One of the best ways to ensure that you have the best chance possible of regaining control of a kidney disorder is by early and correct diagnosis. There are many ways that a nephrologist can tell if kidney damage or disease is the source of your ailments.
The most basic place a nephrologist may start is by attempting to feel your kidneys during a physical examination. Healthy kidneys usually are not able to be felt in kids or adults, but enlarged kidneys or a kidney tumour may be detectable. Often, a distended bladder can be detected, which can be related to kidney problems.
If kidney disease is suspected, testing of the urine will be done. A urine sample is usually collected to evaluate the level of different substances in the urine, including protein, sugars, ketones and blood. Substances are usually detected by inserting a dipstick into the urine sample, and depending how the urine reacts with the chemicals on the dipstick, it can tell the nephrologist what is present in the urine. The nephrologist may also check microscopically to see if red and white blood cells are in the urine, and also to see if there are crystals which can cause kidney stones.
If a nephrologist finds nitrates in the urine, this may indicate a urinary tract infection. Also commonly caused by urinary tract infection is the presence of leukocyte esterase. If this enzyme is detected in the urine, it means that the kidneys are inflamed for some reason.
The ability, or lack thereof, of urine to concentrate is also important in diagnosing kidney disorders. The kidneys capacity to concentrate urine decreases greatly at an early stage of a disorder that leads to kidney failure. In one test, the patient would drink no water or other fluids for half of a day. Alternatively they could receive an injection of anti-diuretic hormone. Afterward, their urine concentration is measured. With efficiently functioning kidneys, the urine should be highly concentrated. If it is not, it is a red flag that the kidneys are not doing their job properly.
In addition to concentration, a nephrologist may look for sediments. A person who has a kidney ailment will have more cells present in their urine, which can then form sediment.
Blood tests can also be used to diagnose kidney problems. Creatinine, a waste product, is increased in the blood when kidney filtration is not working effectively, and can be easily detected by a simple blood test. The levels of the substance blood urea nitrogen can also show a nephrologist how well the kidneys are functioning.
If a nephrologist feels that more detailed diagnostic work is necessary, certain imaging tests may be done. Ultrasounds are often the first imaging technique used because they are non-invasive, painless, and a great way to gauge kidney size, position, and obstruction.
Computed Tomography (CT) is used to evaluate kidney masses, and requires a contrast agent which is injected intravenously. The intravenous contrast agent can help show much detail about the arteries and veins surrounding the kidneys, about tumours (such as renal cell cancer), and about polycystic kidney disease.
A MRI can be a very useful tool to help a nephrologist detect or differentiate between tumours and cysts. MRI’s can also show disorders of kidney blood vessels.
In more serious cases, a kidney biopsy may be in order. This is when a nephrologist removes a sample of kidney tissue and examines it under a microscope. It is used to help diagnose disorders that affect blood vessels of the kidney.
Urine cytology is a microscopic examination of the urine to look for cancer cells, and is the most useful method to diagnose cancers of the kidneys and urinary tract.
A proper diagnosis of any kidney disorder is crucial. Once you know exactly what you are dealing with, you are well on your way to correctly treating the problem. If kidney damage is detected you can do a lot to protect your kidneys from further damage by implementing appropriate dietary and lifestyle changes. You can also use herbs and nutritional supplements to both improve kidney function and treat the cause of your kidney damage to protect the health of your kidneys.