PREVENTION OF KIDNEY FAILURE
The good news is that with the right medication and management plan, the progression of Chronic Kidney Disease (CKD) can be slowed significantly. It is important to detect any kidney damage early.
 To find out if you are in a 'high risk' population group, go to our DETECTION webpage
You can lose up to 90 per cent of kidney function without realising it
At this stage it is difficult to prevent further serious problems. The rate of kidney failure is climbing in Australia at around 6% each year. One-third of Australians are at risk of kidney disease. More worrying is, many people are unaware of these risks. Up to 2 million Australians could have some form of kidney disease and not know it.
Be kind to your kidneys, kidney function is essential for life. Our body cannot function when both kidneys stop working. Kidney function is as important as your heartbeat!
The role of our kidneys is often underrated when we think about our health. Although only small organs, the kidneys are responsible for removing waste and fluid from your body, help to control blood pressure, assist with the production of red blood cells and help keep our bones strong.
You CAN lower your risk of CKD and other chronic diseases
Lifestyle diseases, like diabetes and cardiovascular conditions can also cause damage to your kidneys. Significant evidence indicates being overweight or obese, not getting enough physical activity, smoking, harmful alcohol consumption and unhealthy eating - are major risk factors for many chronic diseases.
It is never too late to make positive changes to your lifestyle - eating well and keeping active can improve long term health and help to maintain good kidney function. To protect your kidneys, these tips can help:
WHAT IS A KIDNEY HEALTH CHECK? HOW IS KIDNEY FUNCTION MEASURED?
 If you are in an 'at risk' population group' you should have a regular Kidney Health Check which consists of:
Our KEY kidney health messages focus on the importance of maintaining a balanced lifestyle. This is important for the 1 in 3 Australians who is ‘at increased risk’ of kidney disease.
What is eGFR? You should know your 'number' eGFR stands for ‘estimated Glomerular Filtration Rate’
Your eGFR is a measure of your kidney function - and should be a number you understand. The glomerular filtration rate measures how well your kidneys filter the wastes from your blood and is the best measure of kidney function. It helps to determine if there is any kidney damage. The higher the filtration rate, the better the kidneys are working. Normal filtration rate is about 100 millilitres per minute, or 100 mL/min.
If your result is over 60 - your kidney function is normal or close to normal. You may still have some kidney damage or be at risk of kidney disease and require ongoing monitoring, particularly if you have one or more high risk factors. Your doctor may decide to monitor your kidney function, suggest treatments and/or discuss healthy lifestyle choices.
A value below 60 suggests some kidney damage - to confirm this, your doctor will most likely repeat the blood test to decide if you have chronic kidney disease. Monitoring changes to your eGFR also tells your doctor how fast or slowly your condition is progressing.
 It is difficult to calculate the exact rate at which your kidneys are working so a formula has been developed to estimate your GFR. This formula uses your age, gender and the level of creatinine in your blood.
Creatinine is a waste product made by the muscles. It is usually removed from the blood by the kidneys before passing out in the urine. When the kidneys aren’t working well, creatinine stays in the blood.
TESTS TO DETERMINE THE MEASURE OF YOUR KIDNEY FUNCTION
If your doctor orders a blood test to learn more about your kidney function, an eGFR result is usually provided automatically by the pathology laboratory along with your blood concentration and creatinine results.
Below are simple brief explanations of what the different analyses are for, and what the different results mean. Your eGFR result helps your doctor to determine how well your kidneys are working. Also refer to our fact sheets Proteinuria, Blood in the Urine and eGFR estimated Glomerular Filtration Rate.
There are five levels of kidney disease, are also known as ‘stages’ Your doctor uses these stages as a guide for deciding which treatment is best for you. Treatment also depends on the cause of your kidney damage. Controlling diabetes and high blood pressure can help to slow or prevent further kidney damage. It also reduces the risk of other health problems, such as heart attacks and strokes.
Your doctor may order some of the following tests to check for other health conditions, including protein in your urine (proteinuria), blood in the urine (haematuria) and diabetes and measure your blood pressure. These tests are also done regularly in the early stages of CKD.
Tests for Anaemia
- Haemoglobin, Hb (“blood count”) - Is a protein found in red blood cells; it carries oxygen to all the body’s cells from the lungs.
- Transferrin saturation (TSAT) - Indicates the proportion of the iron-transporting protein transferrin,
which binds iron.
- Ferritin - An iron-binding protein which is used as an indicator of the amount of iron in the body.
Tests for minerals in the body
- Potassium - An important substance needed by all body cells. Excess or deficient potassium levels can cause an irregular heartbeat.
- Sodium - A substance which together with chloride makes up common salt. High levels of sodium may
indicate dehydration, but sodium concentration is a poor indicator of the body’s total sodium content.
