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Chronic kidney disease, commonly called CKD, occurs when the kidneys have a persistent structural or functional abnormality that affects health. CKD is not defined by one isolated blood test. Under current kidney guidelines, evidence of kidney damage or reduced kidney function must generally be present for at least three months to establish chronicity.
The condition can progress quietly. Early CKD often causes no noticeable symptoms, which means blood and urine testing may reveal changes long before a person feels unwell. The two central kidney measurements are estimated glomerular filtration rate, or eGFR, and urine albumin-to-creatinine ratio, or uACR.
CKD is common and frequently unrecognized. The CDC’s March 2026 estimates indicate that approximately 14% of U.S. adults have CKD and that about 87% of affected adults do not know they have it.
Ulta Lab Tests provides direct online access to many kidney-related blood and urine tests where available. Lab testing can provide valuable information, but results do not replace a medical examination, diagnosis, or individualized guidance from a qualified healthcare provider.
Your kidneys continuously filter blood, remove wastes and excess water, and create urine. They also help regulate:
Chronic kidney disease develops when kidney damage or reduced filtration persists over time. Kidney Disease: Improving Global Outcomes, or KDIGO, defines CKD as an abnormality of kidney structure or function lasting at least three months and having implications for health. CKD is classified using the CGA system:
This approach provides more information than referring to “stage 1 through stage 5” alone. A person’s eGFR and urine albumin level work together to estimate the likelihood of progression and other health complications.
Yes. Someone can have an eGFR of 60 or higher and still meet CKD criteria if there is persistent evidence of kidney damage, such as:
An eGFR in the G1 or G2 range does not by itself establish CKD when no other marker of kidney damage is present.
Healthy kidneys regulate far more than waste removal. As kidney function declines, disturbances may develop in fluid balance, blood pressure, potassium, bicarbonate, red blood cell production, and bone-mineral metabolism.
CKD is also closely connected with cardiovascular health. People with CKD may have an increased risk of high blood pressure, heart disease, stroke, and other complications. Risks generally increase as eGFR falls and albuminuria rises.
Early awareness matters because it allows patients and healthcare providers to:
The “stage” of chronic kidney disease is based largely on eGFR, an estimate of how much blood the kidneys filter each minute. Results are adjusted to a standardized body-surface area and reported as mL/min/1.73 m2.
| GFR Category | eGFR, mL/min/1.73 m2 | General Description | Important Context |
|---|---|---|---|
| G1 | 90 or higher | Normal or high filtration | CKD requires another persistent marker of kidney damage. |
| G2 | 60–89 | Mildly decreased | CKD requires another persistent marker of kidney damage. |
| G3a | 45–59 | Mildly to moderately decreased | Persistent results may indicate stage 3a CKD. |
| G3b | 30–44 | Moderately to severely decreased | Complication and progression risks are generally higher. |
| G4 | 15–29 | Severely decreased | Requires close medical and kidney-specialist evaluation. |
| G5 | Below 15 | Kidney failure | Requires prompt specialist management and planning based on the full clinical picture. |
These categories are based on KDIGO guidance. A low eGFR should generally be repeated and evaluated in context to distinguish chronic kidney disease from an acute or temporary change.
Albumin is a protein that is normally retained in the bloodstream. Damaged kidney filters may allow albumin to leak into the urine.
| Albuminuria Category | uACR Result | Description |
|---|---|---|
| A1 | Less than 30 mg/g | Normal to mildly increased |
| A2 | 30–300 mg/g | Moderately increased |
| A3 | More than 300 mg/g | Severely increased |
A higher uACR can indicate greater kidney damage and higher health risk, even when eGFR remains above 60. The combination of eGFR and uACR gives a more complete picture than either result alone.
Diabetes is a leading cause of CKD. Over time, elevated blood glucose can damage the kidney’s filtering structures, allowing albumin to leak into the urine and gradually reducing filtration.
High blood pressure can damage the small blood vessels and filtering structures in the kidneys. Kidney damage can also contribute to fluid retention and further increases in blood pressure, creating a harmful cycle.
