Chronic Renal Failure

Diagnosis

The diagnostic exam will include a complete medical history, a physical, and blood, urine, and kidney function tests.

Laboratory tests will be run on the blood and urine of patients suspected of having CRF. Blood tests will look for abnormal concentrations of substances such as creatinine, blood urea nitrogen (BUN), uric acid, phosphate, sodium, and potassium. Elevated levels of these wastes indicate that the kidneys are not functioning properly.

Urine samples will also be collected, usually over a 24-hour period. Before the test, the provider will ask if you are taking certain prescription medications, such as Cimetidine (Tagamet, Tagamet HB), Trimethoprim (Bactrim, Cotrim, Septra, Sulfamethoprim, Uro-D/S, Uroplus), and Cefazolin (Ancef, Kefzol, Zolicef), as these drugs may alter laboratory results.

Radiological exams can help determine the cause of kidney failure, and level of remaining kidney function. Your doctor may perform an ultrasound examination of the kidneys, bladder, and/or ureters. In an ultrasound, high-frequency sound waves passed result in a picture of your kidneys. Other detailed imaging studies that the doctor may run include x-rays, computer tomography (CT), or magnetic resonance imagery (MRI) scans.

A provider might remove a small section of kidney tissue to look for microscopic tissue damage under a microscope. This procedure is called a biopsy, and is performed under local anesthesia.

Prevention and Screening

Because several disorders may lead to CKD, treating these underlying disorders may prevent or delay the progression of CKD.

People with diabetes can prevent CKD by controlling their blood sugar and blood pressure as strictly as possible, and by not smoking. People with diabetes can also take a certain type of blood pressure medicine to help prevent kidney disease.

Following a low-protein diet and maintaining healthy cholesterol levels can also help to slow the progression of CKD.

People in the early stages of CKD should avoid medications that are known to be toxic to the kidneys, and avoid dehydration, which can strain the kidneys, and make the CKD worse.