It may be that time of the year to get your lab tests, and see your nephrologist or healthcare team. But perhaps you are feeling overwhelmed, figuring out what these results mean when you are in your appointments. Understanding your lab tests with PKD should not be intimidating. In fact, it can help empower you to take control of your health! This article will dive into some common tests your healthcare team may be checking for your kidney health, and what they mean.

Lab Tests with PKD

Creatinine

Pronounced kree-At-uh-neen, this blood test is crucial in assessing the kidney’s ability to filter waste products. Higher levels of creatinine in the blood indicates more waste products building up, and that your kidneys may not be working as well as they should to remove waste products. The amount of creatinine in your blood can be influenced by hydration status and muscle tissues. Participating in strenuous exercise 48 hours before your bloodwork, not drinking enough, or having large portions of animal protein within 24 hours before your bloodwork, can cause this value to be falsely elevated.

Estimated Glomular Filtration Rate (eGFR)
The eGFR is an estimated measurement of how effectively your kidneys filter waste products from your blood. The eGFR is calculated from the creatinine value or the cystatin C value in your blood, to estimate your kidney function. To calculate your eGFR, your doctor also requires your age, weight, height, and sex, as these can impact how much creatinine we make, and therefore impact the eGFR number. As the creatinine goes up, the eGFR goes down. Tracking trends over time can help you understand your disease progression.

Blood Urea Nitrogen (BUN)
BUN measures the amount of nitrogen in your blood from urea. Urea is a waste product from protein breakdown. A BUN test can help to measure how well the kidneys are working. The kidneys normally remove urea from the blood, so elevated BUN levels may mean impaired kidney function. The BUN test may also be combined with a creatinine test, which can help to identify problems such as dehydration, kidney disease, or a blockage in the flow of urine (like from kidney stones), that can cause abnormal BUN and creatinine levels.

Electrolytes
These include things like potassium, magnesium, phosphorus, and calcium in your blood, and play an important role in overall health. Imbalances in electrolytes can be representative of the kidneys’ inability to filter waste products. The goal is to have these lab tests in range; too high or too low are not safe.

Hemoglobin A1c (A1c)
Is a blood test that helps to measure the amount of sugar (glucose) bound to the hemoglobin in the red blood cells. This test can help to diagnose prediabetes or diabetes, as it checks the long-term control of blood sugars, typically over a 3-month period. Keeping your A1c in target range helps to protect your kidneys from damage of high blood sugars.

Lipid Panel
A panel of tests that includes: total cholesterol; triglycerides; high-density lipoprotein (HDL – the good cholesterol); and low-density lipoprotein (LDL – the bad cholesterol). The lipid panel measures the lipids or fat in your blood. Sometimes this test may require fasting – nothing to eat or drink (except for water) for 9 to 14 hours before the test. Heart and kidney health go hand in hand, so managing cholesterol is important with PKD.

Iron Panel
A panel of tests to measure levels of iron in the blood. Because the kidneys play a role in making the hormones to manage red blood cells and iron in the body, this panel may include iron, total iron-binding capacity, and percent saturation. These tests are used with hemoglobin levels to determine your risk of anemia. The kidneys make the hormones needed to manage red blood cells, so checking iron levels is important with declining kidney function and PKD.

Uric Acid
A blood test used to determine the amount of uric acid, which is produced from the breakdown of food and body cells. If the kidneys are not able to filter enough uric acid out of the body, the level of uric acid can increase in the blood. High levels of uric acid can lead to crystals forming in the joints – causing gout, or uric acid kidney stones. Foods highest in uric acid include animal proteins and protein powders.

Vitamin D
This blood test measures the amount of vitamin D in your blood. Calcium and vitamin D are needed to help keep the bones strong. The kidneys help to convert vitamin D to its active form in the body, so with kidney disease, vitamin D levels can be low. This test is also called 25-hydroxy vitamin D, or 25(OH)D test.

24-hour Urine Collection
A 24-hour urine collection helps to identify the volume of urine, and how many substances such as sodium, protein, uric acid, or oxalates clear through the kidneys in a 24-hour period. This helps to customize nutritional and medical recommendations with PKD.

Things to consider with your lab tests
While these are a few of the common lab tests with PKD, speaking with your healthcare team to understand if there are additional ones to test based on your health is important.

Try tracking your lab tests each time you receive them to give you a better picture of trends in your health. How often your healthcare team checks your bloodwork will depend on your current health status and overall kidney function.

When reviewing your labs, it is important to remember that labs may use different reference ranges, and your healthcare team may also have different cut offs. So, interpret with caution and speak with your healthcare team about any questions or concerns you have.

Chickpea Enchiladas Recipe

Looking for something you can prep ahead and put in the oven during the week, that includes some in-season products this time of year? This chickpea enchiladas recipe is a great plant-based spin on the traditional enchilada, and is packed with fibre and flavour. Plus, this recipe can also be portioned and frozen in freezer-safe containers, and is also great for entertaining.

Ingredients
14.5 oz canned diced tomatoes, no salt added
2 TBSP apple cider vinegar
2 tsp garlic powder
2 tsp chili powder
1 TBSP olive oil
1 cup onion (white or red), diced
1 cup mushroom, sliced
1 cup bell pepper, chopped
2 x 19 oz canned chickpeas, no added salt
1 tsp cumin
8 medium whole wheat tortillas
2 cup mozzarella cheese, grated
2 avocado, sliced

Other topping ideas: cilantro, jalapeno peppers, olives, lettuce, sour cream

Instructions

1. Preheat oven to 350 F.
2. In a blender, combine tomatoes, apple cider vinegar, garlic powder and chili powder. Blend until smooth. Set aside.
3. In a medium pan, on medium-high heat, add oil, onion, mushroom, bell pepper and chickpeas. Season with cumin. Cook about 8-10 minutes until able to mash chickpeas into a chunky mixture with vegetables. If in a time crunch, add chickpeas to blender and puree into chunks before adding to pan with vegetables.
4. Divide the chickpea mixture between the tortillas, and fold burrito style.
5. In a large baking dish, place a small amount of the enchilada sauce at the bottom. Place each wrapped tortilla in the dish. Top with the remaining enchilada sauce and mozzarella cheese. Bake in oven for 25-30 minutes.
6. Top enchiladas off with avocado and other preferred toppings.

Makes 8 servings. Per serving: 518 calories, 53 g carbohydrates, 15 g fibre, 21 g fat, 22 g protein, 548 mg sodium, 321 mg phosphorus, 653 mg potassium.

Written by: Emily Campbell, RD CDE MScFN is a Registered Dietitian and Certified Diabetes Educator with a Master’s Degree in Foods and Nutrition. Emily specializes in renal nutrition, helping those with kidney disease overcome the confusing world of nutrition, to promote health. Emily can be found at kidneynutrition.ca.