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Kidney Lab Tests and health information

Do you have a family history of kidney disease?

 It's important to get tested on a regular basis for CKD with comprehensive lab tests from Ulta Lab Tests.

If so, it's important to know that you could be at risk for developing the condition yourself. Chronic kidney disease can lead to other serious health conditions like heart attack and stroke. It's important to get tested regularly for early detection. We want to help you live a healthier life by providing you with direct access to lab testing to obtain the information you need about your health and well-being as soon as possible. Our tests are quick, accurate, and affordable!

If you want to learn more about kidney disease and the lab tests that can help you, click on the title of the articles below.

You don't want to miss out on the opportunity to catch kidney disease early enough that it can be treated before it becomes more severe. We offer comprehensive lab testing services that will help detect any abnormalities in your kidneys or urinary tract system before they become life-threatening problems. Don't wait until it's too late - get tested today!

If you have been diagnosed with chronic kidney disease, we recommend that you undergo regular blood tests to monitor the condition of your kidneys. These tests can help detect early signs of damage and prevent further damage from occurring with action. We offer a wide range of diagnostic testing services for individuals living with chronic kidney disease or at risk for developing it in the future. We provide accurate results within 24 hours 48 hours for most tests so that you know your health status as soon as possible.

The lab tests used for screening for kidney disease include, at a minimum, the

Improperly functioning kidneys can lead to what is known as kidney disease. Kidney Disease does not fall into one particular description. Instead, various conditions can cause kidney disease and even the loss of kidney function.

The condition of chronic kidney disease or CKD can creep up silently over the years. There may be no signs or symptoms, or the signs and symptoms can be so general that a person doesn't know it's related to kidney function. 

You can trust us to provide comprehensive laboratory and accurate lab testing services for all CKD diagnosis and treatment stages. We provide Quest Diagnostics results every time, so you don't have to worry about receiving incorrect information about your health or delaying necessary treatments. With us, there is no guesswork – just peace of mind knowing that everything will be okay when it comes to your health and well-being.

Ulta Lab Tests is a great way to learn about your health. You can order affordable lab tests online 24 hours a day, 7 days a week, and we'll furnish the doctor's authorization. Plus, with over 2100 sites nationwide, we have a lab near you. Quest Diagnostics provides results in 24 to 48 hours for most tests, and our customer service is always courteous, friendly, and helpful. 

If you want to learn more about kidney disease and the lab tests that can help you, click on the title of the articles below.

Take control of your health by ordering your kidney disease blood tests from the list below.


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Test in the Top 5 Kidney Function Tests to Ask for and How to Interpret Them

  • Creatinine Clearance [ 7943 ]
  • Microalbumin, Random Urine with Creatinine [ 6517 ]
  • Renal Function Panel [ 10314 ]
  • Urinalysis (UA), Complete [ 5463 ]
  • Urine Protein, Total, Random without Creatinine [ 14523 ]
     

  • Renal Function Panel [ 10314 ]
  • Urinalysis (UA), Complete [ 5463 ]
  • Urine Protein, Total, Random without Creatinine [ 14523 ]
     

  • Creatinine Clearance [ 7943 ]
  • Microalbumin, Random Urine with Creatinine [ 6517 ]
  • Renal Function Panel [ 10314 ]
  • Urinalysis (UA), Complete [ 5463 ]
  • Urine Protein, Total, Random without Creatinine [ 14523 ]
     

Most Popular



Important: This panel contains ANA Screen IFA with Reflex to Titer and Pattern #249 which is a Reflex test. If ANA Screen, IFA is positive, then ANA Titer and Pattern will be performed at an additional charge of $13.00


Important: This panel contains ANA Screen IFA with Reflex to Titer and Pattern #249 which is a Reflex test. If ANA Screen, IFA is positive, then ANA Titer and Pattern will be performed at an additional charge of $13.00


Important: This panel contains ANA Screen IFA with Reflex to Titer and Pattern #249 which is a Reflex test. If ANA Screen, IFA is positive, then ANA Titer and Pattern will be performed at an additional charge of $13.00


Important: This panel contains ANA Screen IFA with Reflex to Titer and Pattern #249 which is a Reflex test. If ANA Screen, IFA is positive, then ANA Titer and Pattern will be performed at an additional charge of $13.00


Important: This panel contains ANA Screen IFA with Reflex to Titer and Pattern #249 which is a Reflex test. If ANA Screen, IFA is positive, then ANA Titer and Pattern will be performed at an additional charge of $13.00




Kidney Assess

  • Beta-2-Microglobulin, Serum
  • Creatinine Clearance
  • CYSTATIN C WITH eGFR
  • Microalbumin, Random Urine with Creatinine
  • Protein, Total, Random Urine with Creatini
  • PTH, Intact (without Calcium)
  • Renal Function Panel

Kidney Assess Plus

  • Beta-2-Microglobulin, Serum
  • CBC (includes Differential and Platelets)
  • Comprehensive Metabolic Panel (CMP)
  • Creatinine Clearance
  • CYSTATIN C WITH eGFR
  • Microalbumin, Random Urine with Creatinine
  • Protein, Total, Random Urine with Creatini
  • PTH, Intact (without Calcium)
  • QuestAssureD™ 25-Hydroxyvitamin D (D2, D3), LC/MS/MS
  • Renal Function Panel
  • Uric Acid



This panel is designed for individuals diagnosed as having diabetes mellitus whose kidney disease has advanced to Stage 3/4 impairment. The panel affords the opportunity to assess electrolytes, phosphorus, serum creatinine/eGFR, hemoglobin, microalbumin, parathyroid hormone, calcium, and vitamin D. The grouping of these tests, readily identifiable as elements that adhere to guideline recommendations, is intended to facilitate the ready adherence to professional society clinical practice guidelines. Components of the testing related to the Management of CKD in diabetes, as outlined in the Standards of Medical Care in Diabetes 2013. These recommendations are in broad agreement with those published by the National Kidney Foundation and the American Association of Clinical Endocrinologists.

Description: A Comprehensive Metabolic Panel or CMP is a blood test that is a combination of a Basic Metabolic Panel, a Liver Panel, and electrolyte panel, and is used to screen for, diagnose, and monitor a variety of conditions and diseases such as liver disease, diabetes, and kidney disease. 

Also Known As: CMP, Chem, Chem-14, Chem-12, Chem-21, Chemistry Panel, Chem Panel, Chem Screen, Chemistry Screen, SMA 12, SMA 20, SMA 21, SMAC, Chem test

Collection Method: 

Blood Draw 

Specimen Type: 

Serum 

Test Preparation: 

9-12 hours fasting is preferred. 

When is a Comprehensive Metabolic Panel test ordered:  

A CMP is frequently requested as part of a lab test for a medical evaluation or yearly physical. A CMP test consists of many different tests that give healthcare providers a range of information about your health, including liver and kidney function, electrolyte balance, and blood sugar levels. To confirm or rule out a suspected diagnosis, abnormal test results are frequently followed up with other tests that provide a more in depth or targeted analysis of key areas that need investigating. 

What does a Comprehensive Metabolic Panel blood test check for? 

The complete metabolic panel (CMP) is a set of 20 tests that provides critical information to a healthcare professional about a person's current metabolic status, check for liver or kidney disease, electrolyte and acid/base balance, and blood glucose and blood protein levels. Abnormal results, particularly when they are combined, can suggest a problem that needs to be addressed. 

The following tests are included in the CMP: 

  • Albumin: this is a measure of Albumin levels in your blood. Albumin is a protein made by the liver that is responsible for many vital roles including transporting nutrients throughout the body and preventing fluid from leaking out of blood vessels. 

  • Albumin/Globulin Ratio: this is a ratio between your total Albumin and Globulin  

  • Alkaline Phosphatase: this is a measure of Alkaline phosphatase or ALP in your blood. Alkaline phosphatase is a protein found in all body tissues, however the ALP found in blood comes from the liver and bones. Elevated levels are often associated with liver damage, gallbladder disease, or bone disorder. 

