To help diagnose and manage conditions affecting kidney (renal) function; may be used as part of general health screening or to screen someone who is at risk of developing kidney disease, or to follow someone with known kidney disease
Renal Panel
When you have signs and symptoms that suggest that you may have a condition affecting the function of your kidneys; when you are being treated for kidney disease; when you have certain risk factors for kidney disease, such as high blood pressure or diabetes
A blood sample taken from a vein in your arm
You may be instructed to fast for 8-12 hours (no food, only water) prior to the test.
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How is it used?
A renal panel may be used to evaluate kidney function, to help diagnose kidney-related disorders, to screen those who may be at risk of developing kidney disease or to monitor someone who has been diagnosed with kidney disease.
Blood Tests
The individual tests that make up a renal panel can vary depending on the laboratory that performs the testing, but a panel may include:
- Electrolytes: sodium, potassium, chloride, bicarbonate (TCO2)
- Phosphorus
- Calcium
- Albumin
- Blood Urea Nitrogen (BUN)
- Creatinine
- Glucose
- Cystatin C (if eGFR is borderline low or creatinine measurement is unreliable)
Click on the links above or see the "What is being tested?" section for more about these individual tests.
Two calculated values may also be reported with a renal panel:
Urine Tests
There are other laboratory tests that can be used to assess kidney function, including a urinalysis, urine protein or creatinine clearance. For those with diabetes or high blood pressure (hypertension), a urine albumin (microalbumin) test, which measures small amounts of albumin leakage from the blood into the urine, may also be used to detect early kidney damage. When both albumin and creatinine are measured in a random urine sample, an albumin/creatinine ratio (ACR) can be calculated. This may be done to more accurately determine how much albumin is escaping from the kidneys into the urine.
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When is it requested?
A healthcare professional may request a renal panel when someone has risk factors for kidney dysfunction such as high blood pressure (hypertension), diabetes, cardiovascular disease, obesity, elevated cholesterol, or a family history of kidney disease.
A healthcare professional may request a renal panel when someone has signs and symptoms of kidney disease, though early kidney disease often does not cause any noticeable symptoms. It may be initially detected through routine blood or urine testing. Examples of some signs and symptoms include:
- Swelling or puffiness, especially around the eyes or in the face, wrists, stomach, thighs or ankles
- Urine that is foamy, bloody, or coffee-coloured
- A decrease in the amount of urine
- Problems urinating, such as a burning feeling or abnormal discharge during urination, or a change in the frequency of urination, especially at night
- Mid-back pain, below the ribs, near where the kidneys are located
A renal panel may also be requested at regular intervals when someone is being treated for kidney disease for monitoring purposes.
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What does the test result mean?
Renal panel test results are not diagnostic but rather indicate that there may be a problem with the kidneys and that further testing is required to make a diagnosis and determine the cause. Results of the panel are usually considered together, rather than separately. Individual test result can be abnormal due to causes other than kidney disease, but taken together with risks and/or signs and symptoms, they may give an indication of whether kidney disease is present.
The following table summarises what results might mean in relation to kidney disease or dysfunction.
Test Association with kidney disease/dysfunction Electrolytes: Sodium, Potassium, Chloride, Bicarbonate Concentrations of electrolytes in the blood can be affected by kidney disease in different ways depending on the cause, with some concentrations decreasing while others increase. In general, kidney dysfunction or disease can cause an imbalance among the electrolytes. When these positively and negatively charged ions are out of balance, it can affect the fluid balance and/or pH of the blood. As kidney dysfunction worsens, complications such as metabolic acidosis may result. Phosphorus High blood concentrations are associated with kidney disease. Calcium Low blood concentrations may be seen with kidney failure. Albumin A low blood concentrations may indicate that the kidneys cannot prevent albumin from leaking into the urine and being lost. Urea/BUN High results suggest impaired kidney function caused by acute or chronic kidney disease, damage, or failure, or due to another condition causing decreased blood flow to the kidneys, such as CHF or dehydration, or causing obstruction of urine flow, such as prostate disease or kidney stones. Creatinine High blood concentrations suggests impaired kidney function due to conditions listed above for urea. Glucose High blood concentrations indicates diabetes, a common cause of kidney disease. Cystatin C A high serum cystatin C result indicates a low GFR (glomerular filtration rate). eGFR Calculated from the blood creatinine test result; an eGFR below 60 mL/min suggests that some kidney damage has occurred; an eGFR below 15 indicates kidney failure (see table in the eGFR article) Anion gap A high result can indicate excess acid (acidosis) in the blood that may be related to kidney disease, but the acidosis can also be caused by many other conditions -
Is there anything else I should know?
Additional testing may be performed, such as kidney imaging or a kidney biopsy, if blood and urine testing indicate the possibility of kidney disease. For more information on imaging and other types of testing, see the article on Kidney Disease.
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Will these tests always be run as a panel?
No, each test that is usually included in a renal panel may be run independently or along with different tests, depending on the purpose of the testing. For example, the electrolytes (sodium, potassium, chloride, and bicarbonate) may be run as an electrolyte panel as part of a routine health screen or to detect a potential problem with someone's fluid or acid-base balance, which could be caused by heart disease, for example. The glucose test is also commonly performed to screen for, diagnose, and monitor diabetes.
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What other tests might be ordered to assess kidney function?
The National Kidney Foundation (NKF) and the National Kidney Disease Education Program (NKEDP) recommend two tests, in addition to blood pressure measurement, to screen for kidney disease: urine protein (either urine albumin, urinalysis or urine total protein) and estimated glomerular filtration rate (eGFR). When a structural problem is suspected, a variety of imaging tests can be used to evaluate the kidneys. A sample of kidney tissue, a biopsy, is sometimes helpful in diagnosing the specific cause of the problem. For more information, see the article on Kidney Disease.
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Can I have kidney disease if I feel fine?
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Can I have abnormal test results and not have kidney disease?
Yes. Since the tests included in the renal panel can have broad applications, abnormal results on one or more of the tests could indicate a problem other than kidney disease. Your healthcare professional will interpret the results of your renal panel tests by looking at all of your results, along with the results of any other tests you had performed as well as your symptoms, exam findings, and medical and family history.