How to Read Your Biochemistry Lab Results
PKD patients need to get biochemistry testing as least once or twice a year. But when your results arrive, what do they all mean? Here’s a plain English explanation of how to read these reports (in Australian format) and the significance of each entry: The results are set out in columns with the oldest set of results to the far left and the current results to the right of the double vertical divider lines. The far right column labelled ‘Reference’ is the normal/average range for a person of your sex and age. It is not necessarily an indication of the optimal range though!!! Any of your results that are outside of this range will be highlighted with a small star symbol in front of the result. Don’t freak out if your result is a long way outside of the range. Simply consult your primary doctor for advice as some results can be many times under or over the range without indicating a serious issue. Now onto what it all means:
Sodium: This is a key electrolyte that helps the body balance hydration levels and control impulses of the nerves and function of the muscloskeletal system. The body controls sodium levels through excreting more or less in urine and therefore kidney function is integral in this action. Apart from indicating problems with kidney function, this result can also point to over or under consumption of salt and water. Both too high and too low sodium can be dangerous, particularly for PKD patients.
Potassium: This is another essential electrolyte that must be kept in proper balance alone and against sodium. Later in the progression of PKD, potassium may need to be limited in the diet, depending on your lab results, whereas early in the condition limitation may be completely inappropriate. Potassium regulates the heartbeat and also helps control impulses of the nerves and function of the muscloskeletal system.
Chloride: This is the third key electrolyte that interacts with sodium and potassium to regulate cellular fluid levels. It impacts on blood pressure, blood volume and the body’s acid/alkaline balance. It is lost through heavy sweating and vomiting but levels can also indicate quality of kidney function.
Bicarbonate: Another name for Carbon Dioxide. This electrolyte is also responsible for the acid/alkaline balance in the body and can effect the occurrence of kidney stones.
Urea: This metabolic waste product is excreted via the urine therefore levels reflect kidney filtration function.
Creatinine: This is another metabolic waste product excreted in the urine after it shuttles energy to the cells. If levels in the blood are concentrated this may indicate reduction in kidney function.
eGFR: ‘Estimated Glomerular Filtration Rate’ is an estimated measure of how well the kidneys filter waste products from the blood. It factors in age, gender and blood creatinine levels. The higher the eGFR the better. This result is used to define the level of kidney damage and thereby the PKD Stage.
Urate: This is a salt derived from the metabolism of uric acid. This acid is created when the body breaks down certain foods and also during cell breakdown. High levels of urate can indicate diabetes, gout, leukemia, thyroid issues, kidney disease, cancers or a diet high in purines (found in certain proteins and alcoholic beverages). Low levels can indicate the inverse level of purines in the diet, liver or kidney diseases, alcoholism.
Calcium: This mineral is required for teeth and bone health/repair, neuro-muscular processes and cardiopulmonary processes. In blood work the results only indicate how much calcium is circulating in the blood, not how much calcium is in the bones. High blood calcium can indicate thyroid disorders, cancer, disease or excess Vitamin D intake. Low levels can indicate low blood protein resulting from liver disease or malnutrition, thyroid disorders, excessively low dietary intake of calcium, Vit D or magnesium deficiency, high phosphorous, pancreatitis, kidney failure.
Corr Calcium: The ‘Corr’ prefix stands for ‘corrected’ and this measure is a calculation whereby the calcium level is adjusted against the albumin blood protein level, to verify whether a calcium disorder is at a level requiring treatment.
Phosphate: This mineral is required for teeth and bone health/repair and neuro-muscular processes. High levels may indicate diabetic or thyroid issues, kidney or liver disease, a diet high in phosphate or Vit D. Low levels may indicate malnutrition or thyroid problems.
Bili. Total: Bilirubin, found in bile, is a product of the liver’s process of breaking down red blood cells. In PKD, this result is important is testing for liver disease or blood disorders indicated by high levels of Bilirubin.
ALP: This stands for ‘Alkaline Phosphatase’, an enzyme involved in phosphate regulation. Elevated levels can indicate bone, liver or thyroid disease. Low levels can suggest anemia. ALP is considered towards the measure of liver function.
GGT: This stands for ‘Gamma-Glutamyl Transpeptidase’, another enzyme concentrated in the liver. High levels can indicate bone, liver or thyroid disease and this result is also considered towards the measure of liver function.
LD: This stands for ‘Lactate Dehydrogenase’ (otherwise known as Lactic Acid). It is an enzyme and increases can suggest bone, liver and/or kidney disease.
AST: The full name of this liver enzyme is ‘Aspartate Aminotransferase’. High levels can indicate liver disease.
ALT: This stands for ‘Alanine Aminotransferase’, another enzyme concentrated in the liver. High levels can indicate liver disease or the presence of a virus.
Total Protein: This is the total combined value of the blood proteins Albumin and Globulin. High levels can indicate inflammation or liver disease. Low levels can indicate kidney disease, malabsorption/malnutrition.
Albumin: This protein is produced in the liver and (via clotting) prevents fluid from leaking out of blood vessels. It carries nutrients and hormones. Low levels can indicate anything from kidney/liver disease to shock or Coeliac Disease.
Globulin: The ratio of Albumin to the other blood protein Globulin must be maintained correctly in order for the circulatory system to work efficiently. Globulin also controls blood clotting, nutrient transportation to the cells and helps the body fight infection. It is created in the liver and low levels can indicate kidney, liver or bowel disease. High levels can indicate autoimmune disease, kidney or liver disease, inflammatory diseases or infections.
Cholesterol: This is a fatty substance carried in the blood and used by the body to build cells and produce hormones. Cholesterol can build up inside the arteries and form blockages of plaque leading to heart attack or stroke, however there is some conjecture as to which types of cholesterol-protein bonds are actually responsible for this. It is important to also order readings of the proteins that carry cholesterol when considering the interpretation of Cholesterol results.
Triglycerides: This is a fatty substance carried in the blood and used by the body to store and provide energy to the muscles. The interrelationship of Triglycerides to certain types of Cholesterol-protein bonds can be a strong predictor of heart disease or stroke so these substances must be considered together, in greater detail than provided by the standard biochemistry work up, in terms of diagnosis and treatment of concerns.
CK: ‘Creatine Kinase’ is a blood protein used by the muscles. High levels may indicate muscular or heart damage.
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