Blood and urine tests can help uncover signs of early kidney disease and monitor the condition.
Blood pressure. Your health care provider will devise a plan, which may include diet changes and medications, to keep your blood pressure as close to normal as possible. Target blood pressure is defined as less than 130/80.
Urine protein or albumin in the urine. Albumin is the main protein in the blood. When the kidneys become damaged, the holes in the filtering system of your kidneys become enlarged, allowing protein to leak into the urine. In the early stages of kidney damage, only small amounts of albumin (microalbuminuria) are found. This test is very important for people with diabetes because at this early stage of kidney damage, further deterioration can be prevented by diet, exercise, and medications.
GFR (glomerular filtration rate). This is a measure of how well your kidneys are filtering your blood. An estimate of your "filtering rate" is determined by a blood test called a blood creatinine test, which measures the amount of creatinine -- a waste product -- in your blood. This test, along with your age, body size, and gender, provides an estimate of your GFR. Your GFR, or "filtering rate," helps confirm normal or low kidney function. A score of 90 or above is normal; a score below 15 indicates kidney damage that will require dialysis or a kidney transplant. Another commonly used test to estimate GFR is a creatinine clearance. This test measures the creatinine in the blood and urine to determine kidney function.
Your health care provider may also refer you to a kidney specialist, called a nephrologist, for more specialized testing. A kidney biopsy may also be performed. During a kidney biopsy a small amount of kidney tissue is removed for microscopic exam to pinpoint the cause of kidney damage and plan treatment.
Early detection is the first step in treating chronic kidney disease. The symptoms of kidney disease may include:
Nausea and vomiting
Passing only small amounts of urine
Swelling, particularly of the ankles, and puffiness around the eyes
Unpleasant taste in the mouth and urine-like odor to the breath
Persistent fatigue or shortness of breath
Loss of appetite
Increasingly higher blood pressure
Muscle cramps, especially in the legs
Medications, especially drugs that control diabetes and high blood pressure, can sometimes help slow the progress of chronic kidney disease. A sudden loss of kidney function may improve if the underlying cause -- such as a pregnancy complication -- is resolved.
But with long-term kidney disease, if the kidneys deteriorate and can no longer function at all, there are only two treatment options: dialysis, which uses an artificial device to clean the blood of waste products, or a kidney transplant.
Medications for Kidney Disease
High blood pressure may be both a cause and a result of kidney disease. Your health care provider may prescribe a blood pressure drug for your kidney disease, such as an angiotensin-converting enzyme (ACE) inhibitor, such as Capoten, Vasotec, Prinivil, Zestril, or Altace, or an angiotensin receptor blocker (ARB), such as Cozaar, Diovan, Avapro, or Benicar. Along with controlling blood pressure, these drugs may reduce the amount of protein in your urine, which may also help your kidneys over time.