Laboratory assessment of kidney diseases

Fu Keung Li and Stephen Ka-Nung Ho

Department of Medicine, Queen Mary Hospital, The University of Hong Kong

The kidney is a vital excretory organ. Accurate assessment of renal function is important in order to detect early derangement. Though the measurement of glomerular filtration rate (GFR) is the gold standard for evaluating kidney function, the test procedure is associated with significant practical difficulties, and therefore is not routinely utilized. Quantifying serum markers of renal function is the most commonly used method for estimating renal function. Despite their intrinsic flaws, urea and creatinine are the most accepted serum markers of renal function.

Urinalysis is a simple but informative test for detecting kidney abnormalities. A panel of biochemical tests are usually included in the analysis. Proteinuria is an early indicator of glomerular disease. Hematuria and leukocyturia are also abnormal indicators which mandate further investigation.

The definitive diagnosis for patients with kidney disease sometimes requires a renal biopsy. Percutaneous biopsy of cores of kidney tissue and microscopic examination by various techniques are indicated on many occasions. The inherent risk, however, obligates due caution be taken in patient selection.

Renal function assessment, urinalysis, and kidney biossy serve complementary roles in the detection and diagnosis of kidney disease. Their clinical utilization will be discussed in this review.

Keywords: markers, kidney, glomerular filtration rate

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