How Is Chronic Kidney Disease Diagnosed?

Reviewed by: HU Medical Review Board | Last reviewed: December 2022

Chronic kidney disease (CKD) is when your kidneys are damaged and not working as they should. Getting an early diagnosis of kidney disease is very important so that the disease does not lead to kidney failure down the road.1

The kidneys are vital organs that filter extra water and waste from your blood. This filtration process creates urine. When you pee, the waste leaves your body. This is an efficient system, but when it does not work correctly, waste builds up in your body. Waste buildup can lead to major health issues.1

How is chronic kidney disease diagnosed?

CKD happens slowly over time. In the early stages of CKD, there are usually no symptoms to alert you that something is wrong. Often, the only way to discover that you have CKD is by having a doctor test your kidney function.1,2

To diagnose CKD, your doctor will do a medical history and physical exam. They may follow those with various tests and other procedures.3

Medical history and physical exam

The first step in getting a kidney disease diagnosis is a full medical history and physical exam by your doctor.3

During this visit, your doctor will go over your personal medical history. They might ask you questions about:3

  • Previous or current health conditions, like diabetes or heart disease
  • History of high blood pressure
  • Previous injuries or surgeries
  • Any medicines you are taking
  • Changes in your peeing (urinary) habits
  • Your family history of diseases

If you have a family history of kidney failure, tell your doctor. They may want to perform tests to check how well your kidneys are working and look for any changes that could arise.2

Your doctor will also perform a physical exam. In this test, they will look at your body and check your blood pressure, heart rate, and temperature.3

Blood and urine tests

To confirm a kidney disease diagnosis, doctors use 2 tests to check how well your kidneys are functioning. These are:2,3

  • Blood test – This test is called the GFR test. GFR stands for glomerular filtration rate. The test checks for a waste product called creatinine to determine how well your kidneys are filtering your blood.
  • Urine test – Also called a urine albumin-to-creatinine ratio (UACR), this test checks whether your pee contains albumin. Albumin is a protein that is normally not filtered in large amounts by the kidneys. If albumin shows up in your pee, it means that your kidneys are not working as they should.

Blood and urine tests help diagnose people with kidney disease. They also are used to monitor the kidney function of people who already have kidney disease over time.2

Imaging tests

Your doctor might also use imaging tests to get a clearer picture of your kidneys. Imaging tests help look for problems in and around the kidneys. These problems may include:3-6

  • Cysts
  • Tumors
  • Lesions
  • Blockages to urine flow
  • Inflammation

Some examples of imaging tests for kidney disease are:3-6

  • Ultrasound – Using sound waves, ultrasounds produce images of the kidneys. They are often used during a kidney biopsy procedure.
  • Kidney, ureter, and bladder (KUB) X-ray – KUB X-rays focus on the urinary tract, bladder, and kidneys. They use external radiation to produce images of the inside of the body.
  • Computed tomography (CT) scan – Using a combination of X-rays and computer technology, CT scans provide more detailed imaging of the kidneys than KUB X-rays.

Kidney biopsy

Another procedure that your doctor may recommend in some situations is a kidney biopsy. This is only done when other tests have not provided clear answers and the cause of your kidney disease cannot be explained.3,7

A kidney biopsy is a procedure in which your doctor takes a small tissue sample from your kidney to look at under a microscope. It may help them understand what is causing your kidney problems.3

For this procedure, your doctor first numbs the area. Then, they insert a long, thin needle through your skin and into your kidney to remove the tissue sample. They send the sample to a lab for further study.3

Monitor your health

You cannot regain full function of your kidneys once they are damaged. This is why it is so important to know and tell your doctor about your family history of diseases. Also, make regular doctor's appointments to get your blood work done and blood pressure checked. Monitoring your health in this way can help make sure you and your kidneys stay healthy.1

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