Understanding the Lab Tests That Monitor Your Chronic Kidney Disease (CKD)
Understand your labs, take control of your health, and use your test results to make smarter choices for your kidneys.
When you live with chronic kidney disease (CKD), your lab results become more than just numbers on a page—they become a guide for how to manage your health and slow down disease progression. But many patients I’ve talked to don’t always understand what each test means, or why it matters.
In this issue of Living with Chronic Kidney Disease, I’m breaking down the most important blood and urine tests for people with CKD—what they’re for, what normal and CKD values look like, and how they help you and your doctor monitor the condition.
1. Kidney Function Tests
These are the core of CKD monitoring.
Serum Creatinine
What it is: A waste product from muscle metabolism.
Normal range: 0.6–1.2 mg/dL
Why it matters: High levels can indicate decreased kidney filtration. But it varies by age, sex, and muscle mass, so it's best interpreted along with eGFR.
Estimated Glomerular Filtration Rate (eGFR)
Normal range: ≥90 mL/min/1.73m²
CKD Stage 3: 30–59 mL/min/1.73m²
Why it matters: This is the gold standard for estimating how well your kidneys are filtering blood. Lower numbers mean reduced function.
Blood Urea Nitrogen (BUN)
Normal range: 7–20 mg/dL
Why it matters: BUN rises as kidney function declines, but it can also increase due to high-protein diets or dehydration.
Urine Albumin-to-Creatinine Ratio (ACR)
Normal: <30 mg/g
CKD concern: ≥30 mg/g
Why it matters: One of the earliest signs of kidney damage. Even small increases are significant.
2. Electrolytes & Mineral Balance
As CKD progresses, your kidneys struggle to maintain a healthy mineral balance.
Potassium
CKD target: <5.0 mEq/L
Why it matters: High potassium (hyperkalemia) can cause dangerous heart rhythms.
Sodium
Normal range: 135–145 mEq/L
Why it matters: Imbalances can lead to swelling, high blood pressure, or neurological symptoms.
Phosphorus
CKD target: <4.5 mg/dL
Why it matters: High phosphorus can lead to bone and heart problems.
Calcium
CKD target: 8.5–9.5 mg/dL
Why it matters: Works with phosphorus and PTH to manage bone health.
Parathyroid Hormone (PTH)
CKD Stage 3 target: 35–70 pg/mL
Why it matters: Elevated PTH is a sign that your body is trying to compensate for mineral imbalances. It can lead to bone disease.
3. Acid-Base Balance
Serum Bicarbonate
CKD target: ≥22 mEq/L
Why it matters: Low levels indicate acidosis, a condition where excess acid builds up in the body—common in CKD and harmful to muscles and bones.
4. Protein & Urine Tests
These help detect early kidney damage and monitor progression.
24-hour Urine Protein
Normal: <150 mg/day
CKD concern: >150 mg/day
Why it matters: Measures total protein loss—persistent proteinuria is linked with faster CKD progression.
Serum Albumin
Normal: 3.5–5.0 g/dL
Why it matters: Low levels may indicate malnutrition or inflammation—common in advanced CKD.
5. Blood Count & Anemia Monitoring
Kidneys make a hormone (EPO) that tells your body to produce red blood cells. When kidney function declines, anemia is common.
Hemoglobin (Hb)
CKD target: >10 g/dL
Normal: 13.8–17.2 g/dL (men), 12.1–15.1 g/dL (women)
Why it matters: Low levels cause fatigue, weakness, and reduced quality of life.
Hematocrit (Hct)
Normal: 38.3–48.6% (men), 35.5–44.9% (women)
Why it matters: Helps evaluate anemia severity.
Ferritin
CKD target: ≥100 ng/mL (non-dialysis)
Why it matters: Reflects iron stores. Low levels indicate iron deficiency.
Transferrin Saturation (TSAT)
CKD target: ≥20%
Why it matters: Measures how much iron is available for making red blood cells.
6. Protein & Iron Panel
Nutritional status plays a huge role in CKD management.
Serum Iron
Normal: 50–170 µg/dL (men), 40–150 µg/dL (women)
Why it matters: Low levels may point to iron-deficiency anemia.
Total Iron Binding Capacity (TIBC)
Normal: 250–450 µg/dL
CKD target: <450 µg/dL
Why it matters: Helps assess iron transport and availability.
Total Protein (Blood)
Normal: 6.0–8.3 g/dL
Why it matters: Low levels can suggest malnutrition or inflammation.
7. Lipid Panel (Cholesterol Tests)
Cardiovascular disease is the leading cause of death in people with CKD.
LDL (Bad Cholesterol)
CKD target: <100 mg/dL
High risk patients: <70 mg/dL
Why it matters: High LDL is a major risk factor for heart attacks and strokes.
HDL (Good Cholesterol)
Normal: >40 mg/dL (men), >50 mg/dL (women)
Why it matters: Helps remove bad cholesterol.
Triglycerides
CKD target: <135 mg/dL
Why it matters: Elevated triglycerides are linked with heart disease and insulin resistance.
8. Glucose Control
Especially important if you have both CKD and diabetes.
Fasting Blood Glucose
Normal: 70–99 mg/dL
Diabetes: ≥126 mg/dL
HbA1c (Glycated Hemoglobin)
Normal: <5.7%,
Diabetes: ≥6.5%
Why it matters: Shows your average blood sugar levels over 3 months. Tight glucose control slows CKD progression.
Final Thoughts
If you live with CKD, understanding your lab tests can empower you to take control of your health. These numbers are not just medical jargon—they reflect the inner workings of your body and tell you where to focus your attention, whether it's managing your diet, tracking your anemia, or protecting your heart.
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Stay informed. Stay empowered. You have more control than you think.
— Ewerton
Living with Chronic Kidney Disease