kidney failure in dogs blood test results

Explaining Your Kidney Test Results: A Tool for Clinical Use

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How well are your kidneys working? Explaining your kidney test results

Your GFR result on ___________ (Date), was _________.

• A GFR of 60 or higher is in the normal range.
• A GFR below 60 may mean kidney disease.
• A GFR of 15 or lower may mean kidney failure.

What is GFR?

GFR stands for glomerular filtration rate. GFR is a measure of how well your kidneys filter blood.

Your urine albumin result on _____________ (Date), was ___________.

• A urine albumin result below 30 is normal.
• A urine albumin result above 30 may mean kidney disease.

What is urine albumin?

Albumin is a protein found in the blood. A healthy kidney does not let albumin pass into the urine. A damaged kidney lets some albumin pass into the urine. The less albumin in your urine, the better.

Your blood pressure result on _____________ (Date), was ___________.

Controlling your blood pressure may help to protect your kidneys.

What your kidneys do

You have two kidneys. Their main job is to filter wastes and extra water out of your blood to make urine.

How your kidneys are checked

Two tests are used to check for kidney disease.

• A blood test checks your GFR, which tells how well your kidneys are filtering.
• A urine test checks for albumin in your urine, a sign of kidney damage.

Why your kidneys are being checked

You need to have your kidneys checked because you can't feel kidney disease. Kidney tests are very important for people who have diabetes, high blood pressure, or heart disease. These conditions can hurt your kidneys.

What happens if you have kidney disease

Kidney disease can be treated. The sooner you know you have kidney disease, the sooner you can get treatment to help delay or prevent kidney failure. Treating kidney disease may also help prevent heart disease.

Treatment goals are to:

• Keep your GFR from going down
• Lower your urine albumin

• Keep your blood pressure, blood glucose and blood cholesterol in your target range.
• Choose foods that are healthy for your heart and cut back on salt.
• Be more physically active.
• If you smoke, take steps to quit.
• Take medicines the way your provider tells you to.

For Providers: Educating patients about chronic kidney disease

Four Key Concepts and Talking Points

1. Talk to patients about their kidneys, CKD, and their risk.

What is CKD? CKD (chronic kidney disease) means the kidneys are damaged and may no longer filter blood well. This damage happens over many years. As more damage occurs, the kidneys are unable to keep the body healthy - then dialysis or a kidney transplant may be needed to maintain health.

How can I lower my risk for CKD? The steps you take to manage your diabetes and high blood pressure also help protect your kidneys. Choosing healthy foods, quitting smoking, and being more physically active are all important steps.

2. Communicate the importance of testing and how CKD is diagnosed.

What are the symptoms of CKD? Most people with CKD have no symptoms until their kidneys are about to fail. The only way to know if you have kidney disease is to get tested. The sooner kidney disease is found, the sooner you can take steps to begin treatment and keep your kidneys healthier longer.

How do you check for CKD? A blood test and a urine test are used to find kidney disease. Because you are at risk, you should get these tests regularly:

• GFR - A blood test measures how much blood your kidneys filter each minute, which is known as your glomerular filtration rate (GFR).
• Urine Albumin - A urine test checks for albumin in your urine. Albumin is a protein that can pass into the urine when the filters in the kidneys are damaged.

3. Explain the progressive nature of CKD and the basics of treatment.

Can CKD get better? CKD usually will not get better and is likely to get worse. Treatment helps slow kidney disease and keep the kidneys healthier longer.

How is CKD treated? Treatment includes keeping blood pressure at the level set by your provider, eating foods with less salt and the right amount of protein, and controlling blood sugar if you have diabetes.

Are there medications for CKD? People with CKD often take medicines to lower blood pressure, control blood sugar, and lower blood cholesterol. Two types of blood pressure medications - ACE inhibitors and ARBs - can slow CKD and delay kidney failure, even in people who do not have high blood pressure.

4. Begin to speak about dialysis and transplantation.

Will I ever need dialysis? With proper management, you may never need dialysis or, at least, not for a very long time. But if your kidneys fail, we will need to choose a treatment that can replace the job of your kidneys to maintain health. There are two types of dialysis - one is done at home daily and the other is done in a dialysis center three times a week.

Is kidney transplant an option? You may be able to receive a kidney transplant. The donated kidney can come from an anonymous donor who has recently died or from a living person. A kidney transplant is a treatment - not a cure.

Creatinine test

Overview

A creatinine test is a measure of how well your kidneys are performing their job of filtering waste from your blood.

Creatinine is a chemical compound left over from energy-producing processes in your muscles. Healthy kidneys filter creatinine out of the blood. Creatinine exits your body as a waste product in urine.

A measurement of creatinine in your blood or urine provides clues to help your doctor determine how well the kidneys are working.