  • Alt: this is a measure of Alanine transaminase or ALT in your blood. Alanine Aminotransferase is an enzyme found in the highest amounts in the liver with small amounts in the heart and muscles. Elevated levels are often associated with liver damage. 

  • AST: this is a measure of Aspartate Aminotransferase or AST. Aspartate Aminotransferase is an enzyme found mostly in the heart and liver, with smaller amounts in the kidney and muscles. Elevated levels are often associated with liver damage. 

  • Bilirubin, Total: this is a measure of bilirubin in your blood. Bilirubin is an orange-yellowish waste product produced from the breakdown of heme which is a component of hemoglobin found in red blood cells. The liver is responsible for removal of bilirubin from the body. 

  • Bun/Creatinine Ratio: this is a ratio between your Urea Nitrogen (BUN) result and Creatinine result.  

  • Calcium: this is a measurement of calcium in your blood. Calcium is the most abundant and one of the most important minerals in the body as it essential for proper nerve, muscle, and heart function. 

  • Calcium: is used for blood clot formation and the formation and maintenance of bones and teeth. 

  • Carbon Dioxide: this is a measure of carbon dioxide in your blood. Carbon dioxide is a negatively charged electrolyte that works with other electrolytes such as chloride, potassium, and sodium to regulate the body’s acid-base balance and fluid levels.  

  • Chloride: this is a measure of Chloride in your blood. Chloride is a negatively charged electrolyte that works with other electrolytes such as potassium and sodium to regulate the body’s acid-base balance and fluid levels. 

  • Creatinine: this is a measure of Creatinine levels in your blood. Creatinine is created from the breakdown of creatine in your muscles and is removed from your body by the kidneys. Elevated creatinine levels are often associated with kidney damage. 

  • Egfr African American: this is a measure of how well your kidneys are functioning. Glomeruli are tiny filters in your kidneys that filter out waste products from your blood for removal while retaining important substances such as nutrients and blood cells. 

  • Egfr Non-Afr. American: this is a measure of how well your kidneys are functioning. Glomeruli are tiny filters in your kidneys that filter out waste products from your blood for removal while retaining important substances such as nutrients and blood cells. 

  • Globulin: this is a measure of all blood proteins in your blood that are not albumin. 

  • Glucose: this is a measure of glucose in your blood. Glucose is created from the breakdown of carbohydrates during digestion and is the body’s primary source of energy. 

  • Potassium: this is a measure of Potassium in your blood. Potassium is an electrolyte that plays a vital role in cell metabolism, nerve and muscle function, and transport of nutrients into cells and removal of wastes products out of cells. 

  • Protein, Total: this is a measure of total protein levels in your blood. 
    Sodium: this is a measure of Sodium in your blood. Sodium is an electrolyte that plays a vital role in nerve and muscle function. 

  • Urea Nitrogen (Bun): this is a measure of Urea Nitrogen in your blood, also known as Blood UreaNitrogen (BUN). Urea is a waste product created in the liver when proteins are broken down into amino acids. Elevated levels are often associated with kidney damage. 

Lab tests often ordered with a Comprehensive Metabolic Panel test: 

  • Complete Blood Count with Differential and Platelets
  • Iron and Total Iron Binding Capacity
  • Lipid Panel
  • Vitamin B12 and Folate
  • Prothrombin with INR and Partial Thromboplastin Times
  • Sed Rate (ESR)
  • C-Reactive Protein

Conditions where a Comprehensive Metabolic Panel test is recommended: 

  • Diabetes
  • Kidney Disease
  • Liver Disease
  • Hypertension

Commonly Asked Questions: 

How does my health care provider use a Comprehensive Metabolic Panel test? 

The comprehensive metabolic panel (CMP) is a broad screening tool for assessing organ function and detecting diseases like diabetes, liver disease, and kidney disease. The CMP test may also be requested to monitor known disorders such as hypertension and to check for any renal or liver-related side effects in persons taking specific drugs. If a health practitioner wants to follow two or more separate CMP components, the full CMP might be ordered because it contains more information. 

What do my Comprehensive Metabolic Panel test results mean? 

The results of the tests included in the CMP are usually analyzed together to look for patterns. A single abnormal test result may indicate something different than a series of abnormal test findings. A high result on one of the liver enzyme tests, for example, is not the same as a high result on several liver enzyme tests. 

Several sets of CMPs, frequently performed on various days, may be examined to gain insights into the underlying disease and response to treatment, especially in hospitalized patients. 

Out-of-range findings for any of the CMP tests can be caused by a variety of illnesses, including kidney failure, breathing issues, and diabetes-related complications, to name a few. If any of the results are abnormal, one or more follow-up tests are usually ordered to help determine the reason and/or establish a diagnosis. 

Is there anything else I should know? 

A wide range of prescription and over-the-counter medications can have an impact on the results of the CMP's components. Any medications you're taking should be disclosed to your healthcare professional. Similarly, it is critical to provide a thorough history because many other circumstances can influence how your results are interpreted. 

What's the difference between the CMP and the BMP tests, and why would my doctor choose one over the other? 

The CMP consists of 14 tests, while the basic metabolic panel (BMP) is a subset of those with eight tests. The liver (ALP, ALT, AST, and bilirubin) and protein (albumin and total protein) tests are not included. If a healthcare provider wants a more thorough picture of a person's organ function or to check for specific illnesses like diabetes or liver or kidney disease, he or she may prescribe a CMP rather than a BMP. 

We advise having your results reviewed by a licensed medical healthcare professional for proper interpretation of your results.

Please note the following regarding BUN/Creatinine ratio: 

The lab does not report the calculation for the BUN/Creatinine Ratio unless one or both biomarkers’ results fall out of the published range. 

If you still wish to see the value, it's easy to calculate. Simply take your Urea Nitrogen (BUN) result and divide it by your Creatinine result.  

As an example, if your Urea Nitrogen result is 11 and your Creatinine result is 0.86, then you would divide 11 by 0.86 and get a BUN/Creatinine Ratio result of 12.79. 


Description: A CBC or Complete Blood Count with Differential and Platelets test is a blood test that measures many important features of your blood’s red and white blood cells and platelets. A Complete Blood Count can be used to evaluate your overall health and detect a wide variety of conditions such as infection, anemia, and leukemia. It also looks at other important aspects of your blood health such as hemoglobin, which carries oxygen. 

Also Known As: CBC test, Complete Blood Count Test, Total Blood Count Test, CBC with Differential and Platelets test, Hemogram test  

Collection Method: Blood Draw 

Specimen Type: Whole Blood 

Test Preparation: No preparation required 

When is a Complete Blood Count test ordered?  

The complete blood count (CBC) is an extremely common test. When people go to the doctor for a standard checkup or blood work, they often get a CBC. Suppose a person is healthy and their results are within normal ranges. In that case, they may not need another CBC unless their health condition changes, or their healthcare professional believes it is necessary. 

When a person exhibits a variety of signs and symptoms that could be connected to blood cell abnormalities, a CBC may be done. A health practitioner may request a CBC to help diagnose and determine the severity of lethargy or weakness, as well as infection, inflammation, bruises, or bleeding. 

When a person is diagnosed with a disease that affects blood cells, a CBC is frequently done regularly to keep track of their progress. Similarly, if someone is being treated for a blood condition, a CBC may be performed on a regular basis to see if the treatment is working. 

Chemotherapy, for example, can influence the generation of cells in the bone marrow. Some drugs can lower WBC counts in the long run. To monitor various medication regimens, a CBC may be required on a regular basis. 

What does a Complete Blood Count test check for? 

The complete blood count (CBC) is a blood test that determines the number of cells in circulation. White blood cells (WBCs), red blood cells (RBCs), and platelets (PLTs) are three types of cells suspended in a fluid called plasma. They are largely created and matured in the bone marrow and are released into the bloodstream when needed under normal circumstances. 

A CBC is mainly performed with an automated machine that measures a variety of factors, including the number of cells present in a person's blood sample. The findings of a CBC can reveal not only the quantity of different cell types but also the physical properties of some of the cells. 