The National Institute of Diabetes and Digestive and Kidney Diseases identifies diabetes and high blood pressure as the two most common causes of CKD in adults.
CKD may also be associated with:
Determining the underlying cause may require medical history, physical examination, laboratory testing, imaging, and occasionally specialized testing or kidney biopsy. Routine blood work alone cannot identify every cause.
Testing may be particularly important for people with:
NIDDK recommends considering testing in people with diabetes, high blood pressure, heart disease, or a family history of kidney failure. The benefit of broad CKD screening in people without risk factors is less clear.
Early CKD usually does not cause obvious symptoms. Symptoms become more likely as kidney function declines or complications develop.
| Symptom or Risk Factor | What It May Suggest | Related Lab Tests |
|---|---|---|
| No symptoms but diabetes or high blood pressure | Increased risk of silent kidney damage | Creatinine Test, Albumin Random Urine Test with Creatinine, and Urinalysis Complete Test |
| Foamy or persistently bubbly urine | Albumin or other protein in the urine | Albumin Random Urine Test with Creatinine, Urinalysis Complete Test, and Protein Total Random Urine Test with Creatinine |
| Swelling in the feet, ankles, hands, or face | Fluid retention or significant urinary protein loss | Renal Function Panel Test, Albumin Random Urine Test with Creatinine, and Urinalysis Complete Test |
| Unexplained fatigue or weakness | Anemia, electrolyte imbalance, illness, or reduced kidney function | Complete Blood Count with Differential and Platelets and Renal Function Panel Test |
| Changes in urination | Urinary tract, bladder, prostate, fluid, or kidney issues | Urinalysis Complete Test, Renal Function Panel Test, and Albumin Random Urine Test with Creatinine |
| Blood in the urine | Infection, stone, urinary tract disease, or kidney-filter inflammation | Urinalysis Complete Test and prompt healthcare-provider evaluation |
| Itching, nausea, poor appetite, or altered taste | May occur in advanced CKD but has many other causes | Renal Function Panel Test, Complete Blood Count with Differential and Platelets, and provider-directed testing |
| Muscle cramps or weakness | Possible electrolyte or mineral imbalance | Renal Function Panel Test, Calcium Test, and Phosphate (as Phosphorus) Test |
| Difficulty concentrating or sleep problems | May occur with advanced disease, anemia, or other conditions | Complete Blood Count with Differential and Platelets, Renal Function Panel Test, and medical evaluation |
| Chest pain or shortness of breath | Possible cardiovascular or fluid-related emergency | Seek urgent medical care rather than relying on outpatient testing. |
Advanced CKD symptoms may include fatigue, sleep problems, difficulty concentrating, appetite loss, nausea, changes in urination, foamy urine, itching, muscle cramps, shortness of breath, chest pain, and worsening swelling. These symptoms are not specific to CKD and should not be used for self-diagnosis.
Obtain prompt or emergency medical care for chest pain, severe shortness of breath, confusion, fainting, inability to urinate, rapidly worsening swelling, severe weakness, persistent vomiting, or visible blood in the urine. Do not delay urgent evaluation while waiting for routine laboratory testing.
Kidney testing can answer several different questions.
A temporary illness, dehydration, medication effect, intense exercise, urinary infection, or acute kidney injury may alter kidney-related results. KDIGO recommends repeating an unexpectedly low eGFR, elevated uACR, or blood in the urine to help confirm whether a chronic abnormality is present.
