Beyond 50 or patient at risk – what to do?

The answer to this question is two-fold: Testing and therapy adherence. Unfortunately, there is as yet no cure for chronic kidney disease. However, it is totally feasible to slow down or even stop the progression of the disease. The key to therapeutic interventions is the timely discovery of declining kidney function – ideally before irreversible damage and health impairments have occurred. On this basis, severe complications may be delayed for a long time and can even be prevented.

The tests for diagnosing early stages of kidney disease are not complicated! Simple laboratory or point-of-care tests can reveal the kidneys’ state.

Appointments with a general practitioner or a nephrologist to check kidney function are recommended for individuals above 50 years old or patients suffering from hypertension, diabetes or other risk factors.

Some symptoms may be present but they are not specific and they may also occur in case of other diseases; if they occur in chronic kidney disease, most of them only occur in later stages:

• Fatigue
• Lack of energy
• Trouble with thinking clearly
• Lack of appetite
• Trouble with sleeping
• Dry and itchy skin
• Muscle cramps at night
• Swollen feet and ankles
• Swollen eyes, especially in the morning
• Frequent need to void urine, especially at night

Different blood and urine tests can provide information about the individual’s kidney function. Values out of the normal range can have different causes and usually point to kidney disease. Mutual consideration of blood and urine values has high significance. Values of serum creatinine are required to calculate estimated glomerular filtration rate, and together with urinary albumin this allows for an assessment of kidney function. In case kidney disease is suggested, further examinations can provide more information.

Glomerular filtration rate, abbreviated GFR, is one of the fundamental cornerstones for kidney disease diagnostics. GFR is an important indicator for kidney function because it measures the speed at which the kidneys cleanse blood. A low GFR reveals that the kidneys may not work effectively and that excretion of metabolic waste products and toxins from the body is retarded. On the other hand, a high GFR indicates a high capacity of cleansing blood effectively but if it is above normal, it may be a predictor of later damage, especially in diabetics.

Besides eGFR, it is required to test the urine for any amount of the blood protein albumin. A simple urine test with a regular dipstick is sufficient for this test. A laboratory test for the amount of albumin is even more meaningful, as it allows for calculation of the ratio of albumin to creatinine in urine. This value is considered the best method for diagnosing early deviations of kidney function.