Sodium is an electrolyte that regulates the body’s volume of water and is conserved in the kidneys. Increased sodium levels can be seen in dehydration, diabetes insipidus and other conditions. Decreased levels can be seen in severe diarrhoea, kidney disease, uncontrolled diabetes and other conditions.
Potassium is also one of the electrolytes excreted by the kidney. Increased levels of potassium can cause a decrease in muscle function, and may occur in circulatory failure (shock) and kidney failure. Decreased levels of potassium may be due to low intake of potassium, vomiting, diarrhoea or use of diuretics.
Abnormally high or low levels of potassium outside of normal limits can be dangerous as it can affect muscle function, particularly heart function.
Chloride, another electrolyte is directly dependent on the level of sodium. The level of chloride will increase in dehydration or in loss of carbon dioxide by over breathing (hyperventilating). Low levels of chloride may be seen in uncontrolled diabetes, excessive vomiting and in kidney disease.
Urea is the main end product of protein metabolism in the body and is excreted by the kidneys. Concentration of urea is influenced by the amount of protein digested, diet, hormones and kidney function. Increased levels of urea may be due to kidney disease or after administration of steroids. Slightly increased levels may be due to a high protein diet. Low level may be seen in normal pregnancy or due to decreased intake of protein.
Creatinine is a waste product of creatine phosphate, a substance stored in the muscle and used for energy. Creatinine is excreted by the kidneys and is not affected by diet or hormones. An increase in creatinine level is often associated with kidney disease.
Microalbumin (Urine Test)
Kidney function may be assessed through measurement of albumin levels in the urine. Kidney malfunction results when the capillaries in the kidney become blocked, causing waste products to remain in the blood and important proteins are lost from the blood into the urine. Kidney deterioration is progressive and begins with small amounts of albumin leaking into the urine. This is known as microalbuminuria and indicates early signs of nephropathy. The term ‘micro’ refers to low concentrations of urinary albumin. Progression of kidney disease will lead to larger amounts of albumin leaking into the urine which may develop further to end stage renal disease. Kidney disease is a major concern in diabetes patients and early detection and treatment may slow the onset and progression of the condition.