Evaluation of renal disease progression: Markers

And there is a very famous calculation formula for calculating serum creatinine to creatinine clearance and that’s called cockcroft and gault method And these in this method I think a lot of people actually learn it previously and one thing I want to remind is about using lean body weight that means using the muscle to calculate calculator creatinine because you know for the patient with overweight they may have a lot of fat but that couldn’t produce creatinine So using lean body weight is a very important point by calculating this as creatinine into creatinine clearance and also need to remember the factor for female and lean body weight formula could be different in different countries and hereby thus the formula from textbook but in your own country for example, a lots of Asian country, the calculation and the the cockcroft for lean body weight could be very different.

So you could actually check your local reference for lean body weight. And BUN, as a very important matter to generally to look at the function for filtration and urea as final product of protein catabolism and it can actually help us to know the filtration and the absorption for kidney and the normal level is around 10 to 50 mg/dL but however when a patient has decreased kidney function the patient may have some level above 15 or 18 and …but because this is a very specific matter. So you can actually differentiate if your patient has other issues or other problems related to this increase BUN function.

So we need to check implication if patient has very high protein diet; or the patient has febrile illness infection with high catabolism. So they may have a lot of protein breakdown or using some special medication for example steroids, tetracycline and or the patient has a GI bleeding or hyperthyroidism. So after removing these factors, you may actually see the BUN level back to normal and less indicating that the patient did not have a CKD. And UA, urine analysis And urine analysis is the same.

It actually could tell you a lot of different diseases not only CKD and we normally check color and those chemical property for urine and also check out pH value and concentrating value as the important because there’s an indication about provocations fruit intake and those are the patient’s kidney function. so the gravity is important and osmolality of urine is important and for protein content it actually tells you lots of a disease progression and also probably some issue about infection and also finally that could be also indicator about CKD. And so there will be other factor we want to check including RBC why Y bar cells appearance in urine or some casts and that’s also important.

And one very important factor is about sodium excretion. And usually there will have a big very important calculation about differentiation diseases.