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Diagnosis of End-stage Renal Disease (ESRD)

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The doctor will ask about your symptoms and medical history. A physical exam will be done. Tests may include:

Blood Urea Nitrogen (BUN) and Creatinine —to see whether your kidneys are working properly. If they are not filtering the blood properly, the blood will contain excess amounts of creatinine and urea. Creatinine is a byproduct of muscle function, while urea is a waste product of protein metabolism.

Other Commonly Ordered Blood Tests —including complete blood count; calcium, phosphorus, and parathyroid hormone; blood electrolytes; and potassium levels

Estimated Glomerular Filtration Rate (GFR) —a measurement of how well the kidneys are processing wastes. Your doctor can calculate the GFR based on gender, age, body size, and blood creatinine level.

Stage Glomerular Filtration Rate (GFR)
1 over 90 mL/min (normal)
2 60-89 mL/min (mild decrease)
3 30-59 mL/min (moderate decrease)
4 15-29 mL/min (severe decrease)
5 under 15 mL/min (kidney failure or end-stage renal disease)

Urine Tests —You may be asked to collect urine in a special container over a 24-hour period. This test will also show how well your kidneys are clearing creatinine. The amount of urine you produce is also significant. If your kidneys are failing—or starting to fail—you may produce little or no urine.

Renal Imaging —the use of ultrasound , MRI scan , or CT scan to take pictures of the kidneys. These pictures will show whether urine flow is blocked or whether there is a change in the size of the kidneys.

Kidney Biopsy —A small piece of kidney may be surgically removed and sent to a laboratory in order to determine the cause of kidney failure.

Revision Information

  • Chronic kidney disease. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated April 22, 2013. Accessed July 2, 2013.

  • End-stage renal disease. National Institute of Diabetes & Digestive & Kidney Diseases website. Available at: http://www2.niddk.nih.gov/Research/ScientificAreas/Kidney/KEB.htm. Updated September 15, 2010. 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.