Significant differences in one or more blood cell populations may suggest the presence of one or more diseases. Other tests are frequently performed to assist in determining the reason for aberrant results. This frequently necessitates visual confirmation via a microscope examination of a blood smear. A skilled laboratory technician can assess the appearance and physical features of blood cells, such as size, shape, and color, and note any anomalies. Any extra information is taken note of and communicated to the healthcare provider. This information provides the health care provider with further information about the cause of abnormal CBC results. 

The CBC focuses on three different types of cells: 

WBCs (White Blood Cells) 

The body uses five different types of WBCs, also known as leukocytes, to keep itself healthy and battle infections and other types of harm. The five different leukocytes are eosinophiles, lymphocytes, neutrophiles, basophils, and monocytes. They are found in relatively steady numbers in the blood. Depending on what is going on in the body, these values may momentarily rise or fall. An infection, for example, can cause the body to manufacture more neutrophils in order to combat bacterial infection. The amount of eosinophils in the body may increase as a result of allergies. A viral infection may cause an increase in lymphocyte production. Abnormal (immature or mature) white cells multiply fast in certain illness situations, such as leukemia, raising the WBC count. 

RBCs (Red Blood Cells) 

The bone marrow produces red blood cells, also known as erythrocytes, which are transferred into the bloodstream after maturing. Hemoglobin, a protein that distributes oxygen throughout the body, is found in these cells. Because RBCs have a 120-day lifespan, the bone marrow must constantly manufacture new RBCs to replace those that have aged and disintegrated or have been lost due to hemorrhage. A variety of diseases, including those that cause severe bleeding, can alter the creation of new RBCs and their longevity. 

The CBC measures the number of RBCs and hemoglobin in the blood, as well as the proportion of RBCs in the blood (hematocrit), and if the RBC population appears to be normal. RBCs are generally homogeneous in size and shape, with only minor differences; however, considerable variances can arise in illnesses including vitamin B12 and folate inadequacy, iron deficiency, and a range of other ailments. Anemia occurs when the concentration of red blood cells and/or the amount of hemoglobin in the blood falls below normal, resulting in symptoms such as weariness and weakness. In a far smaller percentage of cases, there may be an excess of RBCs in the blood (erythrocytosis or polycythemia). This might obstruct the flow of blood through the tiny veins and arteries in extreme circumstances. 

Platelets 

Platelets, also known as thrombocytes, are small cell fragments that aid in the regular clotting of blood. A person with insufficient platelets is more likely to experience excessive bleeding and bruises. Excess platelets can induce excessive clotting or excessive bleeding if the platelets are not operating properly. The platelet count and size are determined by the CBC. 

Lab tests often ordered with a Complete Blood Count test: 

  • Reticulocytes
  • Iron and Total Iron Binding Capacity
  • Basic Metabolic Panel
  • Comprehensive Metabolic Panel
  • Lipid Panel
  • Vitamin B12 and Folate
  • Prothrombin with INR and Partial Thromboplastin Times
  • Sed Rate (ESR)
  • C-Reactive Protein
  • Epstein-Barr Virus
  • Von Willebrand Factor Antigen

Conditions where a Complete Blood Count test is recommended: 

  • Anemia
  • Aplastic Anemia
  • Iron Deficiency Anemia
  • Vitamin B12 and Folate Deficiency
  • Sickle Cell Anemia
  • Heart Disease
  • Thalassemia
  • Leukemia
  • Autoimmune Disorders
  • Cancer
  • Bleeding Disorders
  • Inflammation
  • Epstein-Barr Virus
  • Mononucleosis

Commonly Asked Questions: 

How does my health care provider use a Complete Blood Count test? 

The complete blood count (CBC) is a common, comprehensive screening test used to measure a person's overall health status.  

What do my Complete Blood Count results mean? 

A low Red Blood Cell Count, also known as anemia, could be due many different causes such as chronic bleeding, a bone marrow disorder, and nutritional deficiency just to name a few. A high Red Blood Cell Count, also known as polycythemia, could be due to several conditions including lung disease, dehydration, and smoking. Both Hemoglobin and Hematocrit tend to reflect Red Blood Cell Count results, so if your Red Blood Cell Count is low, your Hematocrit and Hemoglobin will likely also be low. Results should be discussed with your health care provider who can provide interpretation of your results and determine the appropriate next steps or lab tests to further investigate your health. 

What do my Differential results mean? 

A low White Blood Cell count or low WBC count, also known as leukopenia, could be due to a number of different disorders including autoimmune issues, severe infection, and lymphoma. A high White Blood Cell count, or high WBC count, also known as leukocytosis, can also be due to many different disorders including infection, leukemia, and inflammation. Abnormal levels in your White Blood Cell Count will be reflected in one or more of your different white blood cells. Knowing which white blood cell types are affected will help your healthcare provider narrow down the issue. Results should be discussed with your health care provider who can provide interpretation of your results and determine the appropriate next steps or lab tests to further investigate your health. 

What do my Platelet results mean? 

A low Platelet Count, also known as thrombocytopenia, could be due to a number of different disorders including autoimmune issues, viral infection, and leukemia. A high Platelet Count, also known as Thrombocytosis, can also be due to many different disorders including cancer, iron deficiency, and rheumatoid arthritis. Results should be discussed with your health care provider who can provide interpretation of your results and determine the appropriate next steps or lab tests to further investigate your health. 

NOTE: Only measurable biomarkers will be reported. Certain biomarkers do not appear in healthy individuals. 

We advise having your results reviewed by a licensed medical healthcare professional for proper interpretation of your results.

Reflex Parameters for Manual Slide Review
  Less than  Greater Than 
WBC  1.5 x 10^3  30.0 x 10^3 
Hemoglobin  7.0 g/dL  19.0 g/dL 
Hematocrit  None  75%
Platelet  100 x 10^3  800 x 10^3 
MCV  70 fL  115 fL 
MCH  22 pg  37 pg 
MCHC  29 g/dL  36.5 g/dL 
RBC  None  8.00 x 10^6 
RDW  None  21.5
Relative Neutrophil %  1% or ABNC <500  None 
Relative Lymphocyte %  1% 70%
Relative Monocyte %  None  25%
Eosinophil  None  35%
Basophil  None  3.50%
     
Platelet  <75 with no flags,
>100 and <130 with platelet clump flag present,
>1000 
Instrument Flags Variant lymphs, blasts,
immature neutrophils,  nRBC’s, abnormal platelets,
giant platelets, potential interference
     
The automated differential averages 6000+ cells. If none of the above parameters are met, the results are released without manual review.
CBC Reflex Pathway

Step 1 - The slide review is performed by qualified Laboratory staff and includes:

  • Confirmation of differential percentages
  • WBC and platelet estimates, when needed
  • Full review of RBC morphology
  • Comments for toxic changes, RBC inclusions, abnormal lymphs, and other
  • significant findings
  • If the differential percentages agree with the automated counts and no abnormal cells are seen, the automated differential is reported with appropriate comments

Step 2 - The slide review is performed by qualified Laboratory staff and includes: If any of the following are seen on the slide review, Laboratory staff will perform a manual differential:

  • Immature, abnormal, or toxic cells
  • nRBC’s
  • Disagreement with automated differential
  • Atypical/abnormal RBC morphology
  • Any RBC inclusions

Step 3 If any of the following are seen on the manual differential, a Pathologist will review the slide:

  • WBC<1,500 with abnormal cells noted
  • Blasts/immature cells, hairy cell lymphs, or megakaryocytes
  • New abnormal lymphocytes or monocytes
  • Variant or atypical lymphs >15%
  • Blood parasites
  • RBC morphology with 3+ spherocytes, RBC inclusions, suspect Hgb-C,
  • crystals, Pappenheimer bodies or bizarre morphology
  • nRBC’s

Description: A Urinalysis complete test is a urine test that is used to screen for, diagnose, and monitor a variety of conditions and diseases urinary tract infections and kidney disorders.

Also Known As: Urine Test, Urine Analysis Test, UA Test, urine microscopic examination Test, Urinalysis Test, Complete Urinalysis Test

Collection Method: Urine Collection

Specimen Type: Urine

Test Preparation: No preparation required

When is a Urinalysis Complete test ordered?