| Lab Test | What It Measures | Why It May Matter | Important Limitations |
|---|---|---|---|
| Creatinine Test | Measures creatinine, a waste product influenced partly by muscle metabolism. The result may be used to calculate eGFR. | A rising creatinine or falling eGFR may indicate reduced kidney filtration. | Results can be influenced by muscle mass, recent meat intake, exercise, certain medications, acute illness, and hydration. |
| Albumin Random Urine Test with Creatinine | Compares urine albumin with urine creatinine in a spot urine sample and reports the uACR. | May detect albumin leakage before eGFR declines. | Exercise, infection, fever, marked hyperglycemia, severe hypertension, heart failure, urinary bleeding, and menstrual contamination may temporarily affect the result. |
| Cystatin C Test with eGFR | Measures cystatin C, a blood protein filtered by the kidneys, and calculates an additional eGFR. | May help when creatinine-based eGFR is uncertain because of unusually high or low muscle mass, frailty, amputation, spinal cord injury, eating disorders, or intensive bodybuilding. | Cystatin C can be affected by thyroid disease, inflammation, smoking, corticosteroid exposure, higher adiposity, and certain cancers. |
| Estimated Glomerular Filtration Rate with Creatinine and Cystatin C | Uses both creatinine and cystatin C to calculate kidney filtration. | The combined estimate may be more accurate than using either filtration marker alone. | It remains an estimate and may be less reliable when non-kidney factors strongly affect both markers. |
| Renal Function Panel Test | Commonly includes creatinine, eGFR, BUN, sodium, potassium, chloride, carbon dioxide, calcium, phosphorus, glucose, and albumin. | Provides information about filtration, electrolytes, acid-base balance, and minerals that may be affected by kidney disease. | Abnormal values are not specific to CKD and may be influenced by diet, hydration, medications, liver disease, endocrine conditions, and other illnesses. |
| Urinalysis Complete Test | Evaluates urine appearance, concentration, pH, protein, blood, glucose, white blood cells, crystals, cells, and casts. | Protein, blood, or abnormal sediment may provide clues about kidney or urinary tract conditions. | Abnormal findings can result from infection, exercise, stones, contamination, menstruation, or non-kidney conditions. |
| Protein Total Random Urine Test with Creatinine | Estimates total protein loss in a spot urine sample. | May be useful when proteins other than albumin are suspected or when total urine protein needs to be quantified. | For common CKD risk assessment, uACR is usually preferred because it is more sensitive to albumin leakage. |
| Complete Blood Count with Differential and Platelets | Measures red blood cells, hemoglobin, hematocrit, white blood cells, and platelets. | Reduced kidney hormone production may contribute to anemia as CKD progresses. | Low hemoglobin has many possible causes, including iron deficiency, blood loss, inflammation, vitamin deficiency, and bone marrow disorders. |
| Hemoglobin A1c Test and Hemoglobin A1c and Glucose Panel | A1c estimates average glucose exposure over approximately two to three months, while glucose measures blood sugar at the time of collection. | Diabetes is a leading cause of CKD, making glucose assessment important for many patients. | Anemia, altered red blood cell survival, transfusion, and advanced kidney disease may affect A1c interpretation. |
| Calcium Test, Phosphate (as Phosphorus) Test, PTH Intact Test, and Vitamin D 25-Hydroxy Total Test | Evaluate mineral and hormone pathways involved in bone health. | More advanced CKD may disturb phosphorus excretion, vitamin D metabolism, calcium balance, and parathyroid hormone regulation. | These tests are usually most useful when selected according to CKD stage, prior results, symptoms, and provider guidance. |
For many adults at increased risk, a foundational assessment may include:
The Kidney Profile combines creatinine with eGFR and urine albumin with creatinine in one kidney-focused option. Testing both filtration and urine albumin is important because one may be abnormal while the other remains within range.
Additional testing may be considered when creatinine-based eGFR appears inconsistent with a person’s health or body composition, a prior result was borderline, albumin or protein is present in the urine, medication dosing requires a more reliable filtration estimate, or kidney function has changed over time.
People with established CKD or suspected complications may need additional testing based on their history, symptoms, CKD stage, and prior results:
These tests should not be ordered as a universal package for everyone. Specialized cause testing is most useful when guided by medical history, urine findings, physical examination, and a healthcare provider.
Follow-up frequency depends on:
A healthcare provider may repeat an unexpected abnormal test sooner to rule out a temporary change. Confirming CKD generally requires evidence that the abnormality has persisted for at least three months.
A result outside the laboratory range does not automatically mean chronic kidney disease. Likewise, a result inside the range does not exclude early kidney damage.
