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.

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 (CO2)

• Phosphorus

• Calcium

• Albumin

• Blood Urea Nitrogen (BUN)

• Creatinine

• Glucose

Three calculated values may also be reported with a renal panel:

• Urea (BUN)/creatinine ratio

• Estimated Glomerular Filtration Rate (eGFR)

• Anion gap

There are other laboratory tests that can be used to assess kidney function, including a urinalysis, urine protein orcreatinine 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.

The following table summarizes what results might mean in relation to kidney disease or dysfunction.

Test Association with kidney disease/dysfunction

Electrolytes:Sodium,Potassium,Chloride,Bicarbonate

Electrolyte blood levels can be affected by kidney disease in different ways depending on the cause, with some levels 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 level is associated with kidney disease.

Calcium

Low blood level may be seen with kidney failure.

Albumin

A low blood level may indicate that the kidneys cannot prevent albumin from leaking into the urine and being lost.

Urea/BUN

High level suggests 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 ordehydration, or causing obstruction of urine flow, such as prostate disease or kidney stones.

Creatinine

High blood level suggests impaired kidney function due to conditions listed above for urea.

Glucose

High blood level indicates diabetes, a common cause of kidney disease.

Urea (BUN)/Creatinine ratio

High ratio may be due to a condition such as decreased blood flow to the kidneys while low ratio may be due to other conditions such as liver disease.

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.