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seton hall ESRD

When Kevin Losch (Seton Hall Graduate) ’2006 needed a kidney transplant , he was surprised when he couldn’t find a donor match among his large extended family.Instead, he found a donor within the Seton Hall family.

Chronic kidney disease usually progresses slowly. With the help of blood and urine examinations, it is possible to estimate whether the kidneys are still working adequately or, if not, dialysis should be started soon.

Blood and urine tests are not only necessary to detect chronic kidney disease. Also, in the further course, healthy controls are essential: They show if and if so, how fast the illness progresses and help to estimate the risk for complications. Depending on the stage of kidney disease, the therapy can be adapted individually, and the next treatment steps can be discussed and planned in good time with the doctor. This is important, for example, when it is foreseeable that dialysis will be necessary.

Chronic kidney disease "CKD" is categorized into five stages:

  • Stage 1: Urinalysis shows signs of kidney damage. Functional areas of the kidneys, however, ensure that they still function as healthy.
  • Stage 2: In addition to kidney damage, kidney function is also slightly limited. Usually, however, no symptoms are noticeable.
  • Stage 3: Kidney function is moderately limited.
  • Stage 4: Kidney function is severely limited. There may already be episodes such as itching, anemia, hyperacidity, or bone pain.
  • Stage 5: Terminal Renal Failure: The kidneys can no longer sufficiently cleanse the blood - there is often pronounced uremia. Dialysis or donor's kidney is needed to replace kidney function.

The health consequences of chronic kidney disease also depend on the state of health. Therefore, doctors are also investigating what could accelerate the progression of kidney failures - such as heart disease, a poorly adjusted high blood pressure or diabetes mellitus.

This is important to adapt the medication therapy individually - or to plan further steps with sufficient lead: For example, if you have a high risk that your kidneys will fail in the foreseeable future, you can discuss the treatment with him or her in time the best would be. Perhaps more close follow-up examinations will be necessary.

How can kidney function and kidney damage be measured?
Kidney function and kidney damage are closely related. The most critical measure of renal function assessment is the so-called glomerular filtration rate. The protein content in the urine is the primary indicator of kidney damage.

Glomerular filtration rate
The kidney contains about a million tiny "filter stations" - the so-called renal corpuscles (glomeruli). The Glomerular Filtration Rate (GFR) indicates how much blood is filtered per minute. In healthy individuals, this is between 85 and 135 milliliters per minute - based on a GFR value of 1.73 m2.

Measuring the GFR directly would be very time-consuming. Therefore, it is usually estimated - for example, using the creatinine in the blood. Creatinine is a breakdown product of muscle. The commonly used formulas for GFR estimation additionally include, for example, age and sex.

Protein excretion in the urine
Kidney damage can be felt by the fact that substances from the blood get into the urine, which usually is almost wholly retained by the kidneys. These include blood proteins, such as albumin. They are only increasingly excreted in the urine if the kidneys are damaged. The level of protein in the urine can be used to estimate how severe kidney damage is.

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