How Nephrologists Diagnose Kidney Diseases

Shivinder Jolly of Kitchener, Ontario, focuses his medical expertise on nephrology, the science of kidney diseases. Board certified in nephrology and hypertension, Shivinder Jolly is on the medical staff of Grand River and St. Mary’s Hospitals in Kitchener and Cambridge Memorial Hospital in Cambridge.

Nephrologists use at least two tests to determine whether a patient has a kidney disorder. The first test is based on the presence of creatinine, which is manufactured by muscles. A creatinine level of 1 is considered normal. However, a level of 4 or 5 indicates a need for dialysis.

In some cases, the creatinine level is misleading. It can be affected by gender differences in muscle mass, can also vary by ethnicity: People of European ancestry may respond differently to creatinine testing than people of African ancestry.

Nephrologists use a second diagnostic measure, the BUN (blood urea nitrogen) test. BUN describes how many protein products exist in your body.

Many conditions affect the BUN level. The use of steroids, bleeding in the gastro-intestinal tract, and amount of hydration all affect it. A high BUN level suggests toxicity, while a low level may indicate malnutrition.

For these reasons, nephrologists rely on both tests for a more accurate picture. For example, low creatinine and BUN results could both point to a need for dialysis, even though they measure different chemicals.