Interpretation depends on:
An eGFR of 45 does not necessarily mean the kidneys are functioning at exactly 45% of normal. eGFR is a calculated estimate with expected biological and analytical variation.
Possible reasons for a temporary decrease include:
Albumin may rise temporarily during strenuous exercise, fever, infection, uncontrolled blood glucose, severe blood pressure elevation, heart failure, or urinary bleeding. Repeating the test can help determine whether albuminuria is persistent.
A healthcare provider may compare:
A stable result and a rapidly changing result can have very different implications even when the numerical values are similar.
Preparation varies by test and panel. Always review the specific instructions provided with the order.
Do not stop or change a medication for testing unless the prescribing healthcare provider specifically instructs you to do so.
Ulta Lab Tests gives patients direct access to many kidney-related laboratory tests online where available. Patients can review test descriptions and transparent pricing before ordering, visit an authorized patient service center for specimen collection, and receive results through a secure online account.
No insurance is required for self-pay testing. HSA and FSA payment may be available for eligible services, and results can be shared with a physician or other qualified healthcare professional for interpretation and follow-up.
Direct access can make it easier to obtain objective health information, but it does not replace medical care. Significant or changing kidney abnormalities should be reviewed promptly with a healthcare provider.
Explore kidney testing options: Kidney Tests at Ulta Lab Tests
The most common blood test is a Creatinine Test with calculated eGFR. A Renal Function Panel Test may also measure BUN, potassium, sodium, bicarbonate, calcium, phosphorus, glucose, and albumin. A Cystatin C Test with eGFR may be added when creatinine-based eGFR is uncertain. Blood testing should usually be paired with urine albumin testing because filtration and kidney damage are different measurements.
The Albumin Random Urine Test with Creatinine reports the urine albumin-to-creatinine ratio, or uACR, and is a key test for detecting albumin leakage. It can reveal kidney-filter damage even when eGFR remains above 60. A Urinalysis Complete Test provides additional information about protein, blood, cells, infection markers, glucose, and urine concentration.
Yes. Many people with early CKD feel completely well. Symptoms such as fatigue, swelling, nausea, itching, cramps, and urination changes are more likely as disease becomes advanced or complications develop. Because symptoms are unreliable in early disease, people with diabetes, high blood pressure, heart disease, or a family history of kidney failure should discuss testing with a healthcare provider.
An eGFR below 60 may indicate reduced kidney filtration, but one result does not necessarily establish CKD. Dehydration, acute illness, medication effects, or acute kidney injury can lower eGFR temporarily. When an eGFR remains below 60 for at least three months, it may meet the filtration criterion for CKD and should be interpreted with urine albumin and other clinical information.
Yes. CKD may be present with an eGFR above 60 when another persistent marker of kidney damage exists. Examples include albuminuria, abnormal urine sediment, structural kidney abnormalities, or certain tubular disorders. This is why urine albumin testing is important in addition to serum creatinine and eGFR.
The term “microalbumin” has historically referred to small but abnormal amounts of albumin in urine. The preferred modern measurement is the urine albumin-to-creatinine ratio, or uACR. The ratio adjusts albumin for urine concentration and is commonly reported in milligrams of albumin per gram of creatinine.
No. Creatinine is influenced by muscle mass and other factors. A person with low muscle mass may have a creatinine result within the laboratory range even when filtration is reduced. Kidney evaluation should consider calculated eGFR, urine albumin, urinalysis, health history, and trends. A Cystatin C Test with eGFR may be useful when creatinine is considered less reliable.
Yes. Dehydration may increase creatinine and BUN and temporarily lower calculated eGFR. However, an abnormal result should not automatically be attributed to dehydration without proper evaluation. A healthcare provider may recommend repeat testing after the temporary condition has resolved, particularly when the change is unexpected.
Fasting is not usually required for an isolated Creatinine Test, Cystatin C Test with eGFR, Albumin Random Urine Test with Creatinine, or Urinalysis Complete Test. Fasting may be required when the order also includes glucose, insulin, triglycerides, or other tests with specific preparation instructions.
