Patient Education

Lab Values
Explained
Common Tests to Help Diagnose
Kidney Disease
Lab work, urine samples and other
tests may be given as you undergo
diagnosis and treatment for renal
failure. The test results will be used working at full strength. Other possible causes of
to assist the healthcare team (your an elevated BUN include dehydration and heart
doctor, nurses, and others) in failure.
evaluating your kidney function and
developing your healthcare plan. Serum Creatinine Creatinine is a waste
Remember, you are in control and product in the blood created by the normal use
you are your own best healthcare of muscle cells. Healthy kidneys take creatinine
provider, so it is essential for you to out of the blood and it’s excreted in the urine. When
understand what these tests mean. the kidneys are not working well, creatinine builds
up in the blood. If the kidneys lose their ability to
Remember, there can be some filter blood, more creatinine will accumulate and
differences in the results from one serum creatinine will rise. As a result, creatinine
lab to another, so make sure you is an indirect marker of how well the kidneys are
learn the normal values for your lab. working. A creatinine level of greater than 1.2
Let’s get started. for women and greater than 1.4 for men may be
an early sign that the kidneys are not working
Blood Urea Nitrogen (BUN) properly.
Blood carries protein to cells
throughout the body. After the cells Creatinine Clearance Creatinine clearance is a
use the protein, the remaining waste measure of how much creatinine is in your urine.
product is returned to the blood as It gives an accurate measure of the kidneys’
urea nitrogen. Healthy kidneys take ability to remove creatinine out of your body.
urea nitrogen out of the blood so it To calculate a creatinine clearance you may be
can be excreted in the urine. If your asked to save your urine for 24 hours and bring
kidneys are not working well, the it to the lab. The lab measures the amount of
urea nitrogen will stay in the blood. creatinine in the urine. The normal creatinine
Normal blood contains 7-20 mg/ clearance is greater than 90 ml/min.
dLof urea. If your BUN is more than
20 mg/dL, your kidneys may not be
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Glomerular Filtration Rate (GFR) measured with a standard dipstick may
GFR is a measurement of how well the leak into the urine.
kidneys are processing waste. A sample This condition is known as micro-
of your blood is sent to the lab. The blood albuminuria. This is how the test is read:
creatinine level is factored in with your • Less than 30 mg/L is normal
age, gender, height, race, and weight to
calculate your glomerular filtration rate • Greater than 30 mg/L but less than
(GFR). Normal GFR varies according to 300 mg/L is called microalbuminuria
age—as you get older it can decrease.
• Greater than 300 mg/L is called
The normal value for GFR is 90 ml/min or
macroalbuminuria
above. A GFR below 60ml/min is a sign the
kidneys are not working properly. A GFR
below 15 ml/min indicates that a treatment Urine Protein As kidney function
for kidney failure, such as dialysis or worsens, the amount of albumin and other
transplant, will be needed. proteins in the urine often increases, and
the condition is called proteinuria. Your
Microalbumin Urine Healthy kidneys doctor may test for protein using a dipstick
remove waste from the blood but leave in a small sample of your urine taken in the
protein. Impaired kidneys may fail to doctor’s office. The color of the dipstick
separate a blood protein called albumin indicates the presence or absence of
from the waste. At first, only a small proteinuria. This test should be negative.
amount of protein that is too tiny to be

Blood Tests to Check for Anemia Hemoglobin Hemoglobin (Hb., Hgb) is

the part of the red blood cell that carries
Hematocrit Hematocrit (Hct) is a oxygen to the cells of the body. Both
blood test that measures the number hemoglobin and hematocrit are measured
and the size of red blood cells. It gives to check for anemia. Three times the
a percentage of red blood cells found hemoglobin level equals the hematocrit. A
in whole blood. It is used to check for normal hemoglobin level for a healthy adult
anemia. Anemia is a shortage of oxygen- is 12-15 g/dl. For a person with CKD the
carrying red blood cells and often begins at desirable hemoglobin is 11-12 g/dl.
the early stages of kidney disease. Anemia
is treatable. A normal hematocrit (Hct) for a
healthy adult is 38-45%. For a person with
CKD, the desirable Hct is 33-36%.

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Blood Tests that Measure
Diabetes Control

Glucose (Blood Sugar) A blood glucose

test measures the amount of a type
of sugar called glucose in your blood.
Glucose is measured to make sure your
body is able to digest and utilize sugar and
carbohydrates correctly. If your blood sugar
is too high, it may mean you have diabetes.
Normal Fasting (before eating)
Glucose levels:
• No known diabetes: less than 100 mg/dl.
blood cells store the sugar information
• Above 125 mg/dl can indicate diabetes. for about four months. A blood test can
then retrieve your average blood glucose
• Diabetics: 70-130 mg/dl is within target
results in the form of a percentage. The
range
greater your A1C value, the higher your
Normal Non-fasting (2 hours after you risk for diabetic complications. For the
have eaten a meal) Glucose levels: diabetic with CKD, good control of your
blood sugar can slow the worsening of
• No known diabetes: less than 140 mg/dl. kidney function. Ask your doctor what your
• Diabetics: less than 180 mg/dl percentage should be. For most people,
the result should be less than 7%.
Hemoglobin A1C (HbA1c)
A glycosylated hemoglobin A1C (also
called HbA1c, Hemoglobin A1C and
A1C) reading reveals your average blood
glucose level over the past three months
and can be used to monitor your diabetic
control and predict your risk for diabetic
complications. How does it do that? Your
body actually memorizes the trail that
sugar leaves in your body. When blood
glucose is high, the sugar molecules attach
themselves to red blood cells. The red

