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VERIFIED CONTENTAuthor: lek. Patryk Jasielski
The kidneys are responsible for the production of urine and the removal of waste products from the body. They are essential organs and their optimal functioning helps to keep the system in balance. Therefore, it is important to take care of them and perform regular checkups. The state of kidney function can be assessed with various tests.
The condition of the kidneyscan be assessed in terms of the efficiency of their primary function, which is to filter the blood and produce urine. Urine is also assessed and may change its composition in kidney disease. Imaging tests are also performed to check their appearance. In some situations, a fragment of an organ is collected in the form of a biopsy to assess its microscopic structure.
There are different indications for checking the condition of your kidneys. They result from the appearance of disturbing symptoms, such as a change in the appearance of urine, pain in the area of the kidneys, the appearance of arterial hypertension or swelling around the ankles and eyes.
Periodic kidney examinations are recommended for the elderly, debilitated, diabetics, rheumatic diseases or hypertension.
Creatinine and eGFR
Creatinine is a product of protein metabolism, and more specifically creatine and phosphocreatine. Its concentration in the body is measured in the blood. It is relatively constant, and to a small extent depends on the muscle mass and the supply of meat products in the diet. An increase in blood creatinine concentration is always evidence of worsening renal excretory function (in acute or chronic renal failure).
The increase in creatinine level, however, only occurs when approximately half of the kidney parenchyma is not working. Reduced concentrations are observed in people with low muscle mass, debilitating people, vegetarians and during pregnancy.
The blood creatinine level is used to calculate the eGFR, or approximate glomerular filtration rate. This is an indicator of how many milliliters of blood gets filtered by the kidneys per minute. Normally it is 80-120 ml / min. Various formulas are used to estimate the eGFR. The most popular are the MDRD, CKD-EPI, and Cockcroft-Gault patterns.
All calculations require the blood creatinine level, age, race, and gender of the tested person. In the latter, you also need to knowbody weight. GFR reduction may indicate chronic renal failure. Based on the determinations of this parameter, the advancement of this failure is also graded.
Urea and uric acid
Urea is a product of protein breakdown in the body and is made of ammonia and carbon dioxide. The concentration in the body depends on the dietary protein supply, hydration and kidney function.
Increase in concentration is observed in acute and chronic renal failure or in dehydration. It may also be the result of gastrointestinal bleeding, increased breakdown (catabolism) of proteins. Such a condition occurs, for example, in the case of large injuries or extensive burns. It is a less sensitive indicator of kidney function than creatinine.
The knowledge of its concentration is, however, useful in much advanced renal failure. Reduced levels are rarely observed, especially in the course of hepatic failure.
Uric acid is a product of purine metabolism, components of DNA-building nucleic acids. Its excretion depends mainly on the kidneys.
Elevated levels may indicate acute and chronic renal failure. It is also found in hypothyroidism or a diet rich in purines (i.e. containing foods such as offal and beer).
Reduced concentration is associated with pregnancy, acromegaly, and kidney diseases such as tubulopathies (or tubular diseases).
Urine general examination
A urine test can tell you a lot about the he alth of your kidneys. It evaluates a number of parameters. Proteinuria, i.e. the appearance of protein in a urine sample, may indicate a disease of the kidneys, more specifically of the kidney glomeruli or tubules. One symptom of proteinuria is foaming of urine in the toilet after passing it.
Similarly, the appearance of sugar in the urine, i.e. glucosuria, may be a symptom of kidney disease, resulting from damage to the filtration membrane. Another change in the urine that may indicate a kidney problem is the presence of red and white blood cells. This symptom is associated with damage to the organ's parenchyma or with an infection.
Similarly, the presence of granular, cellular, erythrocyte and wax rollers. They come from the renal tubules and indicate their impaired function.
kidney ultrasound
Ultrasound is the basic imaging examination used to observe the appearance of the kidneys. It enables the assessment of their location, detection and differentiation of lesions.
Allows you to assess the blood flow in the renal vessels and the appearance of the urinary tract. It is advisable in the case of symptoms suggesting kidney disease, such as pain in the lumbar region, a palpable tumorand changes in urine.
They should be performed after abdominal trauma, in the case of suspicion of urolithiasis, pyelonephritis and blood circulation disorders, e.g. in renal artery embolism.
It is simple, quick and easy to access. It is not accurate enough to recognize some diseases. It is more than once an introduction to the extended diagnosis of diseases of kidney origin.