KIDNEY SPECIFIC MARKERS

Test Test Test Test Test

Test What it Indicates Reference Range Diagnosis
Results Results Results Results Results

The BUN test (Blood Generally, a high blood urea

Urea Nitrogen) along nitrogen level means your
with a creatinine is the kidneys aren't working well.
most widely used blood But elevated blood urea nitrogen
test to assess kidney can also be due to:
disease and its Urinary tract obstruction
Date: Date: Date: Date: Date:
progression. These Congestive heart failure or
Blood Urea
naturally occurring 7 to 20 mg/dL recent heart attackw
Nitrogen) -
chemicals are by-products (2.5 to 7.1 mmol/L) Gastrointestinal bleeding
BUN
of the daily processes Dehydration, resulting from
Result: Result: Result: Result Result
of the body. not drinking enough fluids
or for other reasons
High levels of all of Shock, Severe burns
these chemicals Certain medications, such as
indicate an under some antibiotics
functioning kidney A high-protein diet

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 Increased creatinine levels in the
blood suggest diseases that affect
kidney function. These can include:
Glomerulonephritis (swelling of the
kidney's blood vessels)
Diabetic kidney disease (the filters
Creatinine is the The typical clog up with a proteinaceous
waste product of reference range for substance)Pyelonephritis
creatine, which the serum creatinine is (pus-forming infection of the kidneys)
muscles use to make 60 to 110 Acute kidney injury (death of cells in
energy. Typically, micromoles per the kidney's small tubes) Date: Date: Date: Date: Date:
creatinine travels in the liter (mmol/L) Urinary tract obstruction (e.g.
Creatinine blood to the kidneys (0.7 to 1.2 milligrams prostate disease or kidney stones)
where it leaves the body per deciliter Reduced blood flow to the kidney
in the urine. High (mg/dL)) for men due to shock Dehydration Result: Result: Result: Result Result
levels in the blood and 45 to 90 Congestive heart failure
might indicate that mmol/L (0.5 to 1.0 Atherosclerosis Complications of
the kidneys mg/dL) diabetes.
are not working correctly for women
Creatinine can also increase as a
result of muscle injury.
Reduced levels of creatinine are
not common and are not usually a
cause for concern

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 Stage 1: Slight kidney damage
with normal or increased
filtration
Stage 2: Mild decrease
GFR stands for Kidney disease in kidney function
Glomerular filtration can be broken Stage 3: Moderate
rate and describes the down into five decrease in kidney Date: Date: Date: Date: Date:
flow rate of filtered fluid different stages function (now considered the
eGFR through the kidney. Stage 1: 90+ beginnings
It is also used to rate Stage 2: 60-89 of kidney failure)
the degree to which Stage 3: 30-59 Stage 4: Severe decrease Result: Result: Result: Result: Result:
someone has Kidney Stage 4: 15-29 in kidney function
Disease Stage 5: 14 or less Stage 5: Kidney failure
resis or transplantation.
Also known as End-Stage
Renal Disease (ESRD)

Low urinary creatinine

Creatinine is removed can be an indication
from the body by that the kidneys are not
500 to 2000 effectively excreting Date: Date: Date: Date: Date:
kidneys, via urine. This
mg/day 24 hour creatinine, and
Creatinine is best assessed over a
sample- results therefore of potential
clearance 24hr period to determine
vary due to age kidney damage. This must be
how much creatinine is
and muscle mass taken into account with blood Result: Result: Result: Result: Result:
being removed by the
kidneys creatinine levels and other
indicators to

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 The serum anion gap Optimal metabolic pH
measures the electrolytes balance - 9-11mEq/L
in the body. Electrolytes Mild chronic
are electrically charged metabolic acidosis
materials that help to is likely - > 11mEq/L
control the acid-alkaline Optimal Moderate chronic Date: Date: Date: Date: Date:
balance. The anion gap metabolic metabolic acidosis is
Anion Gap is a measurement of pH balance - likely - >13 mEq/L
the difference or gap 9-11mEq/L Severe chronic
between the negatively metabolic acidosis is Result: Result: Result: Result: Result:
charged and positively likely or other health
charged electrolytes condition - > 15 mEq/L
and is a great way to Consider metabolic
determine pH levels acidosis - > 20 mEq/L
in the blood

