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Diagnosis of Chronic Kidney Disease
Blood Urea Nitrogen (BUN) and Creatinine Levels
Other Commonly Ordered Blood Tests
- Complete blood count
- Calcium, phosphorus, parathyroid hormone
- Potassium, uric acid, albumin
Urine Protein Level
- 24-hour urine protein—measures the amount of protein in urine produced over a 24-hour period
- Dipstick for urine protein—measures the amount of protein in a single urine sample taken first thing in the morning
- Microalbumin screening in type 1 and type 2 diabetic patients
- 24-hour urine albumin—measures the amount of albumin in a sample of all urine produced in 24 hours
- Dipstick for urine albumin—measures the amount of albumin in a single urine sample
- Protein-to-creatinine ratio—compares the amount of protein to the amount of creatinine in a urine sample
- Albumin-to-creatinine ratio—compares the amount of albumin to the amount of creatinine in a urine sample
Estimated Glomerular Filtration Rate
- Body size
- Blood creatinine level
|Stage||Glomerular Filtration Rate (GFR)|
|1||Over 90 mL/min (normal)|
|2||60 to 89 mL/min (mild decrease)|
|3||30 to 59 mL/min (moderate decrease)|
|4||15 to 29 mL/min (severe decrease)|
|5||under 15 mL/min (kidney failure or end-stage renal disease)|
Urinary Tract Ultrasound or CT Scan
- Complements 3 and 4 for possible collagen vascular disease, immune complex disease, or hepatitis C-related disease
- Antineutrophil cytoplasmic antibody assay for possible vasculitis
- Protein electrophoresis for possible multiple myeloma
Are you at increased risk for chronic kidney disease? National Kidney Foundation website. Available at: http://www.kidney.org/atoz/pdf/11-10-1814.pdf. Published 2010. Accessed July 2, 2013.
Chronic kidney disease. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated April 22, 2013. Accessed July 2, 2013.
Chronic kidney disease: patient information handout. American Academy of Family Physicians website. Available at: http://familydoctor.org/online/famdocen/home/common/kidney/832.html. Updated November 2010. Accessed July 2, 2013.
Kidney disease basics. National Kidney Disease Education Program website. Available at: http://www.nkdep.nih.gov/patients/kidney%5Fdisease%5Finformation.htm. March 1, 2012. Accessed July 2, 2013.
Johnson CA, Levey AS, et al. Clinical practice guidelines for chronic kidney disease in adults: Part II. glomerular filtration rate, proteinuria, and other markers. Am Fam Phys. 2004; 70:1091-1097.
Snively CS, Gutierrez C. Chronic kidney disease: prevention and treatment of common complications. Am Fam Phys. 2004;70:1921-1930.
- Reviewer: Adrienne Carmack, MD; Michael Woods, MD
- Review Date: 07/2013
- Update Date: 05/11/2013