringisameasurementofglucose(sugar)intheblood.
Valuescanvarydependingonphysicalactivity,mealsandinsulinadministration.Your
glucoselevelisraisedindiabetes.

Glycosylatedhaemoglobin(HbA1c)Atestthatmeasurestheamountofglycosylated
haemoglobinintheblood.Glycosylatedhaemoglobinisamoleculeinredbloodcellsthat
attachestoglucose.Therearehigherlevelsofglycosylatedhaemoglobinifyouhavemore
glucoseinyourblood.

TESTS FOR HEART HEALTH


BloodpressureThepressureofthebloodagainstthewallsofthearteriesastheheartpumps
thebloodaroundyourbody.Bloodpressureisrecordedastwonumbers,forexample140/90
mmHg.Thehighernumberindicatesthepressureinthearteriesastheheartsqueezesout
bloodduringeachbeat.Thisiscalledthesystolicbloodpressure.Thelowernumberindicates
thepressureastheheartrelaxesbeforethenextbeat.Thisiscalledthediastolicblood
pressure.

Bloodtests
CholesterolAnaturallyoccurring,waxysubstancemadebythebody.Itisanessential
buildingblockofcellmembranes,hormonesandvitaminD.Toomuchcholesterolinthe
bloodcancausecloggingofthearteriesleadingtoheartdisease.

Lowdensitylipoprotein(LDL)cholesterolKnownasthebadcholesterol.Thehigher
theamountofLDLcholesterol,thehighertheriskofheartdisease.

Highdensitylipoprotein(HDL)cholesterolKnownasthegoodcholesterol.Thelower
theamountofHDLcholesterol,thehighertheriskofheartdisease.

Triglyceridesthemostcommontypeoffatstoredinyourbody.Ahighleveloftriglycerides
inyourbloodcanincreaseyourriskofheartdisease.

TESTS FOR VITAMIN AND MINERAL LEVELS

Potassium(K+)Amineralfoundinmanyfoods.Ifyourkidneysarehealthy,they
removeextrapotassiumfromtheblood.Ifyourkidneysaredamaged,thepotassiumlevel
canriseandaffectyourheart.Aloworhighpotassiumlevelcancauseanirregular
heartbeat.

Sodium(salt,Na+)Asubstancewhichtogetherwithchloridemakesupcommonsalt.
Highlevelsofsodiummayindicatedehydration.

Calcium(Ca)Neededforhealthybonesandteeth.Mostofthecells
inthebodyneedcalciumtoworkproperly.Raisedcalciumlevelsmaycauseheadaches,
nausea,soreeyes,achingteeth,itchyskin,moodchangesandconfusion.

Phosphate(PO4)Amineralwhichtogetherwithcalciumkeeps
yourbonesstrongandhealthy.Toomuchphosphatecausesitchingandpaininthe
joints,suchastheknees,elbowsandankles.When
thekidneysarenotfunctioningproperly,highlevelsofphosphateaccumulateinthe
blood.

VitaminDAvitaminthatismadeinyourskinaftertheexposuretothesun.The
kidneyschangeVitaminDsothatyourbodycanuseit.

KidneyDiseaseTests&Procedures

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TESTS FOR ANAEMIA

Haemoglobin(Hb)Theoxygencarryingpartofredbloodcellsthatgivesthemtheir
redcolourandtransportsoxygenaroundthebody.

Haematocrit(Hct)Ameasureofthepercentageofbloodmadeupofredbloodcells.

Transferrinsaturation(TSAT)Measuredasapercentage,itistheratioofserumiron
leveltototalironbindingcapacity,multipliedby100.Avalueof15%meansthat15%of
ironbindingsitesoftransferrinisbeingoccupiedbyiron.

FerritinAproteinthatstoresironinyourbody.

TESTS FOR HORMONES

Parathyroidhormone(PTH)Helpscontrolcalcium,phosphorus,andvitaminDlevels
withinthebloodandbone.Kidneyfailurecancausetheparathyroidglandstoproduce
toomuchPTH.