- Creatinine - A muscle waste product. Levels rise in CKD and it is routinely screened to assess kidney function.
- eGFR - By combining the result of your blood creatinine level with your age and gender, your kidney function is measured using a special formula to provide an ‘estimated glomerular filtration rate’ or eGFR.
- Urea - A waste and breakdown product of protein in the body and food. Levels increase in CKD, but they decrease with lower protein intake.
TESTS AND ANALYSIS
Regular testing
- Albumin - An important protein in the blood. One of its functions is to keep the fluid in its place in the blood circulation.
- Calcium - Is needed for healthy bones and teeth. Most of the cells in the body need calcium to work properly.
- Phosphate - In conjunction with calcium, phosphate is instrumental in skeletal formation and also helps to regulate the acid-base balance in the body. In CKD phosphate levels increase.
Tests for proteins
- Albumin - An important protein in the blood. One of its functions is to keep the fluid in its place in the blood circulation.
Tests for hormones
- Parathyroid hormone, PTH - Regulates the calcium balance in the body. If the PTH level is too high, calcium is released from the skeleton, causing serious bone disease and the calcium level in the blood increases.
Tests for cholesterol
- Cholesterol - Blood lipids. The overall cholesterol level is often normal or low in advanced CKD and is not directly related to the risk of heart disease the way it is in people with healthy kidneys.
- LDL-cholesterol - The “bad” cholesterol. Levels do not necessarily increase in CKD.
- HDL-cholesterol - The “good” cholesterol. In CKD the HDL level is often low.
- Triglycerides - the most common type of fat stored in your body. Usually only a small amount is found in your blood. Triglycerides may not cause fatty deposits in your arteries but are often linked to low HDL.
Tests for Diabetes
- Glucose - Blood glucose monitoring is a measurement of glucose (sugar) in the blood. Values can vary depending on physical activity, meals and insulin administration. Your glucose level is raised in diabetes
- Glycosylated haemoglobin (HbA1c) - A test that measures the amount of glycosylated haemoglobin in the blood. Glycosylated haemoglobin is a molecule in red blood cells that attaches to glucose (blood sugar). There is higher levels of glycosylated haemoglobin if you have more glucose in your blood.
Urine tests
- Urine dipstick - Leukocytes, white blood cells in the urine which may be elevated in urinary tract infections.
- Erythrocytes - The presence of red blood cells in the urine can be a common occurrence in kidney disease, but it is abnormal if found in healthy people.
- Albumin/protein - Protein excretion in the urine - the lower the better.
A routine kidney blood test is a general marker of kidney function
If a blood test is abnormal it does not reveal what is causing the kidney problem. Therefore, if you have an abnormal result you may need further tests to find the cause of a kidney problem e.g. urine tests, other blood tests, scans, X-rays, kidney biopsy, etc.
Non‐invasive tests used to assess your health
- Blood pressure - can be measured in a number of ways. A stethoscope and an arm cuff attached to either a special pressure device called a sphygmomanometer is often used. An automatic machine may be used in certain situations.
- Urine dipstick ‐ uses a chemically treated test strip to check your urine. The strips will change colour if there are higher than normal levels of substances like protein, blood or glucose (sugar).
- X‐rays ‐ use energy beams of very short to be able to see body parts such as bones and organs.
- An ultrasound - examination of the kidneys, prostate or bladder using sound waves to outline the structure of organs.
- Computerised Tomography (CT) Scan or Magnetic Resonance Imaging (MRI) - uses radio‐frequency wavelengths and a strong magnetic field rather than x‐rays to provide clear and detailed pictures of internal organs and tissues.
Some diagnostic invasive tests include:
- Blood tests ‐often used as a starting point to identify the cause of a health problem by analysing chemicals in your blood, eg. creatinine levels (waste product made by muscles).
- Kidney biopsy ‐ a needle is passed through your skin into the kidney and a small piece of kidney tissue is removed for examination under a microscope. Local anaesthetic is used and it is a relatively painless procedure. There are no nerves in the kidney.
- Fistulagram is used to check fistula function - dye is injected into your fistula to allow its structure to show up on an X‐ray.
- Cystoscopy ‐uses a thin, flexible, tube‐like telescope called a cystoscope to view the bladder and kidney.
- Intravenous Pyelogram (IVP) - set of X‐rays done after dye has been injected into a vein to view the kidneys.
Quick links Fact Sheets - Health Publications - Transplantation
UPDATED 2 FEBRUARY 2012
Disclaimer: This information is intended as a general introduction to this topic, and is not meant to substitute for your doctor's or health professional's advice. All care is taken to ensure the information is relevant and applicable to each Australian state. It should be noted Kidney Health Australia recognises each person's experience is individual and variations do occur in treatment and management due to personal circumstances. Always consult your doctor or health professional for personal health advice. |