Blood tests

Albumin is a type of protein in your blood and an indicator of how well you are eating. A side effect of kidney failure is loss of appetite or intolerance for certain types of foods. Patients with kidney failure can become malnourished so it is important that you know your serum albumin levels. If you need help, ask your renal dietitian.

The normal level of bicarbonate typically measured by CO2 in the blood is 22 to 29 mEq/L (milliequivalents per liter). Acids, a waste product from food, accumulate in the blood of people with kidney failure, and the level of bicarbonate (the body's natural anti-acid) falls. If this is not corrected the patient may become malnourished.

Blood Urea Nitrogen (BUN or Urea)
BUN levels indicate how well your kidneys are clearing toxins from your blood. This test measures the amount of waste product produced by normal protein breakdown and released into the blood.

The level of calcium in your blood is one indicator of how healthy your bones are. Calcium is a mineral that helps strengthen bones. One of the functions of the kidneys is to help keep calcium in the bones. If you have kidney failure, calcium passes out of the bones making them weak. The kidneys also help Vitamin D control the blood calcium level. In kidney failure the level of calcium in the blood is often reduced.

Cholesterol is a form of fat present in the blood. High levels may put you at risk of heart attack and strokes. A low-fat diet can reduce the level of cholesterol in some patients. Many patients also need to take a medication known as a statin to control their cholesterol level.

Creatinine levels also indicate how well your kidneys are clearing toxins from your blood. Creatinine is the medical name for a waste product produced by the muscles and released into the blood.

For EPO to work well it is necessary to have enough iron in the body. The best guide to this is the level of a substance called ferritin. To keep the ferritin level above the desired minimum level many patients on EPO need to take iron pills, or have regular iron injections.

If you are a diabetic it is important that you monitor the levels of glucose in your blood. Recent studies have shown that the progression of kidney damage can be slowed significantly with good glucose control.

Hematocrit levels measure how much of your blood is made up of red blood cells.

Hemoglobin (Hb)
Hemoglobin levels measure your blood's ability to carry oxygen. Most patients with kidney failure do not have enough hemoglobin in their blood. They become anemic. Hemoglobin is important because it carries oxygen around the body, and every part of the body needs oxygen to function properly. Hemoglobin levels in kidney patients with anemia can be increased by injections of erythropoeitin (EPO). The normal level of hemoglobin in the blood is 11-18 g/dL (grams per deciliter).

Liver problems
Patients with kidney failure may have liver problems, such as hepatitis and other viral infections.

Phosphate or phosphorus
Phosphate levels indicate how healthy the bones are. High levels of phosphate in the blood can make you itch and can also affect your bone strength or density. You should avoid food high in phosphate. You may also need to take phosphate binders, such as calcium carbonate, with your food to lower your phosphate levels. Your renal dietitian can advise you on your diet.

Parathyroid hormone (PTH)
A high level of PTH in the blood indicates problems with the bones.

Potassium is a mineral that helps the heart to function. Either too much or too little potassium can be dangerous, causing the heart to stop. Controlling the level of potassium can be quite difficult, especially in patients being treated by hemodialysis.

Sodium (Salt)
Sodium is a mineral present in the blood that helps to keep water in the body and to control blood pressure.

May 1, 2006