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A.D.A.M. Medical Encyclopedia [Internet]. Atlanta (GA): A.D.A.M.; 2013.

A.D.A.M. Medical Encyclopedia.

Kidney function tests

Last reviewed: October 14, 2012.

Kidney function tests are common lab tests used to evaluate how well the kidneys are working. Such tests include:

References

  1. Pincus MR, Abraham NZ. Interpreting laboratory results. In: McPherson RA, Pincus MR, eds. Henry's Clinical Diagnosis and Management by Laboratory Methods. 22nd ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 8.
  2. Oh MS. Evaluation of renal function, water, electrolytes and acid-base balance. In: McPherson RA, Pincus MR, eds. Henry's Clinical Diagnosis and Management by Laboratory Methods. 22nd ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 14.

Review Date: 10/14/2012.

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  • Angiotensin‐converting enzyme inhibitors and angiotensin‐II receptor blockers for preserving residual kidney function in peritoneal dialysis patientsAngiotensin‐converting enzyme inhibitors and angiotensin‐II receptor blockers for preserving residual kidney function in peritoneal dialysis patients
    Residual kidney function plays a key role in the health and quality of life of patients on peritoneal dialysis (PD). Better preservation of residual kidney function is associated with decreased mortality, even at 1 mL/min of residual glomerular filtration rate (GFR), which is associated with a nearly 50% reduction in mortality rate. Two kinds of antihypertensive drugs, angiotensin‐converting enzyme inhibitors (ACEis) and angiotensin‐II receptor blockers (ARBs), are frequently prescribed for PD patients (primarily to control hypertension or heart failure), and could provide significant cardiovascular benefit for ESKD patients. Nowadays, while ACEis and ARBs use is advocated in PD patients, the supporting evidence is still unclear. However studies have focused on heart protection rather than residual kidney function. The aim of this review was to assess the benefits and harms of ACEis and ARBs therapy for preserving residual kidney function in PD patients. Six studies (257 patients) were included (three ARB studies, one ACEi study and ACEi versus ARB studies). Long‐term use (12 months or more) of an ARB showed a significant benefit in preserving residual kidney function in continuous ambulatory PD (CAPD) patients compared with other antihypertensive drugs, although there was no significant benefit when an ARB were used for less than six months). One study showed that compared with other antihypertensive drugs, long‐term use of the ACEi ramipril showed a significant reduction in the decline of residual kidney function in patients on CAPD as well as anuria rate. While dizziness and cough are the main adverse events when an ACEi is used, only one study comparing an ARB with an ACEi reported this outcome and no significant difference between the two groups were found. While the use of an ARB or an ACEi may both be useful in preserving residual kidney function, the small number of studies and small number of patients enrolled means there is currently insufficient evidence to support the use of an ACEi or an ARB as first line antihypertensive therapy in PD patients.
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Figures

  • Kidney anatomy.
    Kidney - blood and urine flow.
    Kidney function tests.

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