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Nutritional Blood Tests

Serum Albumin Albumin is the protein

level in the blood. It is produced in the liver
and released into the blood. Albumin helps
prevent blood from leaking out of blood
vessels. It also carries medications and
other substances through the blood, and
is important for tissue growth and healing.
The normal serum albumin in a healthy
adult is 3.5 g/dl. The target for adults with
CKD is 4 g/dl. for healthy adults and adults with CKD are
40-79 mg/dl.
Lipid Panel Lipids are found in your blood
and are stored in your tissues. They are an Low Density Lipoprotein (LDL) This is
important part of cells, and help keep your known as the “bad” cholesterol. Higher
body working normally. Lipid disorders levels of LDL are associated with a higher
such as high cholesterol, may lead to life- risk of heart disease and stroke. The
threatening illnesses, such as coronary artery normal range for healthy adults and adults
disease, heart attack and stroke. There is with CKD are less than 100 mg/dl.
also growing evidence that hyperlipidemia
contributes not only to cardiovascular disease, Triglycerides Triglycerides are the main
but also to kidney disease progression. form of fat in foods and in the human body.
The normal range for healthy adults and
Total Cholesterol People with high adults with CKD are less than 150 mg/dl.
levels of cholesterol may feel well, but they
are at a higher risk for heart attacks and Additional Tests for Kidney Disease
hardening of the arteries than those with If blood and urine tests indicate reduced
normal levels. Normal range for cholesterol kidney function, your doctor may
in healthy adults and adults with CKD is recommend additional tests to help identify
less than 200 mg/dl. the cause of the problem.

High-Density Lipoprotein (HDL) This is Renal Imaging Methods of renal imaging

known as the “good” cholesterol. Higher (taking pictures of the kidneys) include
levels are associated with a lower risk of ultrasound, computed tomography (CT
heart disease. The normal range for HDL scan), and magnetic resonance imaging

Content courtesy of DCI.

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(MRI). These tools are most helpful in inserts a needle through your skin and into
finding unusual growths or blockages to the kidney. The needle retrieves a strand of
the flow of urine. tissue about 1/2 to 3/4 of an inch long. For
the procedure, you will lie on your stomach
Renal Biopsy Your doctor may want to on a table and receive local anesthetic to
see a close-up of your kidney tissue under numb the skin. The sample tissue will help
a microscope. To obtain this tissue sample, the doctor identify the cause and severity
the doctor will perform a kidney biopsy—a of your kidney disease.
hospital procedure in which the doctor

Laboratory Tests That Measure Kidney Function

Blood Urea Nitrogen A waste product formed after Normal: 7–20 mg/dL.
your body used the protein it
needs.

Serum Creatinine A waste product in the blood Normal:

created by the metabolism of <1.2 mg/dL for women
muscle cells. <1.4 mg/dL for men.

Creatinine Clearance A measure of how much of Normal:

the waste product creatinine is Greater than 90 ml/min.
in your urine.

Glomerular Filtration Rate (GFR) A measure of how well the Normal: 90 ml/min.
kidneys are processing Less than 15 indicates Kidney
wastes. failure.

Microalbunin Urine Test A measure of microscopic Normal: Less than 30 mg/L

amounts of protein in the urine • 30 mg/L – 300 mg/L is
may be an early sign of kidney called microalbuminuria.
disease. • Greater than 300 mg/L is
called macroalbuminuria.

Urine Protein Test A measure of protein in the urine. Normal: Negative.

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 Quick Reference Lab Test List — Continued
Laboratory Tests That Measure Kidney Function
Hematocrit Measures the number and size of Normal: a healthy adult is 38–
red blood cells. 45%. A desireable HCT for
a person with CKD is 33–36%.

Hemoglobin Measures the part of the red Normal: a healthy adult is

blood cell that carries oxygen to 12–15 g/dL. A desireable
the cells of the body hemoglobin fo a person with
CKD is 11-12 g/dL.

Blood Tests that Measure Diabetes Control

Glucose (Blood Sugar) Measures the amount of a type Normal Fasting (before eating)
of sugar, called glucose, in your Glucose levels:
blood. It is measured to make • No known diabetes: less than
sure your body is able to digest 100 mg/dL.
and utilize sugar and carbohy- Above 125 mg/dL can indicate
drates correctly. If your blood diabetes.
sugar is too high, it may mean • Diabetics; 70-130 mg/dL is
you have diabetes. within target range.
Normal Non-fasting (2 hours
after you have eaten a meal)
• No known diabetes: less than
140 mg/dL.
• Diabetics: less than 180 mg/dL.

Hemoglobin A1C (HbA1c) Reveals your average blood For most people, the result
glucose level ove the past three should be less than 7%.
months.

Content courtesy of DCI.

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