A urinalysis test may be ordered when a person undergoes a routine wellness examination, is admitted into a hospital, will have surgery, or is having a prenatal checkup.

When a person visits a doctor with symptoms of a urinary tract infection or another urinary system ailment, such as kidney disease, a urinalysis will almost certainly be prescribed. The following are some possible signs and symptoms:

  • Pain in the abdomen
  • Backache
  • Urination that is painful or occurs frequently
  • Urine with blood in it

Testing may also be conducted at regular intervals to track the progress of a condition.

What does a Urinalysis Complete test check for?

A urinalysis is a series of examinations done on urine that are physical, chemical, and microscopic. The tests identify and/or measure a number of elements in the urine, including cells, cellular fragments, and microbes. These elements include byproducts of healthy and unhealthy metabolism.

Urine is produced by the kidneys, two fist-sized organs located on either side of the spine near the base of the rib cage. The kidneys help the body regulate its water balance, filter wastes from the blood, and store proteins, electrolytes, and other molecules for later use. To get rid of everything unnecessary, urine travels from the kidneys to the ureters, bladder, and urethra before exiting the body. The color, amount, concentration, and content of urine will change slightly every time a person urinates due to the varied elements in urine, despite the fact that pee is normally yellow and clear.

By screening for components in the urine that aren't typically present and/or monitoring aberrant levels of specific substances, many illnesses can be caught early on. Glucose, bilirubin, protein, red and white blood cells, crystals, and germs are among examples. They could be present because of the following reasons:

  • The body responds to an elevated amount of the substance in the blood by attempting to remove the excess through urine.
  • There is a problem with the kidneys.
  • As with bacteria and white blood cells, there is a urinary tract infection present.

Three separate phases make up a full urinalysis:

  • The color and clarity of the urine are assessed using a visual examination.
  • Chemical examination, which determines the concentration of urine and tests for roughly 9 chemicals that provide useful information about health and disease.
  • Microscopic inspection that identifies and counts the different types of cells, casts, crystals, and other components found in urine, such as bacteria and mucus.

When abnormal results are found, or if a healthcare provider requests it, a microscopic analysis is usually performed.

It may be essential to repeat the test if the findings of a urinalysis are abnormal, and further other urine and blood tests may be needed to help establish a diagnosis, if the results are abnormal.

Lab tests often ordered with a Urinalysis Complete test:

  • Complete Blood Count
  • Iron Total and Total Iron binding capacity
  • Hemoglobin A1c
  • Lipid Panel
  • CMP
  • TSH
  • Urine Culture
  • Bilirubin Fractionated
  • Glucose

Conditions where a Urinalysis Complete test is recommended:

  • Diabetes
  • Kidney Disease
  • Liver Disease
  • Hypertension
  • Pregnancy
  • Hematuria
  • Proteinuria
  • Kidney Stones

How does my health care provider use a Urinalysis Complete test?

A urinalysis is a series of tests that can diagnose a variety of disorders. It can be used to screen for and/or diagnose a variety of illnesses, including urinary tract infections, renal abnormalities, liver diseases, diabetes, and other metabolic disorders, to name a few.

Urinalysis may be used in conjunction with other tests, such as urine albumin, to monitor the progress of treatment in patients with diseases or conditions like diabetes or kidney disease.

What do my urinalysis complete test results mean?

There are numerous ways to interpret the results of a urinalysis. Unusual results are a warning sign that something isn't right and needs further testing.  To connect the urinalysis results with an individual's symptoms and clinical findings and to look for the causes of aberrant findings, other targeted tests must be done, such as a complete blood count, metabolic panel, or urine culture.

It is more likely that a problem must be addressed the higher the concentration of the atypical component, such as noticeably increased levels of protein, glucose, or red blood cells. On the other hand, the outcomes do not inform the medical professional as to what led to the finding or whether it is a transient or ongoing sickness.

A normal urinalysis does not rule out the possibility of disease. Early in a disease process, some persons will not release elevated amounts of a drug, and others will release them irregularly throughout the day, which means they could be overlooked by a single urine sample. Small amounts of substances may be undetectable in very dilute urine.

NOTE: Only measurable biomarkers will be reported.

We advise having your results reviewed by a licensed medical healthcare professional for proper interpretation of your results.


Description: A Basic Metabolic Panel is a blood test used to screen for, diagnose, and monitor a variety of conditions and diseases such as diabetes and kidney disease.  

Also Known As: BMP, Chemistry Panel, Chemistry Screen, Chem 7, Chem 11, BMP Test, SMA 7, SMAC7, Basic Metabolic Test, Chem Test, Chem Panel Test 

Collection Method: Blood Draw 

Specimen Type: Serum 

Test Preparation: 9-12 hours fasting is preferred. 

When is a Basic Metabolic Panel test ordered?  

A BMP may be requested as part of a standard physical examination. 

The panel is frequently ordered in hospital emergency rooms because its components provide vital information regarding a person's renal state, electrolyte and acid/base balance, blood glucose, and calcium levels. Significant changes in these test results can suggest serious issues such as renal failure, insulin shock or diabetic coma, respiratory distress, or abnormalities in heart rhythm. 

What does a Basic Metabolic Panel blood test check for? 

The basic metabolic panel (BMP) is a 9-test panel that provides essential information to a health practitioner about a person's current metabolic status, including kidney health, blood glucose level, electrolyte and acid/base balance. Abnormal results, particularly when they are combined, can suggest a problem that needs to be addressed. 

The following tests are included in the BMP test: 

  • Bun/Creatinine Ratio: this is a ratio between your Urea Nitrogen (BUN) result and Creatinine result.  

  • Calcium: this is a measurement of calcium in your blood. Calcium is the most abundant and one of the most important minerals in the body as it essential for proper nerve, muscle, and heart function. Calcium is also used for blood clot formation and the formation and maintenance of bones and teeth. 

  • Carbon Dioxide: this is a measure of carbon dioxide in your blood. Carbon dioxide is a negatively charged electrolyte that works with other electrolytes such as chloride, potassium, and sodium to regulate the body’s acid-base balance and fluid levels.  

  • Chloride: this is a measure of Chloride in your blood. Chloride is a negatively charged electrolyte that works with other electrolytes such as potassium and sodium to regulate the body’s acid-base balance and fluid levels. 

  • Creatinine: this is a measure of Creatinine levels in your blood. Creatinine is created from the breakdown of creatine in your muscles and is removed from your body by the kidneys. Elevated creatinine levels are often associated with kidney damage. 

  • Egfr African American: this is a measure of how well your kidneys are functioning. Glomeruli are tiny filters in your kidneys that filter out waste products from your blood for removal while retaining important substances such as nutrients and blood cells. 

  • Egfr Non-Afr. American: this is a measure of how well your kidneys are functioning. Glomeruli are tiny filters in your kidneys that filter out waste products from your blood for removal while retaining important substances such as nutrients and blood cells. 

  • Glucose: this is a measure of glucose in your blood. Glucose is created from the breakdown of carbohydrates during digestion and is the body’s primary source of energy. 

  • Potassium: this is a measure of Potassium in your blood. Potassium is an electrolyte that plays a vital role in cell metabolism, nerve and muscle function, and transport of nutrients into cells and removal of wastes products out of cells. 

  • Sodium: this is a measure of Sodium in your blood. Sodium is an electrolyte that plays a vital role in nerve and muscle function. 

  • Urea Nitrogen (Bun): this is a measure of Urea Nitrogen in your blood, also known as Blood Urea Nitrogen (BUN). Urea is a waste product created in the liver when proteins are broken down into amino acids. Elevated levels are often associated with kidney damage. 

Lab tests often ordered with a Basic Metabolic Panel test: 

  • Complete Blood Count with Differential and Platelets
  • Hemoglobin A1c
  • Iron and Total Iron Binding Capacity
  • Lipid Panel
  • Insulin
  • Vitamin B12 and Folate
  • C-Reactive Protein

Conditions where a Basic Metabolic Panel test is recommended: 

  • Diabetes 
  • Kidney Disease 
  • Liver Disease 

Commonly Asked Questions: 

How does my health care provider use a Basic Metabolic Panel test? 