IMAGING TESTS

XrayUsesveryshortenergybeamstoproduceanimageofbodyparts,suchasbones
andorgans.

UltrasoundExaminationofthekidneys,prostateorbladderusingsoundwavestooutline
thestructureoforgans.

ComputerisedTomography(CT)ScanorMagneticResonanceImaging(MRI)These
testsusemultiplesmallXraybeamsorradiofrequencywavelengthsandastrong
magneticfieldtoprovideclearanddetailedpicturesofinternalorgansandtissues.You
maybeaskedtodrinkaliquidcontainingapositivecontrastmaterial,ordye,which
allowstheradiologisttoseethekidneysmoreclearly.

KidneybiopsyAprocedurewhereaneedleispassedthroughyourskinintothekidney
inordertoremoveasmallpieceofkidneytissueforexaminationunderamicroscope.
Localanaestheticisused,soitisarelativelypainlessprocedure.

FistulagramUsedtocheckfistulafunction.Dyeisinjectedintoyourfistulatoallowits
structuretoshowuponanXray.

CystoscopyAtestthatusesathin,flexible,tubeliketelescopecalledacystoscopetoview
theinsideofthebladderandsomepartsofthekidney.

RadionuclidescanAsmallamountofradionuclide(achemicalwhichemitsatypeof
radioactivitycalledgammarays)isputintoyourbody,usuallybyaninjection.Aftera
fewhours,aspecialcameraviewsthegammaraysandturnsthemintopictures.The
picturescanshowifyourkidneysaredamagedorscarred.

CONSENT FOR MEDICAL TESTS


Youneedtogiveconsentforanymedicaltest.However,consentforatestcanmeansimply
cooperating,e.g.holdingoutyourarmforyourbloodpressuretobetaken.Thisiscalledinformal,
inferredorimpliedconsent.

Ifatestisinvasive,carriesaparticularrisk,ormayhaveimplicationsfortherapyand
management,thenyoumaybeaskedtoprovidewritteninformedconsentbeforethetestis
performed.Youwillbeprovidedwithaninformationsheetoutliningthedetailsofthe
procedureandtherisksinvolved.Youwillbethenaskedtosignaformconfirmingthatyouagree
totheprocedurebeingperformed.

KidneyDiseaseTests&Procedures

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Itisimportantthatyoutakeyourtimewhenreadingtheconsentform.Makesureyouunderstand
allthewordsanddescriptions,anddonthesitatetoaskformoreinformationifyouneedit.If
Englishisnotyourfirstlanguageandyouareunsureaboutwhatyouhavebeentold,askforan
interpretertobewithyouordiscussthetestswithadoctorwhospeaksyourfirstlanguage.

SeetheMakethemostofyourvisittothedoctorfactsheetforsuggestionsonhowtoprepare
forvisitswithyourhealthcareteam.

FormoreinformationaboutKidneyorUrinaryhealth,pleasecontactourfreecallKidneyHealth
InformationService(KHIS)on1800454363.Alternatively,youmaywishtoemailKHIS@kidney.org.au
orvisitourwebsitewww.kidney.org.autoaccessfreehealthliterature.

Thisisintendedasageneralintroductiontothistopicandisnotmeanttosubstituteforyourdoctor'sorHealth
Professional'sadvice.Allcareistakentoensurethattheinformationisrelevanttothereaderandapplicableto
eachstateinAustralia.ItshouldbenotedthatKidneyHealthAustraliarecognisesthateachperson'sexperience
isindividualandthatvariationsdooccurintreatmentandmanagementduetopersonalcircumstances,thehealth
professionalandthestateonelivesin.Shouldyourequirefurtherinformation,alwaysconsultyourdoctororhealth
professional.

RevisedSeptember2015

Ifyouhaveahearingorspeechimpairment,contacttheNationalRelayServiceon1800555677or
www.relayservice.com.au.Foralltypesofservicesaskfor1800454363.