Diagnosing Chronic Kidney Disease (CKD)
Chronic kidney disease is often silent in its early stages. Diagnosis relies on a combination of blood and urine tests, imaging, and in some cases a kidney biopsy. Knowing your risk factors is the first step toward timely detection.
Who Is at Higher Risk?
People with the following conditions or history are at greater risk of developing chronic kidney disease or kidney failure and should undergo regular screening:
If any of these apply to you, ensure you have regular check-ups and report any unusual symptoms to your doctor promptly.
How Chronic Kidney Disease Is Diagnosed
Your nephrologist will typically use a combination of the following assessments to diagnose CKD and determine its cause and severity.
Physical Examination
Kidney failure can cause fluid to accumulate around the heart or lungs. Your doctor will typically use a stethoscope to examine these organs as part of the initial assessment.
Urine Tests
Urine tests check for abnormal protein levels — one of the earliest markers of kidney disease, often appearing before other symptoms. Urine sediment and cells are examined under a microscope in a laboratory.
Normally, only trace amounts of protein are present in urine. Elevated protein levels may indicate early kidney damage.
Blood Tests
Blood tests measure electrolyte levels and waste products — particularly blood urea and creatinine, which are filtered out by healthy kidneys. Elevated levels indicate that the kidneys are not clearing waste effectively. These tests also help calculate the GFR (Glomerular Filtration Rate) used to stage CKD.
Kidney Imaging
Your nephrologist will typically order imaging tests — such as a CT scan, MRI, or ultrasound — to assess the structural details of the kidneys. These can detect size abnormalities, cysts, obstruction, scarring, and other structural problems.
Kidney Biopsy
When the cause of kidney disease remains unclear after other tests, a kidney biopsy may be required. A small sample of kidney tissue is collected for microscopic examination in a laboratory.
Two approaches are used: an open biopsy (a surgical incision under general anaesthesia) or a needle biopsy (less invasive — a fine needle is inserted directly into the kidney). The needle biopsy is more common.
A biopsy is not suitable for all patients — those taking blood thinners such as aspirin, or patients with very small kidneys, may not be candidates.
What Happens After a CKD Diagnosis?
The results of your tests help your doctor confirm the diagnosis and identify the underlying cause of kidney impairment. From there, a personalised management plan is developed.
Alongside regular blood and kidney function tests to monitor urea and creatinine levels, you will typically be advised to adopt a kidney-friendly renal diet and make lifestyle adjustments to slow disease progression.
Managing chronic kidney disease is a long-term commitment that varies significantly for each patient based on medical history, current conditions, lifestyle, and diet. A personalised approach — guided by a specialist nephrologist — is essential to achieving the best possible outcomes.
Get Expert Advice on Kidney Disease Diagnosis
Dr. Francisco Salcido-Ochoa offers specialist nephrology consultations in Singapore and via international teleconsultation.
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