The basic metabolic panel (BMP) is used to evaluate a person's kidney function, electrolyte, acid/base balance, and blood glucose level, all of which are linked to their metabolism. It can also be used to keep track of hospitalized patients and persons with known illnesses like hypertension and hypokalemia. 

If a health practitioner wants to track two or more separate BMP components, the full BMP might be ordered because it contains more information. Alternatively, when monitoring, the healthcare provider may order specific tests, such as a follow-up glucose, potassium, or calcium test, or an electrolyte panel to track sodium, potassium, chloride, and CO2. If a doctor needs further information, he or she can request a comprehensive metabolic panel (CMP), which is a collection of 21 tests that includes the BMP. 

What do my Basic Metabolic Panel results mean? 

The results of the tests included in the BMP are usually analyzed together to look for patterns. A single abnormal test result may indicate something different than a series of abnormal test findings. 

Out-of-range results on any of the BMP's tests can be caused by a number of things, including kidney failure, breathing issues, and diabetes-related consequences. If any of the results are abnormal, one or more follow-up tests are usually ordered to help determine the reason and/or establish a diagnosis. 

Is there anything else I should know? 

The results of the BMP components can be influenced by a range of prescription and over-the-counter medicines. Any medications you're taking should be disclosed to your healthcare professional. Similarly, it is critical to provide them with a thorough medical history because many other circumstances can influence how your results are interpreted. 

We advise having your results reviewed by a licensed medical healthcare professional for proper interpretation of your results.

Please note the following regarding BUN/Creatinine ratio: 

The lab does not report the calculation for the BUN/Creatinine Ratio unless one or both biomarkers’ results fall out of the published range. 

If you still wish to see the value, it's easy to calculate. Simply take your Urea Nitrogen (BUN) result and divide it by your Creatinine result.  

As an example, if your Urea Nitrogen result is 11 and your Creatinine result is 0.86, then you would divide 11 by 0.86 and get a BUN/Creatinine Ratio result of 12.79. 


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Description: A Uric Acid test is a blood test that measures Uric Acid levels in your blood’s serum to screen for goat and monitor those undergoing chemotherapy or the development of kidney stones.

Also Known As: Serum Urate Test, UA Test

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: No preparation required

When is a Uric Acid test ordered?

When a healthcare provider suspects a patient has a high uric acid level, a uric acid blood test is ordered. Gout is a prevalent form of arthritis that affects some people who have excessive uric acid levels. Gout causes discomfort in the joints, most commonly in the toes but also in other joints. When cancer patients are undergoing chemotherapy or radiation therapy, the test is also ordered to verify that their uric acid levels do not rise dangerously high.

When a person has recurring kidney stones or gout and has to be monitored for the production of these stones, a urine uric acid test may be ordered.

What does a Uric Acid blood test check for?

Purines are broken down to form uric acid. Purines are nitrogen-containing molecules that can be found in all of the body's cells, including DNA. This test determines how much uric acid is present in the blood or urine.

Cells break down as they age and die, releasing purines into the bloodstream. Purines can also be obtained through the digestion of specific foods, such as liver, anchovies, mackerel, dried beans and peas, and alcoholic beverages, particularly beer. The kidneys remove the majority of uric acid from the body, which is then excreted in the urine, with the remaining excreted in the stool.

When too much uric acid is created or not enough is eliminated from the body, it can build up in the body, causing blood levels to rise. Excess uric acid can induce gout, which is characterized by joint inflammation caused by the production of uric acid crystals in the joint fluid. Excess uric acid can also build up in tissues like the kidney, resulting in kidney stones or failure.

Too much uric acid in the body can occur as a result of creating too much, not removing enough, or a combination of both. Uric acid levels can rise as a result of an increase in cell death, as seen with some cancer treatments, or as a result of a rare hereditary tendency to make too much uric acid. Reduced uric acid removal is frequently caused by reduced renal function as a result of kidney disease.

Lab tests often ordered with a Uric Acid test:

  • Complete Blood Count
  • Iron Total and Total Iron binding capacity
  • Comprehensive Metabolic Panel
  • Lipid Panel
  • Urinalysis Complete

Conditions where a Uric Acid test is recommended:

  • Arthritis
  • Gout
  • Kidney Disease

How does my health care provider use a Uric Acid test?

The uric acid blood test is used to diagnose gout by detecting elevated levels of this molecule in the blood. The test is also used to monitor uric acid levels in persons who are receiving cancer treatment such as chemotherapy or radiation. Rapid cell turnover can lead to a rise in uric acid levels as a result of such treatment.

The uric acid urine test is used to detect the source of recurring kidney stones and to monitor the production of stones in persons with gout.

What does my Uric Acid result mean?

Hyperuricemia is defined as blood uric acid levels that are higher than usual. It can be caused by the body creating too much uric acid or the kidneys failing to eliminate enough uric acid from the body. To determine the reason of uric acid overproduction or reduced elimination, more research is needed.

Purine break-down is affected by a number of genetic inborn defects. Increased uric acid production can be caused by cancer that has spread from its original place, leukemias, multiple myeloma, and cancer chemotherapy. Reduced uric acid elimination can be caused by chronic renal illness, acidosis, pregnancy toxemia, and alcoholism.

Increased uric acid levels can cause crystals to develop in the joints, resulting in the joint inflammation and pain associated with gout. Uric acid can form crystals or kidney stones, which can cause kidney injury.

Low uric acid levels in the blood are significantly less common than high ones, and they are rarely a cause for concern. Although low uric acid levels have been linked to liver and renal disease, Fanconi syndrome, toxic exposure, and in rare cases, a hereditary metabolic deficiency, these problems are usually detected by other tests and symptoms rather than a single low uric acid result.

We advise having your results reviewed by a licensed medical healthcare professional for proper interpretation of your results.


Description: A Urinalysis complete test is a urine test that is used to screen for, diagnose, and monitor a variety of conditions and diseases urinary tract infections (UTIs) and kidney disorders.

A Urine Culture test is a test that is used to identify bacteria or foreign organisms in urine and test for antibiotic susceptibilities.

Also Known As: Urine Test, Urine Analysis Test, UA Test, urine microscopic examination, Urine Culture Test, Urine Culture and Sensitivity test, Urine C and S test, UTI test, Culture Urine test

Collection Method: Urine Collection

Specimen Type: Urine

Test Preparation: No preparation required

IMPORTANT - If initial testing results in a Reflex to Culture, the lab will add and charge for Culture, Urine, Routine #395 for $29.

If you need just a Urinalysis, Complete test, order Urinalysis (UA), Complete #5463

Culture, Urine, Routine #395 can Reflex to additional testing and charges, detailed below, if Culture is positive.

If culture is positive, CPT code(s): 87088 (each isolate) will be added with an additional charge.  Identification will be performed at an additional charge (CPT code(s): 87077 or 87140 or 87143 or 87147 or 87149).

Antibiotic susceptibilities are only performed when appropriate (CPT code(s): 87181 or 87184 or 87185 or 87186).

  • ORG ID 1. $ 12.45 
  • ORG ID 2. $ 23.95 
  • PRESUMPTIVE ID 1. $ 12.45 
  • PRESUMPTIVE ID 2. $ 23.95 
  • SUSC-1  $14.95 
  • SUSC-2  $28.95

When is a Urinalysis with Reflex to Culture test ordered?

A urinalysis test may be ordered when a person undergoes a routine wellness examination, is admitted into a hospital, will have surgery, or is having a prenatal checkup.

When a person visits a doctor with symptoms of a urinary tract infection or another urinary system ailment, such as kidney disease, a urinalysis will almost certainly be prescribed. The following are some possible signs and symptoms:

  • Pain in the abdomen
  • Backache
  • Urination that is painful or occurs frequently
  • Urine with blood in it

Testing may also be conducted at regular intervals to track the progress of a condition.

