RENAL FUNCTION TEST

Kidney function tests are common lab tests used to evaluate how well the kidneys are working. Such tests include:

BUN- Blood Urea Nitrogen Creatinine - blood Creatinine clearance Creatinine - urine

BUN - blood test

BUN stands for blood urea nitrogen. Urea nitrogen is what forms when protein breaks down.A test can be done to measure the amount of urea nitrogen in the blood. A blood sample is needed. Most of the time blood is typically drawn from a vein located on the inside of the elbow or the back of the hand.. The BUN test is often done to check kidney function. The normal result is generally 6 - 20 mg/dL. Normal values may vary among different labs. Higher-than-normal levels may be due to:

Congestive heart failure Excessive protein levels in the gastrointestinal tract Gastrointestinal bleeding Hypovolemia (dehydration) Heart attack Kidney disease, including glomerulonephritis, pyelonephritis, and acute tubular necrosis Kidney failure Shock Urinary tract obstruction

Lower-than-normal levels may be due to:

Liver failure Low protein diet Malnutrition Over-hydration

CREATININE BLOOD (SERUM CREATININE) Creatinine is a breakdown product of creatine, which is an important part of muscle. Creatinine can also be measured with a urine test.Creatinine is removed from the body entirely by the kidneys. If kidney function is abnormal, creatinine levels will increase in the

blood (because less creatinine is released through your urine).Creatinine levels also vary according to a person's size and muscle mass. A normal result is 0.7 to 1.3 mg/dL for men and 0.6 to 1.1 mg/dL for women.Females usually have a lower creatinine than males, because they usually have less muscle mass. Higher than normal levels may be due to:

Dehydration Eclampsia(a condition of pregnancy that includes seizures) Glomerulonephritis Kidney failure Muscular dystrophy Preeclampsia (pregnancy-induced hypertension) Pyelonephritis Reduced kidney blood flow (shock, congestive heart failure) Rhabdomyolysis Urinary tract obstruction

Lower than normal levels may be due to:

Muscular dystrophy (late stage) Myasthenia gravis

RISKS
The risks associated with having blood drawn are slight but may include:

Excessive bleeding Fainting or feeling light-headed Hematoma (blood accumulating under the skin) Infection (a slight risk any time the skin is broken)

Creatinine - urine
Creatinine is a breakdown product of creatine, which is an important part of muscle. Creatinine is removed from the body entirely by the kidneys. A random urine sample or a 24-hour collection may used.This test can be used as a screening test to evaluate kidney function. It may also be used as part of the creatinine clearance test. It is often used to provide information on other chemicals in the urine such as albumin or protein. Urine creatinine (24-hour sample) values can range from 500 to 2000 mg/day. Results depend greatly on your age and amount of lean body mass.Another way of expressing the normal range for these test results are:

14 to 26 mg per kg of body mass per day for men 11 to 20 mg per kg of body mass per day for women

Abnormal results of urine creatinine are nonspecific, but may be due to any of the following conditions

High meat diet Kidney infection (pyelonephritis) Kidney failure Muscular dystrophy Reduced kidney blood flow (as in shock or congestive heart failure) Urinary tract obstruction

Creatinine clearance
The creatinine clearance test compares the level of creatinine in urine with the creatinine level in the blood. (Creatinine is a breakdown product of creatine, which is an important part of muscle.) The test helps provide information on kidney function. Creatinine blood test Creatinine urine test This test requires both a blood and urine sample. You will collect your urine for 24 hours, and then have blood taken. The samples are sent to a laboratory. The laboratory specialist measures the level of creatinine in both the urine and blood samples, and looks at how much urine you collected in 24 hours. The clearance rate is then calculated. The calculation is adjusted for your specific body size. The creatinine clearance appears to decrease with age (each decade corresponds to a decrease of about 6.5 ml/min./1.73 ml/min. If the collection is being taken from an infant, a couple of extra collection bags may be necessary.

Need For The Test

The creatinine clearance test is used to estimate the glomerular filtration rate (GFR). However, because a small amount of creatinine is released by the filtering tubes in the kidneys, creatinine clearance is not exactly the same as the GFR. In fact, creatinine clearance usually overestimates the GFR. This is particularly true in patients with advanced kidney disease.

Normal Results
Clearance is often measured as milliliters/minute (ml/min). Normal values are:

Male: 97 to 137 ml/min. Female: 88 to 128 ml/min.

The examples above are common measurements for results of these tests. Normal value ranges may vary slightly among different laboratories. Some labs use different measurements or test different samples.

Abnormal Results
Abnormal results (lower than normal creatinine clearance) may indicates,

Bladder outlet obstruction Dehydration End-stage kidney disease Glomerulonephritis Kidney failure Renal ischemia (too little blood flow to the kidneys) Renal outflow obstruction (usually must affect both kidneys to reduce the creatinine clearance)

Risks
The risks of the test are minimal and are related to the blood draw process. Rarely, the following will occur:

Excessive bleeding at blood draw site Fainting or feeling lightheaded Hematoma (blood accumulating under the skin) Infection (a slight risk any time the skin is broken) Multiple punctures to locate veins

Considerations
Factors that may interfere with the accuracy of the test are as follows:

Incomplete urine collection Pregnancy Vigorous exercise

Drugs that can interfere with creatinine clearance measurements include: cimetidine, trimethoprim, and drugs that can damage the kidneys, such as cephalosporins.