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Why it's done

Your doctor or other health care provider may order a creatinine test for the following reasons:

• To make a diagnosis if you have signs or symptoms of kidney disease
• To screen for kidney disease if you have diabetes, high blood pressure or other conditions that increase the risk of kidney disease
• To monitor kidney disease treatment or progression
• To monitor for side effects of drugs that may include kidney damage or altered kidney function
• To monitor the function of a transplanted kidney

How you prepare

A standard blood test is used to measure creatinine levels in your blood (serum creatinine). Your doctor may ask you not to eat (fast) overnight before the test.

For a creatinine urine test, you may need to collect urine over 24 hours in containers provided by the clinic.

For either test, you may need to avoid eating meat for a certain period before the test. If you take a creatine supplement, you'll likely need to stop use.

What you can expect

For a serum creatinine test, a member of your health care team takes a blood sample by inserting a needle into a vein in your arm.

For a urine test, youll need to provide a single sample in the clinic or collect samples at home over 24 hours and return them to the clinic.

Results

Results from creatinine in blood or urine are measured and interpreted in many ways, including the following:

Serum creatinine level

Creatinine usually enters your bloodstream and is filtered from the bloodstream at a generally constant rate. The amount of creatinine in your blood should be relatively stable. An increased level of creatinine may be a sign of poor kidney function.

Serum creatinine is reported as milligrams of creatinine to a deciliter of blood (mg/dL) or micromoles of creatinine to a liter of blood (micromoles/L). The typical range for serum creatinine is:

• For adult men, 0.74 to 1.35 mg/dL (65.4 to 119.3 micromoles/L)
• For adult women, 0.59 to 1.04 mg/dL (52.2 to 91.9 micromoles/L)

Glomerular filtration rate (GFR)

The measure of serum creatinine may also be used to estimate how quickly the kidneys filter blood (glomerular filtration rate). Because of variability in serum creatinine from one person to another, the GFR may provide a more accurate reading on kidney function.

The formula for calculating GFR takes into account the serum creatinine count and other factors, such as age and sex. A GFR score below 60 suggests kidney disease. The range of scores below 60 may be used to monitor treatment and disease progression.

Creatinine clearance

Creatinine clearance is a measure of how well the kidneys filter creatinine out of the bloodstream for excretion in urine.

Creatinine clearance is usually determined from a measurement of creatinine in a 24-hour urine sample and from a serum sample taken during the same time period. However, shorter time periods for urine samples may be used. Accurate timing and collection of the urine sample is important.

Creatinine clearance is reported as milliliters of creatinine per minute per body surface area (mL/min/BSA). The typical range for men, 19 to 75 years old, is 77 to 160 mL/min/BSA.

The typical range, by age, for creatinine clearance in women is as follows:

• 18 to 29 years: 78 to 161 mL/min/BSA
• 30 to 39 years: 72 to 154 mL/min/BSA
• 40 to 49 years: 67 to 146 mL/min/BSA
• 50 to 59 years: 62 to 139 mL/min/BSA
• 60 to 72 years: 56- to 131 mL/min/BSA

Standard measures have not been determined for older adults.

Results lower than the typical range for your age group may be a sign of poor kidney function or conditions that affect blood flow to your kidneys.

Albumin/creatinine ratio

Another interpretation of urine creatinine count is called the albumin/creatinine ratio. Albumin is a protein in blood. Healthy kidneys generally don't filter it out of the blood, so there should be little to no albumin found in the urine.

Albumin/creatinine ratio describes how much albumin is in a urine sample relative to how much creatinine there is. The results are reported as the number of milligrams (mg) of albumin for every gram (g) of creatinine. Results indicating a healthy kidney are:

• For adult men, less than 17 mg/g
• For adult women, less than 25 mg/g

A higher than typical result may be a sign of kidney disease. In particular, the result may indicate a complication of diabetes called diabetic nephropathy, or diabetic kidney disease.

Your doctor or other health care provider will discuss the results of a creatinine test with you and help you understand what the information means for a diagnosis or treatment plan.

Feb. 09, 2023

Kidney Disease in Dogs: Signs, Symptoms, and Treatment

Your dogs kidneys are essential organs that filter waste products from the bloodstream. When the kidneys are weakened, either by acute or chronic kidney disease, your dogs health could suffer. Because kidney disease progresses over time, its important to learn the common symptoms so tha you can recognize them. If you catch kidney disease in dogs early on, treatment can slow down the progression and allow your dog to live longer.

What Is Kidney Disease in Dogs?

Kidney disease in dogs is sometimes called renal or kidney insufficiency because it occurs when a dogs kidneys stop doing their job as efficiently as they should. The main job of the kidneys is to help clear and excrete waste products from the blood and convert them to urine, says Dr. Jerry Klein, Chief Veterinary Officer for the AKC. If the kidneys are not working properly, these waste products can build up in the blood, causing detrimental effects.

