Kidney Feature Lab Values

The renal function panel (aka renal function tests or RFTs) is one of the blood tests your physician will order when you have kidney disease. This test is reviewed by your doctor and renal dietitian.

Your labs can provide your healthcare providers with details of what is going on inside your body- whether you realize it or not. Let’s dive into exactly what an adult renal function panel includes.

Your doctor or kidney specialist will determine whether or not you need a renal function panel. Some of the other health conditions that may trigger a physician to order it include;

Assessing Kidney Function — Measured And Estimated Glomerular Filtration Rate

Additionally, your doctor may order the testing if you have a family history of kidney disease or show signs and symptoms of kidney issues. Some symptoms can include;

Generally, the test results are reported within 24 hours. Many doctors, however, will require “signing off” the results prior to passing them on to the patient.

A renal function panel requires a blood sample. This is taken from a vein in your arm by a phlebotomist. This may be done in your doctors office or at a separate lab location.

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Your doctor will instruct you on whether or not you need to fast. This is generally not required for the kidney function test, but could be ordered for other lab testing you may also be getting at the same time.

To fast before a blood test, you do not eat any food for the 8 to 12 hours before the appointment time. It’s important you still drink plenty of water before as dehydration can negatively affect your renal function test results.

If you have told your doctor about a family history of kidney disease, or you are already aware of your own diagnosis of kidney disease, you are likely to have a renal panel or renal function panel in your blood test results.

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These results can be drawn anywhere from monthly to annually (once per year). The timing will be based on your nephrologist or physician’s orders. Many doctors are open to having additional labs drawn when requested – but be prepared to put in work if you want to get your renal function panel drawn more frequently.

BUN is generally below 20 mg/dL but will often rise when there is kidney damage. This is because the kidneys are unable to keep up with eliminating excessive waste.

A low-protein diet can help in reducing BUN for those not on dialysis. However, if done improperly it can increase the risk of protein-energy wasting and malnutrition. This can then increase inflammation and potentially increase kidney damage. Ketoanalogues can also help lower BUN levels when paired with a low protein diet.

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Creatinine is a waste product from normal muscle metabolism and breakdown. It is not directly related to dietary protein intake over time. One study found that eating meat prior to a blood draw for creatinine testing, creatinine was falsely higher.

A normal serum creatinine level is between 0.6 – 1.2 mg/dL for males and 0.5 – 1.1 mg/dL for females. However, it can vary for many reasons , including gender, age, and activity level.

While creatinine is not directly related to nutrition, finding other culprits that impact your kidney health may help to lower or stabilize creatinine levels. This can come from dietary changes that help promote a healthy kidney!

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Albumin is a protein that is made in the liver. Your serum albumin is a measurement of how much albumin is in your blood. It was previously thought was that albumin would indicate how much protein you are eating. We now know that it is much more than just that.

Normal albumin will range from about 3.4 – 5.0 g/dL. As it can signal problems with inflammation, it will decrease when there is more inflammation.

If you’ve been hospitalized and have access to your labs, take a look at your albumin before, during, and after your hospitalization. When a person is hospitalized, they go through a lot that can be inflammatory. Once they get better the albumin can increase, indicating the healing process.

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Sodium is the most common particle in our blood outside of our cells. It helps with muscle function, acid-base balance, cellular balance, and osmotic pressure of body fluids.

Your blood test result is not a reliable measurement of your sodium intake. It is a better marker for your fluid balance.

The blood serum sodium levels are typically between 135 – 145 mEq/L. If you experience edema or swelling of extremities with excessive fluids, you may see a slightly lower sodium level. Additionally, sodium levels may also be falsely low if you drink a lot of water right before your blood draw.

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It’s been thought before that if your sodium is out of range that you should eat more/less salt. That may not necessarily be the case and may cause more issues. Before making drastic changes in your diet, it’s best to consult with a registered dietitian to help assess all factors that may be causing an out-of-range sodium level.

Potassium is the third most abundant mineral in our bodies. It acts as an electrolyte and helps with nerve conductivity, muscle contraction, and fluid balance.

High- and low-potassium values should be reviewed promptly with your physician and healthcare team as potassium plays an important role in our heart function.

Kidney Function Tests Information

Your serum bicarbonate (or carbon dioxide or CO2) is related to the acid-base balance, or pH levels, of your body. With kidney issues, the bicarbonate levels tend to decline. As a result, the body then leans towards a more acidic state.

Low bicarbonate levels have been associated with an increased risk of kidney problems. This is caused by metabolic acidosis, a common outcome of prolonged kidney damage.

By paying attention to the potential renal acid load in your diet, you may be able to keep your kidney function with healthy diet changes.

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A low level of chloride may indicate overhydration or be a result of excessive vomiting. Low chloride can also be due to other health issues like diabetic ketoacidosis, aldosterone deficiency, Addison disease, emphysema, or chronic lung diseases.

High levels of chloride can indicate dehydration. However, it can also indicate health issues including kidney disease due to the imbalance of the acid-base balance that the kidney helps with.

Phosphorus does plenty of things to help keep us healthy, such as manage how your body uses energy, build strong bones and teeth, regulate vitamin use, and help with muscle contraction (including our heart!).

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Blood serum levels of phosphorus should generally be approximately 2.5 – 4.5 mg/dL, but ranges may differ depending on the individual. Some nephrology clinics have different ranges to accommodate for the expected higher ranges of phosphorus in late-stage CKD, which may look closer to 3.0 – 5.0 mg/dL.

Even though there is some “forgiveness” with slightly higher phosphorus levels, the Kidney Disease International Outcomes Guidelines (KDIGO) still express the need to focus on striving for phosphorus within the normal range to prevent increased risk of death.

Calcium is the number one mineral stored in our body. It helps with many things including bone health and muscle contraction. General calcium levels are between 8.5 – 10.2 mg/dL.

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With many people with CKD, calcium can trend out of range. Calcium can either go above the healthy range or below. This often leads to either including or avoiding calcium supplements, depending on your labs and other health conditions.

Never take calcium supplements without first discussing them with your nephrologist. Too much calcium can lead to calcification in your soft tissues. As a result, it can lead to an increased risk of heart attack and stroke.

Glucose is considered the primary source of energy for our body. It is taken from the blood into the cells with the help of insulin. It’s important the level of glucose in our body doesn’t get too low or too high.

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The normal range for glucose is broken down into two categories: fasting or non-fasting. Non-fasting just means you ate something in the hours or day before your renal panel. Again, it’s important to find out if you should be fasting or not. A renal function panel alone does not generally require fasting.

Fasting glucose is between 70 – 100 mg/dL. For non-fasting glucose, it’s normal to have a level at or below 200 mg/dL.

The glomerular filtration rate, or GFR, is a measurement of your kidney function of blood filtration. This is a calculation based on your gender, age, size, and creatinine in your blood. This is one of the most common tests to assess your kidney function.

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A normal GFR is above 90. Some lab reports will look for a GFR of at least 60, as the function will naturally decline as we age.

GFR is associated with stages of kidney disease. Kidney failure is associated with a GFR below 15. However, not just one low value will be enough to confirm kidney issues.

A low GFR for three months can indicate kidney disease along with a diagnosis from a physician. Calculate your eGFR here .

Normal Lab Values: Complete Reference Cheat Sheet (2023)

Also known as the BUN-to-creatinine ratio or BCR, this is a calculator to evaluate waste removal. The reference range for this ratio is anywhere from 6 – 22.

Since it is a ratio,

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