A urine culture may be administered in conjunction with a urinalysis or as a follow-up to abnormal urinalysis results.

Urinary tract infections can cause pressure in the lower abdomen as well as small quantities of blood in the urine. If the UTI is severe and/or has gone to the kidneys, it can cause symptoms such as flank pain, high fever, trembling, chills, nausea, and vomiting.

For young women with signs or symptoms of a UTI and an uncomplicated lower urinary tract infection, antibiotics may be administered without obtaining a urine culture. A urine culture is advised if there is a suspicion of a complex infection or if symptoms do not respond to first treatment.

Pregnant women without symptoms should be examined for bacteria in their urine during their first trimester or first prenatal appointment, as bacteria in the urine can harm the growing baby's health.

What does a Urinalysis with Reflex to Urine Culture test check for?

A urinalysis is a series of examinations done on urine that are physical, chemical, and microscopic. The tests identify and/or measure a number of elements in the urine, including cells, cellular fragments, and microbes. These elements include byproducts of healthy and unhealthy metabolism.

Urine is produced by the kidneys, two fist-sized organs located on either side of the spine near the base of the rib cage. The kidneys help the body regulate its water balance, filter wastes from the blood, and store proteins, electrolytes, and other molecules for later use. To get rid of everything unnecessary, urine travels from the kidneys to the ureters, bladder, and urethra before exiting the body. The color, amount, concentration, and content of urine will change slightly every time a person urinates due to the varied elements in urine, despite the fact that pee is normally yellow and clear.

By screening for components in the urine that aren't typically present and/or monitoring aberrant levels of specific substances, many illnesses can be caught early on. Glucose, bilirubin, protein, red and white blood cells, crystals, and germs are among examples. They could be present because of the following reasons:

  • The body responds to an elevated amount of the substance in the blood by attempting to remove the excess through urine.
  • There is a problem with the kidneys.
  • As with bacteria and white blood cells, there is a urinary tract infection present.

Three separate phases make up a full urinalysis:

  • The color and clarity of the urine are assessed using a visual examination.
  • Chemical examination, which determines the concentration of urine and tests for roughly 9 chemicals that provide useful information about health and disease.
  • Microscopic inspection that identifies and counts the different types of cells, casts, crystals, and other components found in urine, such as bacteria and mucus.

When abnormal results are found, or if a healthcare provider requests it, a microscopic analysis is usually performed.

It may be essential to repeat the test if the findings of a urinalysis are abnormal, and further other urine and blood tests may be needed to help establish a diagnosis, if the results are abnormal.

Urine culture is a test that detects and identifies bacteria and yeast in the urine that could be the source of a urinary tract infection.

A small amount of urine is placed on one or more agar plates and incubated at body temperature for a urine culture. Any bacteria or yeast present in the urine sample will grow into little circular colonies during the next 24 to 48 hours. The number of colonies and the size, shape, and color of these colonies assist identify which bacteria are present in the urine sample, and the number of colonies shows the amount of bacteria that were initially present in the urine sample. A laboratory technician counts the total number of colonies on the agar plate and determines how many types have grown. If a good, clean catch sample was taken for the test, the only bacteria found should be from an infection. Typically, there will be only one variety of bacterium present in relatively significant quantities. More than one type of bacteria may be present at any given time. This could be the result of a multi-pathogen infection, although it's more likely owing to contamination from the skin picked up during the urine collection.

A gram stain will be performed on a colony from each type by the laboratory technician. The bacteria are examined under a microscope by the laboratory technician. Different species of bacteria will have distinct colors and forms. Under a microscope, the bacterium Escherichia coli, which is responsible for the majority of urinary tract infections, will appear as gram-negative rods. Lactobacillus, a frequent vaginal contaminant found in women's urine, will show up as gram-positive rods. Some bacteria, such as Lactobacillus, are easy to detect by a skilled lab technician, are nonpathogenic, and do not require additional research. Others, such as gram-negative rods, represent clusters of identical bacteria that will necessitate extra testing to determine which bacteria are present.

After 24 to 48 hours of incubation, if there is no or little growth on the agar, the urine culture is declared negative for pathogens and the culture is complete. If one or more pathogens are found, more testing is done. Testing is performed to determine which bacteria are present, as well as susceptibility testing to determine which antibiotics are most likely to cure the infection.

Lab tests often ordered with a Urinalysis with Reflex to Culture test:

  • Complete Blood Count (CBC)
  • Iron and Total Iron Capacity
  • Hemoglobin A1c
  • Lipid Panel
  • Comprehensive Metabolic Panel (CMP)
  • TSH
  • Bilirubin Fractionated
  • Glucose
  • C-Reactive Protein
  • ANA
  • Rheumatoid Factor

Conditions where a Urinalysis with Reflex to Culture test is recommended:

  • Diabetes
  • Kidney Disease
  • Liver Disease
  • Hypertension
  • Pregnancy
  • Hematuria
  • Urinary Tract Infection

How does my health care provider use a Urinalysis with Reflex to Culture test?

A urinalysis is a series of tests that can diagnose a variety of disorders. It can be used to screen for and/or diagnose a variety of illnesses, including urinary tract infections, renal abnormalities, liver diseases, diabetes, and other metabolic disorders, to name a few.

Urinalysis may be used in conjunction with other tests, such as urine albumin, to monitor the progress of treatment in patients with diseases or conditions like diabetes or kidney disease.

The urine culture is often used to diagnose a urinary tract infection and to identify the bacteria or yeast that is causing it. It can be used in conjunction with susceptibility testing to discover which drugs will stop the infection-causing bacterium from growing. The findings will aid a doctor in determining which treatments are most likely to be beneficial in treating a patient's infection.

The kidneys, a pair of bean-shaped organs positioned near the bottom of the ribcage on the right and left sides of the back, produce urine. To transport wastes out of the body, the kidneys filter waste from the blood and generate urine, a yellow fluid. Urine goes from the kidneys to the bladder, where it is briefly stored, and then via the urethra to be emptied. Urine is normally sterile, but bacteria or, more rarely, yeast can migrate up the urinary tract from the skin outside the urethra and produce a urinary tract infection.

The majority of UTIs are considered simple and treatable. The infection may spread up through the ureters and into the kidneys if they are not treated. A kidney infection is more hazardous and can result in renal damage that is irreversible. In some situations, a urinary tract infection can escalate to a life-threatening infection in the bloodstream.

People with renal disease or other illnesses that impact the kidneys, such as diabetes or kidney stones, as well as people with compromised immune systems, may be more susceptible to UTIs.

What do my Urinalysis test results mean?

There are numerous ways to interpret the results of a urinalysis. Unusual results are a warning sign that something isn't right and needs further testing.  To connect the urinalysis results with an individual's symptoms and clinical findings and to look for the causes of aberrant findings, other targeted tests must be done, such as a complete blood count, metabolic panel, or urine culture.

It is more likely that a problem must be addressed the higher the concentration of the atypical component, such as noticeably increased levels of protein, glucose, or red blood cells. On the other hand, the outcomes do not inform the medical professional as to what led to the finding or whether it is a transient or ongoing sickness.

A normal urinalysis does not rule out the possibility of disease. Early in a disease process, some persons will not release elevated amounts of a drug, and others will release them irregularly throughout the day, which means they could be overlooked by a single urine sample. Small amounts of substances may be undetectable in very dilute urine.

What do my Urine Culture test results mean?

Urine culture results are frequently interpreted in conjunction with urinalysis results, as well as how the sample was taken and whether symptoms are present. Because certain urine samples may contain bacteria that are ordinarily found on the skin, some culture results must be interpreted with caution.

A positive urine culture is usually defined as the presence of a single kind of bacteria growing at high colony counts. Cultures containing more than 100,000 CFU/mL of one species of bacteria in clean catch samples that have been correctly collected usually indicate infection. Even if an infection is present, there may not be a large number of germs present in some circumstances. Lower levels can sometimes suggest infection, particularly if symptoms are present. Similarly, values of 1,000 to 100,000 CFU/mL may be deemed significant for samples acquired using a technique that reduces contamination, such as a sample collected with a catheter.

