Kidney Disease Diagnoses at Southwest Virginia Nephrology Medicine, PC
Southwest Virginia Nephrology Medicine in Roanoke will thoroughly examine you to determine if you have a kidney disorder or in the early stages of Chronic Kidney Disease (CKD). It is important for you not only become aware you have a renal problem, but also the steps that you can take to keep your kidneys healthier longer. To detect and manage chronic kidney disease (CKD), you need systematic screening, linked with your cardiovascular (CVD), hypertension and diabetes screening programs. An important first step is to get tested, since the absence of any noticeable symptoms does not exclude you from having a renal disorder.
Our kidney doctor follows the kidney disease diagnostic process to determine if you have kidney issues as follows:
- History and Physical Examination – History and physical examination are key to the diagnostic workup in nephrology. This includes your family history, medical history, medications, clinical pharmacology, diet, exercise habits, blood pressure management, diabetes management, drug use, occupation and anything else that we need to know. Examination typically includes an assessment of volume state, blood pressure, skin, joints, abdomen and flank. See high risk factors – click here.
- Urinalysis – Examination of your urine allows our kidney specialist to direct assessment you for possible kidney problems, which may be suggested by appearance of blood in the urine (haematuria), protein in the urine (proteinuria), pus cells in the urine (pyuria) or cancer cells in the urine. A 24-hour urine collection can be used to quantify daily protein loss, urine output, creatinine clearance or electrolyte handling by the renal tubules. Measuring urine output is one of the simplest tests to help diagnose kidney failure. For example, low urinary output may suggest that kidney disease is due to a urinary blockage, which can be caused by multiple illnesses or injuries.
- Blood Tests – We use basic blood tests to check the concentration of hemoglobin, platelets, sodium, potassium, chloride, bicarbonate, urea, creatinine, calcium, magnesium or phosphate in your blood. All of these may be affected if you have kidney problems. The serum creatinine concentration is used to estimate the function of your kidney, called the creatinine clearance or estimated glomerular filtration rate (GFR). Higher levels of creatinine indicate a lower glomerular filtration rate and as a result a decreased capability of your kidneys to excrete waste products. Creatinine levels may be normal in the early stages of Chronic kidney disease (CKD), and the condition is discovered if urinalysis (see above) shows the kidney is allowing the loss of protein or red blood cells into the urine. Our kidney doctor can order more specialized tests to discover or link certain systemic diseases to kidney failure such as infections (hepatitis B, hepatitis C), autoimmune conditions (systemic lupus erythematosus, ANCA vasculitis), paraproteinemias (amyloidosis, multiple myeloma) and metabolic diseases (diabetes, cystinosis).
- Imaging Tests – Our Nephrologist, Dr Matthews identifies blockages, structural abnormalities of your kidneys and urinary tract with imaging tests. These may include medical ultrasonography/ultrasound, computed axial tomography (CT), scintigraphy (nuclear medicine), angiography or magnetic resonance imaging (MRI).
- Renal Biopsy – Less invasive testing as outlined above may not always provide a certain diagnosis and when we require a definitive diagnosis, we may perform a simple biopsy of the kidney (renal biopsy). A biopsy is performed under local anaesthetic (usually while you’re awake) to eliminate any discomfort. X-ray or ultrasound is then used to locate the kidneys and assist our kidney specialist in guiding the core biopsy needle through your skin and down into your kidney, to obtain a small sample of your kidney tissue. Your kidney tissue is then examined under a microscope, allowing direct visualization of any changes occurring within your kidney, abnormal deposits, scarring, or infectious organisms. Additionally, the pathology (causes and effects of diseases) may also stage a problem affecting the kidney, allowing some degree of prognostication (forecast or predict (something future) from present indications or signs).
Chronic kidney disease (CKD) is classified from stage 1 to 5 and as stable or progressive (for more information click here). If you have progressive CKD stages 3–4 (rate of loss of GFR > 5 ml/min/year) you have an even higher cardiovascular (CVD) risk and a much higher risk of developing renal failure with need for dialysis or transplant.
Dr. Matthews and his renal support team of SWVA Nephrology Medicine provide advanced, renal disease and disorder diagnostic services and will determine if your kidneys are healthy! If you suffer from any of the kidney disorders or you feel you are at high risk for Chronic Kidney Disease (CKD), please call the kidney specialist at Southwest Virginia Nephrology Medicine in Virginia by calling (540) 904 -5366 or complete the contact us form (click here).