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Introduction to Renal Function Test

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Module 5: Clinical Correlation & Interpretation

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1. Overview


Renal Function Tests (RFTs) help us understand kidney health. By interpreting patterns of abnormalities, we can identify whether a patient has Acute Kidney Injury (AKI), Chronic Kidney Disease (CKD), or other causes of kidney dysfunction.


ကျောက်ကပ် လုပ်ဆောင်မှု စမ်းသပ်မှုများ (RFTs) သည် ကျောက်ကပ်ကျန်းမာရေးကို သိရန် အထောက်အကူဖြစ်သည်။ အခြားကျောက်ကပ်ရောဂါများထဲမှ AKI၊ CKD တို့ကို ခွဲခြားသိနိုင်ရန် RFT စမ်းသပ်မှုရလဒ်များကို မှန်ကန်စွာ ဖတ်ရှုရန်လိုအပ်သည်။

2. Patterns of RFT Abnormalities

ConditionKey Findings (English)Myanmar Explanation
Acute Kidney Injury (AKI)Sudden rise in serum creatinine, reduced urine output (oliguria), ↑BUNသွေးထဲ creatinine မြင့်တက်ပြီး ညာယာကြာအချိန်တိုအတွင်း မကြာခဏ ဆီးနည်းလာခြင်း
Chronic Kidney Disease (CKD)Persistent high creatinine (>3 months), anemia, electrolyte imbalance (↑K⁺, ↓Ca²⁺)အချိန်ရှည်လျားစွာ creatinine မြင့်နေခြင်း၊ သွေးနည်းခြင်း၊ electrolyte မညီမျှခြင်း
Pre-renal FailureHigh BUN:Creatinine ratio (>20:1), concentrated urine, ↓Na⁺ in urineသွေးထဲ BUN/Cr အချိုးမြင့်၊ ဆီး濃သော၊ ဆီးထဲ Na+ နည်း
Intrinsic Renal FailureBUN:Creatinine ratio normal (10-15:1), muddy brown casts in urineBUN/Cr အချိုး ပုံမှန်၊ ဆီးထဲမှာ granular cast တွေ တွေ့ရနိုင်သည်
Post-renal FailureInitially like pre-renal, then progresses to intrinsic if obstruction persistsဆီးကြောင်းပိတ်ဆို့မှုကြောင့် ဖြစ်ပြီး ပိတ်ဆို့မှုကြာသွားပါက intrinsic failure ဖြစ်နိုင်သည်

3. Correlating Labs with Symptoms

  • AKI: Rapid swelling, ↓urine output, fatigue, confusion (due to uremia)

  • CKD: Long-term symptoms: bone pain, anemia, itching, hypertension

  • Post-renal: Severe flank pain, distended bladder, difficulty urinating

4. Case Example

Case: 45-year-old male with sudden oliguria, creatinine 3.2 mg/dL, BUN/Cr = 25:1, BP low.

Interpretation: Pre-renal AKI (likely hypovolemia/shock). Treat with fluids and correct cause.


FAQs (10 with Answers)

  1. Q: How do we differentiate AKI from CKD?
    A: CKD lasts >3 months, shows small kidneys on ultrasound; AKI is sudden.

  2. Q: What is the normal BUN:Creatinine ratio?
    A: Around 10–15:1.

  3. Q: What does a high BUN:Cr ratio indicate?
    A: Pre-renal failure (e.g. dehydration, hypovolemia).

  4. Q: Which electrolyte is most dangerous in kidney failure?
    A: Potassium (↑K⁺ can cause fatal arrhythmias).

  5. Q: Why does CKD cause anemia?
    A: Decreased erythropoietin production.

  6. Q: What test is most specific for GFR?
    A: Serum creatinine and eGFR calculation.

  7. Q: What is post-renal AKI?
    A: Kidney failure due to obstruction (stones, enlarged prostate).

  8. Q: Can AKI be reversible?
    A: Yes, if treated early and cause removed.

  9. Q: What is the first step in AKI management?
    A: Assess volume status and restore perfusion.

  10. Q: Which urine finding suggests intrinsic renal injury?
    A: Muddy brown granular casts.
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