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)
Blood Urea Nitrogen (BUN)
Click on the links above for more about these individual tests.
Three calculated values may also be reported with a renal panel:
Urea (BUN)/creatinine ratio
Estimated Glomerular Filtration Rate (eGFR)
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.
A health practitioner may order 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 health practitioner may order 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-colored
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 ordered at regular intervals when someone is being treated for kidney disease for monitoring purposes.
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 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 or dehydration, 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.
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.