Although UTIs can be caused by a variety of bacteria, the majority are caused by Escherichia coli, a kind of bacteria that is widespread in the digestive tract and frequently detected in stool. Proteus, Klebsiella, Enterococcus, and Staphylococcus are among the bacteria that can cause UTIs. A yeast infection, such as Candida albicans, can cause a UTI, but urethritis is more commonly caused by a sexually transmitted illness, such as herpes, chlamydia, or gonorrhea.

When a culture says "no growth in 24 or 48 hours," it usually means there isn't an infection. If the symptoms persist, a urine culture on a new sample may be performed to test for bacteria with reduced colony numbers or other microorganisms that could be causing the symptoms. Acute urethral syndrome is defined as the presence of white blood cells and low quantities of bacteria in a sick person's urine.

If multiple different species of bacteria thrive in a culture, the growth is almost certainly due to contamination. This is notably true in urine samples containing Lactobacillus and/or other prevalent nonpathogenic vaginal bacteria in women. If the symptoms persist, the healthcare provider may order a second culture on a more thoroughly collected sample. However, if one species of bacteria has considerably larger colony counts than the others, such as 100,000 CFUs/mL versus 1,000 CFUs/mL, further testing to determine the dominating bacterium may be required.

Susceptibility testing may be used to guide treatment if a culture is positive. Any bacterial infection can be dangerous and, if left untreated, can spread to other parts of the body. Pain is frequently the first sign of infection. Treatment as soon as possible, generally with antibiotics, will help to relieve the pain.

We advise having your results reviewed by a licensed medical healthcare professional for proper interpretation of your results.

NOTE: Only measurable biomarkers will be reported.


Myasthenia Gravis (MG) is a neuromuscular disorder characterized by muscle weakness, most commonly due to autoantibody-mediated loss of functional acetylcholine receptors (AChR) in the neuromuscular junction. This assay aids in the differential diagnosis of MG-like muscle weakness, in differentiating between generalized MG and ocular MG, and in monitoring therapeutic response. If binding antibodies are negative, assays for blocking and modulating antibodies should be considered.


Improperly functioning kidneys can lead to what is known as kidney disease. Kidney Disease does not fall into one particular description. Instead, there are a variety of conditions that can cause kidney disease and even the loss of kidney function.

Various symptoms and signs of kidney disease depend on how the kidneys are affected. They fall into three main categories:

  • Pre-renal

Pre-renal describes decreased blood flow to the kidney. This reduced flow stops the kidneys from operating correctly. Over time, the reduced flow can damage the kidneys.

When blood flow to the kidneys decreases, it can happen quickly. Shock, severe dehydration, and sepsis are examples of conditions that can cause reduced blood flow. Heart failure and liver failure, for example, can also, over time, contribute to reduced blood flow.

  • Renal

Some conditions can affect the actual kidney. These conditions are called “renal.” When this happens, the kidney is damaged or impaired in function.

Examples of health conditions that contribute to a “renal” condition are:

  • Diabetes
  • Hypertension, otherwise known as high blood pressure
  • Autoimmune diseases such as Goodpasture syndrome, lupus or other abnormal immune responses
  • Infection such as an untreated urinary tract infection or UTI that has spread to the kidneys
  • Injury or trauma
  • Toxins such as ethylene glycol or heavy metals
  • Medications such as non-steroidal anti-inflammatory drugs or NSAIDs, analgesics or pain killers, and particular antibiotics
  • Certain contrast dyes that are used for imaging procedures
  • Damage to muscles otherwise known as rhabdomyolysis
  • Congenital renal disease (those that appear at birth) which includes kidneys that do not develop or form normally
  • Polycystic kidney disease which are disorders that are identified as multiple fluid-filled sacks or spaces within the kidneys

Post-renal

Post-renal kidney disease occurs when the drainage of the kidney is blocked. It can increase the pressure in the kidneys and prevent the organs from functioning. When there is an ongoing obstruction within the organs and, similar to decreased blood flow, the kidneys can be damaged. When there is obstruction of drainage from the kidneys, it can be due to health conditions such as:

  • Tumors
  • Kidney stones
  • An enlarged prostate, such as BPH (benign prostatic hyperplasia)

All functions of the kidney can be affected by some of these causes. Depending on the duration, they occur in one of three primary ways:

  • Acute Kidney Injury or AKI (an older name for AKI is acute renal failure or ARF) is defined as the rapid loss of kidney function. If suddenly, a person produces urine significantly less frequently and/or has a massive increase in the amount of waste products in the blood that are typically filtered out by the kidneys, the condition may be recognized.  AKI is often caused by trauma, medication that damages the kidneys, or illness. Many people who are hospitalized, such as those in intensive care and who are critically ill, commonly exhibit AKI. If AKI-related damage continues, it can become chronic kidney disease.
  • Chronic Kidney Disease, or CKD, occurs when a significant amount of kidney function is lost over time. The National Kidney Foundation reports that 30 million adults are suffering from CKD and that there are millions more that are at an increased risk. CKD is preventable. If it is found early, it can be treated to stop or delay the progression that leads to end-stage renal disease.
  • End-stage Renal Disease, or ESRD, is described as when kidney function is at a near or total loss. It is permanent. The only options to treat ESRD are dialysis or a kidney transplant.

Glomerular Damage

There are some contributors to kidney damage that initially affect only one part of the kidney, especially the glomerulus. The glomerulus filters blood to let water and small molecules move into the urine while retaining cells and large molecules, such as proteins. The appearance of glomerular damage manifests itself in three main ways:

  • Proteinuria is an increased amount of protein found in the urine. When there is mild damage, the glomeruli lose the ability to keep protein that can be detected in the urine. However, if the body can make up for the protein loss, there will be few to no symptoms.
  • Nephrotic syndrome is when the glomeruli are more severely damaged.  The type of damage can vary. Specifically, large amounts of protein (mainly albumin, a protein that helps to maintain the proper amount of water in the blood) get lost in one’s urine, making the body unable to compensate fully. People with nephrotic syndrome often have edema, which is an accumulation of fluid that causes swelling.
  • Glomerulonephritis, known as nephritic syndrome, may also indicate severe damage to the glomeruli.  The specific result is severe inflammation and damage to the functioning of the kidneys. This causes high blood pressure, accumulation of fluid, a decrease in urine production, and small amounts of protein and blood or red blood cells leaking into the urine.

Tumors of the Kidney

When there are tumors in the kidney, there is often no effect on the function of the organs. However, when they are detected, these tumors present as a mass in the kidney detectable through imaging and/or they can be felt by the patient, family, or medical practitioner. There may also be blood and protein in the urine.

Three significant tumors can appear in the kidney:

  • Renal cell carcinoma is cancer that can develop in adult kidneys.
  • Wilms tumor is a cancer that develops in the kidneys of children mostly those that are between the ages of 2 and 5.
  • Transitional cell carcinoma is cancer that often occurs in the bladder and can also develop in the lining of the ureters (which are the tubes that exist between the bladder and the kidney). In addition, sometimes it can appear in the kidney itself.

Risk Factors

  • Diabetes is when there is a continued high level of blood glucose as a result of uncontrolled diabetes that can gradually damage the nephrons located in the kidneys. Therefore, people with diabetes need to maintain good glucose control.
  • High Blood Pressure is known as hypertension and can damage the blood vessels inside the kidneys. Therefore, it’s essential to keep your blood pressure under control to help reduce the risk of kidney disease as well as other health problems.
  • Age: People over 60 are more likely to develop kidney disease. However, the condition can occur at any age.
  • Family History: If there is a history of kidney disease in the family, a person is at risk for developing it. For example, polycystic kidney disease or PKD is an inherited medical disorder.
  • Heart Disease: If you have been diagnosed with heart disease, you are at higher risk for developing kidney disease.
  • Certain Races: It is more common for Native Americans, African Americans, Hispanic Americans, Asians, and Pacific Islanders to get chronic kidney disease.

