North Texas Kidney Disease Associates

Glossary Of Terms

Your Lab Results

BUN (blood urea nitrogen):  Urea nitrogen is a normal waste product in your blood that comes from the breakdown of protein from foods you eat. Healthy kidneys remove BUN from your blood, but when kidney failure occurs, your BUN rises.

Creatinine:  Creatinine is a waste product in your blood that comes from the normal function of your muscles. Healthy kidneys remove creatinine from your blood, but when the kidneys are not working properly, your creatinine level rises.

GFR (glomerular filtration rate):  Glomerular filtration rate is the best test to measure your level of kidney function and determine your stage of kidney disease. Your doctor can calculate it from the results of your blood creatinine test, your age, body size and gender. The earlier kidney disease is detected, the better the chance of slowing or stopping its progression.

Hemoglobin:  Hemoglobin is the part of red blood cells that carries oxygen from your lungs to all the tissues in your body.  Measuring your hemoglobin level tells your doctor if you have anemia.

Phosphorous:  A high phosphorus level in your blood can lead to weak bones, itching, bone pain and hardening of blood vessels. If your level is too high, your doctor may ask you to reduce your intake of foods that are high in phosphorus and take a phosphate binder.

Potassium:  Potassium is a mineral that helps your heart and muscles work properly. Your kidneys help regulate your potassium level.  A potassium level that is too high or too low may weaken muscles and change your heartbeat. 

PTH (parathyroid hormone):  Parathyroid hormone is produced by several small, bean-like parathyroid glands in the neck. Its job is to tell the bones to release calcium into the bloodstream.  High levels of PTH may result from a poor balance of calcium and phosphorus in your blood. This can cause bone disease.  PTH levels are also increased in CKD due to vitamin D deficiency. Your doctor may order a special form of vitamin D to help lower your PTH.

 

Chronic Conditions

Anemia:  a condition of having too few red blood cells in the body. Red blood cells carry oxygen from the lungs to supply all the body’s needs and to give you the energy you need for your daily activities.  One cause of anemia in people with chronic kidney disease is low supply of erythropoietin which is a hormone made by healthy kidneys to signal red blood cell production.  Treatment- See ESA Therapy.

CKD (chronic kidney disease):  Chronic kidney disease means the kidneys have been damaged by diabetes, high blood pressure or other disorders.  Damaged kidneys are not able to keep you healthy by doing important functions such as removing wastes and fluid from your body, regulating your body water and chemicals in your blood such as sodium, potassium, phosphorus and calcium. Healthy kidneys remove drugs and toxins introduced into your body.  They also release hormones into your blood to help your body regulate blood pressure, make red blood cells and promote strong bones.  Kidney damage is categorized by stages 1-5 based on the amount of kidney damage.

Hypertension:  high blood pressure.  Ask your doctor what your blood pressure should be. If your blood pressure is high, make sure to follow all the steps in your prescribed treatment.  These steps may include taking high blood pressure medications, cutting down on the amount of salt in your diet, losing weight if you are overweight, and exercising.

Secondary Hyperparathyroidism: a condition that affects people with CKD. It is a result of vitamin D deficiency, associated with CKD stages 3-5.  As kidney function declines, the ability of the kidney to make active vitamin D, which is needed by all the tissues and cells in the body, declines. The consequences of low vitamin D levels are many; including bone disease and recent evidence suggests there are consequences to the heart, to blood pressure and to overall vascular health. Measurement of your parathyroid hormone (PTH) helps establish this diagnosis.

 

Treatment Options

Dialysis: Dialysis is a treatment that does some of the things done by healthy kidneys. It is needed when your own kidneys can no longer take care of your body's needs. Like healthy kidneys, dialysis keeps your body in balance. Dialysis does the following:

  • removes waste, salt and extra water to prevent them from building up in the body
  • keeps a safe level of certain chemicals in your blood, such as potassium, sodium  and bicarbonate
  • helps to control blood pressure

There are two forms of dialysis, see "Hemodialysis" and "Peritoneal Dialysis"

ESA Therapy (erythropoietin stimulating agent therapy):  One cause of anemia in people with chronic kidney disease (CKD) is low supply of EPO. EPO stands for erythropoietin, which is a hormone made by healthy kidneys to signal red blood cell production. When you have CKD, your EPO supply is low and therefore anemia can develop.  If you have anemia caused by low supply of EPO, you may be prescribed a medicine called ESA, which stands for erythropoiesis-stimulating agent. ESA is an injectable form of the EPO that is made by healthy kidneys. ESA therapy should help you feel much better by improving symptoms of anemia such as fatigue and low energy.

HemodialysisIn hemodialysis, an artificial kidney (hemodialyzer) is used to remove waste and extra chemicals and fluid from your blood. To get your blood into the artificial kidney, the doctor needs to make an access (entrance) into your blood vessels. This is done by minor surgery to your arm or leg. Sometimes, an access is made by  joining an artery to a vein under your skin to make a bigger blood vessel called a fistula. However, if your blood vessels are not adequate for a fistula, the doctor may use a soft plastic tube to join an artery and a vein under your skin.  This is called a graft

Peritoneal Dialysis:  In this type of dialysis, your blood is cleaned inside your body. The doctor will do surgery to place a plastic tube called a catheter into your abdomen (belly) to make an access. During the treatment, your abdominal area (called the peritoneal cavity) is slowly filled with dialysate (special fluid) through the catheter. The blood stays in the arteries and veins that line your peritoneal cavity. Extra fluid and waste products are drawn out of your blood and into the dialysate.

Transplant: involves an operation to place a donated kidney inside your body to take over the work of your failed kidneys. The kidney may come from someone who has died (nonliving donor) or from a living donor who may be a close relative, friend or possibly a stranger who wished to donate a kidney to anyone in need of a transplant (nondirected donor).