Renal Function - Indirect Markers

Indirect Markers

Most doctors use the plasma concentrations of the waste substances of creatinine and urea (U), as well as electrolytes (E), to determine renal function. These measures are adequate to determine whether a patient is suffering from kidney disease.

However, blood urea nitrogen (BUN) and creatinine will not be raised above the normal range until 60% of total kidney function is lost. Hence, the more accurate Glomerular filtration rate or its approximation of the creatinine clearance is measured whenever renal disease is suspected or careful dosing of nephrotoxic drugs is required.

Another prognostic marker for kidney disease is an elevated level of protein in the urine. The most sensitive marker of proteinuria is elevated urine albumin. Persistent presence of more than 30 mg albumin per gram creatinine in the urine is diagnostic of chronic kidney disease (Microalbuminuria is a level of 30–299 mg/g; a concentration of albumin in the urine that is not detected by usual urine dipstick methods).

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