Dogs can get either acute kidney disease, which develops suddenly, or chronic kidney disease (CKD), which develops slowly and worsens over an extended period. Both involve loss of kidney function, but they result from different circumstances. Acute kidney disease is a sudden attack or injury to the kidney, whereas chronic kidney disease is a slow, degenerative loss of kidney function, Dr. Klein explains.

What Causes Kidney Disease in Dogs?

Dr. Klein warns that kidney disease could be caused by a lot of things, including infection (such as with the bacteria that causes leptospirosis), trauma, genetics, drugs, toxins, cancer, mechanical obstructions (like kidney stones), and degenerative diseases (where the job and form of the affected body part get worse over time). Anything that decreases blood flow to the kidneys, such as dehydration or heatstroke, can cause the kidneys to fail.

Acute kidney disease in dogs can be caused by exposure to hazardous materials, including toxic plants such as lilies, certain drugs, harmful foods such as grapes or raisins, or antifreeze. Puppy-proofing your home and yard can keep your dog away from potentially harmful items or foods that could be toxic.

Chronic kidney disease in dogs is also associated with growing older. Because kidney tissue cant regenerate once its damaged, the kidneys can wear out over time. As small-breed dogs often live longer than large-breed dogs, they tend to show early signs of kidney disease at an older age10 years old or more, compared to as young as 7 for the large breeds.

What Are the Symptoms of Kidney Disease in Dogs?

The earliest signs of kidney disease in dogs are increased urination and therefore increased thirst. Other symptoms dont usually become apparent until about two-thirds of the kidney tissue is destroyed. So, in the case of CKD, the damage may have begun months or even years before the owner notices. Because of this, its common for the signs of kidney disease in dogs to seem like they came out of the blue when in fact, the kidneys have been struggling for a long time.

Other signs of chronic kidney disease in dogs to watch for include:

Dr. Klein says there are some rarer symptoms of kidney disease in dogs to be aware of, as well. On occasion, there can be abdominal painurinary obstructions or stonesand in certain instances, one can see ulcers in the oral or gastric cavity. In extreme cases, little or no urine is produced at all.

What Are the Stages of Chronic Kidney Disease in Dogs?

Kidney disease in dogs is measured in stages. Many veterinarians use the IRIS scale, which has four stages. Blood work measurements like creatinine and SDMA (biomarkers for kidney function) allow your vet to assign your dog to a particular stage which will determine the exact treatment.

Dr. Klein explains, The stages determine how well the kidneys can filter waste and extra fluid from the blood. As the stages go up, the kidney function worsens. In the early stages of CKD, the kidneys are still able to filter out waste from the blood. In the latter stages, the kidneys must work harder to filter the blood and in late stages may stop working altogether.

How Is Kidney Disease in Dogs Treated?

Dialysis (a medical procedure that removes waste products and extra fluid from the blood) is far more common in humans than in dogs, although peritoneal (kidney) dialysis can be performed in some cases. On rare occasions, surgical kidney transplant is possible in dogs.

But Dr. Klein specifies that depending on the type and stage of kidney disease, the main treatments for CKD are diet changes and administration of fluids, either directly into the veins (intravenous) or under the skin (subcutaneous). The balancing and correction of electrolytes are extremely important in the management of kidney patients, he explains.

Proper nutrition is needed, and there are many available diets formulated for cats and dogs with kidney issues, some by prescription only. Your veterinarian can help guide you to the most appropriate diet for your pet.

Because kidney disease, particularly in the late stages, can cause a dog to lose their appetite, it can be difficult to encourage your dog to eat enough. Dr. Klein advises, There are medications used as appetite stimulators available, such as the prescription drug mirtazapine. Capromorelin has recently been FDA-approved for dogs to address appetite in chronic kidney disease.

When Do You Need to Call Your Vet?

The prognosis and expected life span for a dog with kidney disease depend on the type of disease, the speed of progression, and underlying conditions present in the dog. However, the more serious the disease, the poorer the outcome. Thats why its so crucial to catch the illness early on.

According to Dr. Klein, In chronic kidney disease, there are methods, such as diets and medications, that can be used to lessen the burden of work the kidneys need to do and may help slow down the progression from one stage to the next. In acute kidney disease, there is less time and fewer choices available to prevent further damage to the kidneys and to try to jump-start the kidneys to get them to function normally.

Regular veterinary exams, including bloodwork, are an excellent way to spot kidney problems before the outward symptoms become apparent. And if you notice any of the above signs, dont hesitate to get your dog to the vet for further testing. It can make a huge difference in preserving kidney function and your dogs well-being for as long as possible.