Testing frequency varies according to eGFR, urine albumin, diabetes, blood pressure, medication use, and previous trends. An unexpected abnormality may be repeated sooner to determine whether it is temporary. People with established CKD may need periodic monitoring based on their combined eGFR and albuminuria risk category. A healthcare provider should determine the appropriate schedule.
Ulta Lab Tests allows patients to order many kidney-related tests online where direct-access testing is available. Options include the Kidney Profile, Renal Function Panel Test, Albumin Random Urine Test with Creatinine, Cystatin C Test with eGFR, and Urinalysis Complete Test. Results should be shared with a qualified healthcare provider, especially when eGFR is low, urine albumin is elevated, or results are changing.
Referral may be considered for advanced CKD, rapidly declining eGFR, severe albuminuria, persistent blood in the urine, resistant electrolyte abnormalities, suspected inherited disease, uncertain cause, or results that are difficult to interpret. Urgent symptoms such as severe shortness of breath, chest pain, confusion, or inability to urinate require immediate medical evaluation.
Chronic kidney disease often develops without early warning symptoms. Understanding both CKD stages and albuminuria categories provides a clearer picture of kidney health than relying on symptoms, creatinine, or eGFR alone.
The most useful initial evaluation typically combines a blood-based filtration estimate with a urine albumin measurement. Additional tests—including a Cystatin C Test with eGFR, Renal Function Panel Test, Urinalysis Complete Test, Complete Blood Count with Differential and Platelets, glucose testing, and mineral-bone markers—may provide further information when chosen according to individual risk and prior results.
Ulta Lab Tests offers direct access to kidney-related laboratory testing where available. Explore kidney testing options and review significant, persistent, or changing results with a qualified healthcare provider.
Definition: Chronic kidney disease is a persistent abnormality of kidney structure or function lasting at least three months and affecting health. CKD is classified by its cause, eGFR category, and urine albumin category.
Related lab tests: Creatinine Test, Albumin Random Urine Test with Creatinine, Cystatin C Test with eGFR, Estimated Glomerular Filtration Rate with Creatinine and Cystatin C, Renal Function Panel Test, Urinalysis Complete Test, Protein Total Random Urine Test with Creatinine, Complete Blood Count with Differential and Platelets, Hemoglobin A1c Test, Calcium Test, Phosphate (as Phosphorus) Test, PTH Intact Test, and Vitamin D 25-Hydroxy Total Test.
How Ulta Lab Tests helps: Ulta Lab Tests provides direct online access to many kidney-related blood and urine tests, with secure online results that patients can review with a qualified healthcare provider.
Medical disclaimer: Laboratory testing is informational and does not replace professional medical evaluation, diagnosis, or treatment.
The Ulta Lab Tests Kidney hub identifies creatinine with eGFR, uACR, and urinalysis as core kidney tests and emphasizes using eGFR and urine albumin together.
Ulta Lab Tests describes cystatin C as a filtration marker that may help confirm or refine creatinine-based eGFR and lists urine protein-to-creatinine testing as an adjunct to uACR.
These tests help provide context for diabetes and cardiovascular risk factors associated with CKD. Ulta Lab Tests includes A1c and lipid testing among relevant additions for patients with diabetes, hypertension, and kidney risk.
CBC and iron studies may help evaluate anemia and iron status when clinically appropriate. Ulta Lab Tests includes CBC and iron studies among potential complication checks for CKD follow-up.
Ulta Lab Tests identifies calcium, phosphorus, intact PTH, and 25-hydroxy vitamin D as relevant markers when evaluating bone and mineral changes associated with more advanced CKD.
These health-area links align with the kidney, metabolic, cardiovascular, anemia, and mineral-balance topics discussed in the article. The Ulta Lab Tests Kidney hub specifically connects CKD evaluation with eGFR, uACR, urinalysis, cystatin C, electrolytes, calcium, phosphorus, PTH, diabetes, hypertension, cardiovascular disease, anemia, and iron studies.
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