Albumin is a protein that is High albumin levels in the

not usually present in the urine are indicative of kidney
In a 24 hours
urine as the kidneys are damage. This test alone is not Date: Date: Date: Date: Date:
urine sample,
able to filter it, but in used to diagnose kidney
Urine albumin should
albumin cases of kidney damage damage and results are
not be above
it can build up, taken into consideration Result: Result: Result: Result: Result:
150mg
causing a condition known along with creatinine
as albuminurea and other markers

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 30-300mg of
albumin in 24hr
Micro-albuminuria allows
urine collection
This test is used to for detection of early stages of
is called Date: Date: Date: Date: Date:
detect small amounts kidney damage and can be used
microalbuminuria.
Micro as a screen in high risk patients.
of albumin in In a single
albuminuria Raised microalbuminuria
order to detect early collection
levels are indicative of Result: Result: Result: Result: Result:
kidney damage above 30mg per
kidney damage
creatinine gram is
positive.

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DIALYSIS
Dialysis can be a very stressful and daunting process that can drasatically change the lifestyle of patients. So it is essential to know that if you are going to
undertake an intrusive treatment that it is working effectively. Using the two calculations below, nephrologists are able to monitor dialysis effectiveness by
assessing the levels at which urea is removed via dialysis treatment.

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65% or higher There is no fixed

This measures the Between treatments percentage to
reduction the results of the URR measure satisfactory
of urea as a result test can vary dialysis
Date: Date: Date: Date: Date:
of the dialysis process. considerably, therefore treatment, however
The URR is calculated a solitary test result it has been found that
URR
as a percentage below 65 percent patients generally live
of the remaining urea should not be of great longer and have fewer
Result: Result: Result: Result: Result:
compared to the urea concern; it is the hospitalizations
level before a patient’s average URR if the URR is at least
dialysis session. that is important to 60 percent.
be above 65%.

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 This is a measurement of
how effectively urea is
removed via dialysis.
There is no fixed value to
It compares the amount of
measure satisfactory
fluid that goes through the
dialysis treatment, however
dialysis machine to the 1.2 or above for
it has been found that Date: Date: Date: Date: Date:
amount of fluid in the haemodialysis patients
patients generally live
patient's body. Kt/V is a
Kt/V longer and have fewer
similar calculation to URR 1.8 or above for
hospitalizations if the
but is a more reliable peritoneal dialysis
Kt/V is at least 1.2 percent Result: Result: Result: Result: Result:
measure as it also takes into patients is optimal
for haemodialysis patients
consideration urea that is
and 1.8 or above for
formed by an individual
peritoneal dialysis patients.
during dialysis
and urea that is removed
along with excess bodily fluid.

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BONE HEALTH
Kidney failure can often lead to parathyroid problems as kidney damage results in build up of phosphorus. Phosphorus and calcium work together in regard to
parathyroid health, so this throws out the balance. The parathyroid excretes parathyroid hormone(PTH) to help control blood calcium levels. Excess phosphorus
causes a decrease in calcium, which in turn stimulates a release of PTH.

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Date: Date: Date: Date: Date:

The kidneys are required
USA - 30 ng/mL
to produce Vitamin D so Low Vitamin D
Vitamin D to
levels are often low will require
60 ng/mL
in kidney disease.
Result: Result: Result: Result: Result:

Australian serum: Date: Date: Date: Date: Date:

Phosphorus
0.70-1.50 mmol/L High phosphate
levels are
Phosphate causes increased
often high in
urine test: secretion of PTH
renal failure
10-40 mmol/ 24hours Result: Result: Result: Result: Result:

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 Date: Date: Date: Date: Date:
USA - 8.5 -10.2 mg/dL PTH regulates calcium
Calcium levels are
via kidneys. High
Calcium often low in
Australia - 2.12 mmol/L phosphate leads to
renal failure
to 2.55 mol/L low calcium
Result: Result: Result: Result: Result:

Date: Date: Date: Date: Date:

High levels are often High PTH can cause
PTH seen in kidney damage Intact PTH 10–65 pg/ mL thinning of bones in
due to high phosphorus some kidney patients
Result: Result: Result: Result: Result:

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IRON STUDIES
Patients with kidney disease often show test results that indicate anaemia. The kidneys are required to form the hormone erythropoeitin (EPO), that stimulates the
formation of red blood cells in bone marrow. In cases of poor kidney function, EPO becomes deficient, which results in anaemia. The following test results indicate
iron status.

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The level of iron in Female: 26-170ug/dL Male: Date: Date: Date: Date: Date:
Total Serum the blood that is 76-198ug/dL Low TSI indicates
Iron (TSI) bound Australian reference: iron deficiency
to transferrin 5-30umol/L Result: Result: Result: Result: Result:

A protein that stores iron Female: 14 -150ug/L 120

Low levels Date: Date: Date: Date: Date:
in a non-toxic form. -160ng/ ml Male:
indicate likely iron
Ferritin Ferritin levels indicate 17-300ug/l 18-250ng/mL
deficiency
levels Australian reference:
anaemia Result: Result: Result: Result: Result:
of iron storage 30-200ng/mL

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 Iron containing protein Female
Low Hb is referred
that is attached to red 115-165g/l 12-15.2gm/ dL Date: Date: Date: Date: Date:
to as anaemia. Can
Haemo blood cells & carries Male
be caused by blood
globin (Hb) oxygen around the body. 130-180g/l 13.2-16.2gm/ dL
loss, poor nutrition
Gives blood cells their Australian reference: Result: Result: Result: Result: Result:
& some drugs.
red colour. 115-160g/L

Transferrin is high Date: Date: Date: Date: Date:

A plasma protein that
2-4g/l 204-360mg/ dl in iron deficiency as
Transferrin carries iron around
Australian ref: 2.0-3.6 g/L the liver increases
the body.
the production Result: Result: Result: Result: Result:

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ELECTROLYTES
The following nutrients are important electrolytes that are essential to maintain at the right levels. In kidney disease the levels of these nutrients may show to be out
of range due to the altered filtering capacity of the kidney. This is important to control either by diet or supplementation as stated below. These nutrients need to be
at optimal levels for nervous system and cardiovascular health and should be monitored regularly.

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Results Results Results Results Results

Date: Date: Date: Date: Date:

8.5-10.2 mg/dL 2.12 Low calcium levels are
Low calcium levels are
mmol/L to 2.55 mmol/L often seen inpatients with
Calcium often a result of high blood
Australian ref: 2.10-2.55 kidney disease & high
phosphorus
mmol/L phosphorus
Result: Result: Result: Result: Result:

Date: Date: Date: Date: Date:

When kidneys are not High sodium stresses the
135-145 mEq/vL
working effectively they are kidneys, causing fluid
Sodium Australian ref: 135 -145
not able to filter sodium and retention and high blood
mmol/L
levels build up pressure
Result: Result: Result: Result: Result:

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 The kidneys are required
Low Vitamin D will require Date: Date: Date: Date: Date:
to filter excess
supplements. Vitamin D is
Phosphorus phosphorus from the 2.4 - 4.1mg/dL Australian
essential
(phosphate) blood so levels are ref:
for absorption
often high in
of calcium. Result: Result: Result: Result: Result:
kidney disease

Date: Date: Date: Date: Date:

Australian serum:
Phosphorus levels High phosphate causes
0.70-1.50 mmol/L urine
Phosphate are often high in increased secretion
test:
renal failure of PTH
10-40 mmol/ 24hours
Result: Result: Result: Result: Result:

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CARDIOVASCULAR MARKERS
If you are being treated for kidney damage it is essential to understand what is happening with your cardiovascular system. Heart disease and many conditions of the
cardiovascular system are linked to Kidney Disease. The following table takes a look at some cardiovascular specific blood measurements that need to be assessed
when looking at overall health and disease prevention.

