Diagnosis and Treatment

Diagnosis

We perform a spectrum of tests to help us uncover the type of underlying kidney disease (diagnosis) and its severity (grading). Those may include urine, blood and imaging tests. In some cases, a bit of kidney tissue (biopsy) may be taken from you under local anesthesia for further study. Those tests are important to help determine the likely outcome (prognosis) of your kidney condition.

The details of those tests will be explained to you, but typically, you are required to fast overnight (simply do not eat or drink after midnight), have a glass of water in the morning, and do not take blood-thinning medicines, especially if a biopsy is being planned.

Blood Tests

The kidneys remove waste products from your blood. With kidney disease, that ability is impaired, resulting in a build-up of toxic waste material in the blood, which can readily be measured. The 2 common waste products assessed are BUN (urea) and creatinine. Those can be used to measure the filtering capacity of both kidneys.

There are other blood chemicals that could provide clues to the cause or severity of kidney disease. A high blood sugar might suggest diabetes as a cause of kidney failure, and low calcium levels may indicate chronicity of kidney disease, and slow development of bone disease (osteodystrophy). In such cases, blood levels of parathyroid hormone are often high.

Urine Tests

Often, a small amount of urine is collected for testing, usually in the middle of a voiding stream. It is tested for blood cells, protein, bacteria and other microscopic components. In some cases, a full 24 hour urine collection is required. For this to be meaningful, it has to be collected properly. Please ask our staff how to complete this important test.

Imaging

Several imaging tests are used, including ultrasound, utilizing sound waves to “look” at the kidney structure. Simple abdominal x-rays are also used, as well as nuclear scans in certain situations. If a cyst or mass is found, it might be further scrutinized with a CT scan or MRI scan, where additional contrast dyes may be used to help “light up” the kidneys. Contrast dyes do carry a risk of adverse effects, so be sure to discuss this fully with your doctor.

Kidney Biopsy

A kidney biopsy is often done to help find out the cause of excessive protein leakage or blood in the urine. Less commonly, it may help decide the underlying cause of kidney failure or help track (stage) the progression of known kidney disease, where simpler tests have failed to uncover any likely cause, or are not sensitive enough to quickly identify subtle changes in progressive kidney disease.

Patients may present with frothy urine (signifying protein leakage) or blood-tinged urine, but could also be blissfully unaware of those initial symptoms, and present much later with generalized swelling or severe anemia. You will be required to sign an informed consent, explaining the benefits of performing a biopsy, as well as outlining the risks of a biopsy.

While serious complications following a biopsy are rare, it can cause kidney infections, uncontrollable bleeding within the kidney, loss of a kidney, and even death. It is important to discuss your fears openly with your doctor prior to the test. We ask patients on blood-thinning medications, including Aspirin, to stop taking those pills for at least 10 days before the planned biopsy.

After the biopsy, please notify our office immediately, if you are unable to pass urine
running a fever or having chills feeling faint or light-headed continuing to pass bloody urine after 36 hours of the biopsy experiencing worsened pain at the biopsy site experiencing increased swelling at the biopsy site having difficulty controlling your blood pressure.

Preparing For Your First Visit

Your first office visit to see a kidney specialist can be very scary. You are worried about having to see yet another doctor (!!!), how much all this will cost, whether you will end up on dialysis, whether you might even live. We understand all too well how you feel, and we try to make it as easy (and painless) as possible.

Remember that your primary doctor requested our services because of his/her confidence in our expertise. Remember that most kidney conditions are now treatable. And also remember that we at Athens Kidney Center are well-trained experts, and work together to provide the very best care for you.

First, try as much as possible to have a good night’s rest. Have a light breakfast in the morning, and take all your usual morning pills. Bring along a close relative or trusted friend for support. Bring all your usual home medicines with you. Do not forget to bring along any medical papers or other information with you, including laboratory tests, x-ray films, records of past blood pressure/blood sugar readings and your insurance cards. If you have a list of allergies, either to medications or foods, please bring it along.

Finally, do not smoke or drink coffee/alcohol for at least 1 hour before your scheduled appointment.