Chronic Kidney Disease is often asymptomatic. The commonest causes are diabetes and hypertension.There are a number of tests that clinicians use to both detect and measure the severity of impaired kidney function. Levey and colleagues examine the use of these tests in a review article in the June 2, 2022 issue of the New England Journal of Medicine – Uses of GFR and Albuminuria Level in Acute and Chronic Kidney Disease. As the paper is behind a paywall here are its conclusions: “The GFR and level of albuminuria are powerful measures for detecting and staging AKD and CKD and for predicting the risk of kidney-disease progression and CVD, but they remain underused. We suggest that greater use of these measures can lead to further advances in clinical practice, research, and public health.”
The following is not intended to replace a medical professional’s examination as to whether you have renal disease. Rather it’s a simple way you can assess your own risk for impaired kidney function using simple measurements that are inexpensive and noninvasive. You don’t even need a blood sample. It consists of just two parts.
First, measure your blood pressure. There are many devices of varying accuracy available for home use. While most of them give valid readings it’s best to check whatever device you use against a standard sphygmomanometer. Several reading at different times are best.
Next do a urinalysis. There are a number of simple paper strips that measure many different variables in a urine sample. One such test, available from Amazon, is the CYBOW 11 Series Reagent Strips for Urinalysis. It tests for protein, glucose, leukocytes, nitrite, urobilinogen, pH, blood, specific gravity, ketone-acetoacetic acid, bilirubin, and ascorbic acid (vitamin C). Specific gravity and pH depend of fluid intake and diet. There is no abnormal value for these under usual conditions. Vitamin C in urine can alter some test results.
If your blood pressure is normal (I’ll use 120/80 as normal) and your urinalysis is likewise completely normal, the likelihood that you have kidney disease is close to zero. This two part procedure is just a general screening test. Many patients with hypertension do not have impaired kidney function, but they should be under the care of a physician. The same is true of people who are diabetic.
On the other hand, if a calculated glomerular function rate (eGFR) comes back low, the test is part of the standard blood panel that your doctor will order as part of a routine visit, and he wants to send you to a nephrologist ask him what your blood pressure is and if a urinalysis shows any abnormalities. If both are normal, you and he might want to rethink a renal consultation. This is especially true in elderly patients whose calculated eGFR is often reported as decreased. Renal function declines with age irrespective of the presence of kidney disease.