Signs and Symptoms

The condition of chronic kidney disease or CKD can creep up silently over the years. There may be no signs or symptoms, or the signs and symptoms can be so general that a person doesn’t know it’s related to kidney function. Regular health examinations with routine lab tests can help to detect the early warning signs of kidney disease.

Early warning signs of kidney disease include:

  • Blood in the urine (hematuria)
  • Protein in the urine (proteinuria)
  • Decreased estimated glomerular filtration rate, or eGFR
  • Elevated creatinine
  • Urea (blood urea nitrogen, or BUN)

Some other early warning signs:

  • Puffiness or swelling on the face, around the eyes, on the wrists, abdomen, thighs, ankles, etc.
  • Urine that is bloody, coffee-colored or foamy
  • Decreased quantity of urine that is out-of-the-ordinary
  • Issues with urinating, such as abnormal discharge, a burning feeling, or a change in the number of times you urinate, particularly at night
  • Flank or mid-back pain, pain below the ribs, close to where the kidneys are located
  • High blood pressure or hypertension

The worse the kidney disease gets, additional signs and symptoms may occur and are likely to occur in combination:

  • Itchy feeling
  • Tiredness
  • Loss of concentration
  • Loss of appetite
  • Nausea
  • Vomiting
  • Hands and feet numbness
  • Darkened skin
  • Muscle cramps
  • Gout

Acute Kidney Injury

Acute kidney injury, or AKI, is the sudden loss of kidney functioning. This is a condition that can be fatal and requires immediate treatment.

The symptoms include:

  • Reduced number of urinations
  • Fluid retention that causes swelling in the feet, ankles, and legs
  • Drowsiness
  • Fatigue
  • Shortness of breath
  • Nausea
  • Confusion
  • Seizures
  • Coma
  • Chest pain

Tests for Screening and Diagnosis

The National Kidney Disease Education Program (NKDEP) and The National Kidney Foundation (NKF) both recommend that if you are a person of high risk, you should be screened for kidney disease. The NKF recommends explicitly that if you have diabetes and are between the ages of 12 and 70, you should get tested at least once per year.

A child with type 1 diabetes should get a kidney disease screening within five years of the diagnosis. A child with type 2 diabetes should get a kidney disease screening as soon as the diagnosis. After the initial screening, such children should be screened for kidney disease once per year.

Currently, no consensus exists on screening people who have no risk symptoms or factors.  However, both the NKF and the NKDEP recommend two tests, in addition to testing for blood pressure, to screen for kidney disease:

1. Urine Protein

Urine albumin as well as albumin/creatinine ratio (ACR): These tests will look for tiny amounts of albumin in the urine. According to the American Diabetes Association, ACR is the recommended test for screening for albumin in the urine, also known as microalbuminuria.

Urinalysis: This routine test can find protein, red blood cells, and white blood cells in the urine. These are not typically found in the urine and, therefore, can indicate if there may be kidney disease.

Urine total protein and urine protein to creatinine ratio (UP/CR): This test detects not only albumin but also any other proteins that may be in the urine.

2. Estimated glomerular filtration rate (eGFR) is a calculation that is based on a blood creatinine or cystatin C test. Also, other variables, such as sex, age, race (for example, if you are African-American or non-African-American) are taken into consideration depending on the equation used.  The eGFR rate means the amount of blood filtered by the glomeruli per minute. When kidney function declines, the filtration rate also drops.

General Tests for Kidney Function and Disease:https://www.ultalabtests.com/test/comprehensive-metabolic-panel-cmp

A renal panel is a group of tests that can be used to evaluate how the kidneys are functioning. They can also screen for, monitor, or diagnose kidney disease. The test panels vary by laboratory, but generally include:

  • Electrolytes, specifically potassium, sodium, chloride, and carbon dioxide (CO2)
  • Urea (urea nitrogen or blood urea nitrogen, BUN)

There may be calculated values that include eGFR, urea (BUN) to creatinine ratio, and anion gap.

Each of the tests above can be ordered individually.

Further Tests:

  • Creatinine clearance: The patient produces a 24-hour collection. A blood sample is tested as well. Both of these tests will measure creatinine levels. If the level of creatinine clearance is decreased, it may signal a decrease in kidney function.
  • Parathyroid hormone (PTH) controls calcium levels in the blood. PTH levels are often increased in the presence of kidney disease.
  • Hemoglobin, which is part of a complete blood count or CBC, may be performed to detect anemia. Kidneys typically create the erythropoietin hormone that controls red blood cell production. It can be negatively affected by kidney damage. A medical laboratory can also measure erythropoietin directly, but it is not a routine test.
  • Beta 2 microglobulin (B2M) tests may be ordered, along with other kidney function tests, to evaluate kidney damage and disease, as well as to distinguish between disorders affecting the renal tubules and the glomeruli.
  • Uric acid, which is eliminated from the body by the kidneys, is often elevated when there is chronic kidney disease.
  • Vitamin D is necessary for managing calcium and phosphate metabolism. It also plays a part in cell kidney, immune system, and cardiac functions.

After considering a person’s physical condition, medical history, and routine lab test results, additional tests may be ordered, such as:

  • A blood culture may be used to identify sepsis, which can cause kidney damage.
  • Hepatitis B and C tests detect a hepatitis viral infection that is associated with some kinds of kidney disease.

Kidney stone risk panel assesses the risks of developing a kidney stone. It is also used to suggest and monitor treatment and prevention.

Kidney stone analysis reveals the composition of a kidney stone that has passed or that is removed from the urinary tract. The test may also be done to determine how the kidney stone was formed, how other stones can be treated, and how to prevent another occurrence.

  • Myoglobin is another test that may be ordered for patients who have had severe damage to their skeletal muscles (rhabdomyolysis).  When there is rhabdomyolysis, both urine and blood levels of myoglobin can quickly rise.

Structural problems or blockage can occur in the kidneys and, if suspected, a medical professional is likely to order an image. The techniques used for imaging include ultrasound, CT scan (or computed tomography), intravenous pyelogram (or IVP), and isotope scan.

Kidney Biopsy

If there is structural damage to the kidney suspected, a kidney biopsy can help establish the nature and extent of the damage. A medical professional analyzes a small piece of kidney tissue that is obtained with the use of a biopsy needle and diagnostic imaging equipment. This can be useful when disease of the glomeruli or tubules is suspected.

Tests for Biomarkers of Acute Kidney Injury

There are a few biomarkers that are becoming popular as early indicators of acute kidney injury (or AKI). Traditional tests, such as serum creatinine, a kidney function test, may not detect AKI as early as some other tests highlighted below. Early detection of AKI is critical. This is because injury to the kidneys can occur rapidly over hours to days. These AKI biomarkers are still under study but may become more widely available in the future.

AKI is a severe condition that creates millions of dollars in cost to the American healthcare system every year. However, AKI biomarkers do not directly help in the treatment of AKI as there are no particular FDA-approved therapies that are currently available. When a diagnosis of AKI is produced, imaging scans of the kidneys are frequently performed to rule out the possibility of an obstruction in the urinary tract. Supportive treatment, such as an introduction of IV fluids or a transfusion of blood components. If a person is in shock, drugs to improve blood pressure and heart function may be provided. Dialysis may be dictated if a person does not spontaneously recover from AKI.

Examples of New AKI Tests that Look Promising

Urinary insulin-like growth factor-binding protein 7 (IGFBP7), as well as urinary tissue inhibitor of metalloproteinases-2 (TIMP-2), are two markers that have been combined into a point-of-care test, and it is the first test that has been approved by the U.S. Food and Drug Administration to determine what the risk is for a critically ill patient to develop AKI within 12 hours.

Neutrophil gelatinase-associated lipocalin (NGAL) is a protein found in many tissues in the body, including kidney cells.  The level of NGAL rises rapidly when there is AKI (within 2 to 4 hours), making it a good indicator.  Other factors are also under study.  These include biomarkers like metalloproteinase 2 (a tissue inhibitor known as TIMP-2). They also include liver-type fatty-acid-binding protein (or L-FABP). Two other biomarkers under study include interleukin 18 (or IL-18) as well as kidney injury molecule 1 (or KIM-1).