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Excess cholesterol gets

Total cholesterol: less Date: Date: Date: Date: Date:
deposited in artery walls
Total measure of all forms than 200 mg/dL is
Total leading to narrowing
of cholesterol and lipid optimal. Australian
Cholesterol of arteries, which leads
components reference range:
to an increased risk of
3.5-5.5mmol/L Result: Result: Result: Result: Result:
heart attacks & stroke

LDL: Under 100 mg/dL Date: Date: Date: Date: Date:

optimal 100-129 mg/ dL
Low density lipoprotein High levels increase risk
LDL cholesterol slightly high Australian
(bad cholesterol) of heart disease.
reference: less than
3.5mmol/L Result: Result: Result: Result: Result:

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 HDL: above 60 mg/ dL
less than 40mg/dL in Helps reduce levels Date: Date: Date: Date: Date:
men and 50md/dL in of ‘bad cholesterol’
HDL High density lipoprotein
women increases heart therefore low levels
cholesterol (good cholesterol)
disease risk. Australian increase risk of
reference: greater heart disease. Result: Result: Result: Result: Result:
than 1.2mmol/L

Normal levels 150 mg/ High triglycerides are

This is the medical Date: Date: Date: Date: Date:
dL. Any reading above seen in many conditions
term for blood fats.
this is considered including kidney
Triglycerides High levels indicate
too high. Australian damage, and diabetes
increased risk of
reference range: 0.5-2.0 which is the no.1 cause
coronary artery disease. Result: Result: Result: Result: Result:
mmol/L of kidney disease.

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 The normal range of
homocysteine levels are
Homocysteine is a type less than 15 micromoles
of amino acid. Your body per liter (mcmol/L). A high level of
naturally makes it. But at homocysteine is a
Date: Date: Date: Date: Date:
high levels, it can damage Higher levels are: risk factor for heart
the lining of arteries. It can Moderate (15 to 30 disease. It’s associated
Homocysteine
encourage blood clotting. mcmol/L) with low levels of
This may raise your risk for vitamins B6, B12, and
Result: Result: Result: Result: Result:
coronary artery disease, Intermediate (30 to 100 folate, as well as renal
heart attacks, blood clots, mcmol/L) disease.
and strokes.
Severe (greater than 100
mcmol/L)

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DIABETIC MARKERS
If you are being treated for kidney damage it is essential to understand what is happening with your blood sugar levels. Diabetes is linked to Kidney Disease. The
following table takes a look at some blood sugar measurements that need to be assessed when looking at overall health and disease prevention.

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It is essential to control
This test in used to monitor blood sugar to prevent or Date: Date: Date: Date: Date:
T70-100 mg/dl Diabetes:
Fasting diabetes and screen diabetes control diabetes.
over 126 mg/dL Australian
blood risk by measuring levels Diabetes is the leading
ref range: 3.6-6.0 mmol/L
glucose of glucose after fasting cause of kidney disease&
Diabetes: over 7mmol/L
for at least 8 hours causes kidney damage via Result: Result: Result: Result: Result:
several mechanisms.

Fasting Insulin testing evaluates

Fasting blood sugar levels
insulin production by the beta
under 100 milligrams/
cells in the pancreas; to help
deciliter (mg/dL) are
diagnose the presence of an It is essential to control
considered normal.
insulin-producing tumor in blood sugar to prevent or Date: Date: Date: Date: Date:
the islet cells of the pancreas control diabetes.
Fasting Levels between 100
(insulinoma); to help determine Diabetes is the leading
Insulin and 125 mg/dL indicate
the cause of low blood glucose cause of kidney disease&
prediabetes.
(hypoglycemia); to help identify causes kidney damage via Result: Result: Result: Result: Result:
insulin resistance, or to help several mechanisms.
Levels equal to or greater
determine when a type 2 diabetic
than 126 mg/dL are
might need to start taking insulin to
diagnostic for diabetes
supplement oral medications.

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