Blood tests can tell how well the dialysis is working, how well nourished you are, the state of your bones, how much acid thereis, in your blood , as well as your blood count. Monthly blood tests to check the levels of urea/creatinine, waste products produced by metabolism within the body, help to determine the adequacy of the dialysis prescription. Another test, called Kt/V is also performed to assess patient progress and dialysis adequacy. Abnormal electrolyte (Sodium, Potassium) levels may cause organ dysfunction for eg the heart and therefore the need for regular checks. Serum albumin levels tell us how well nourished the patient is, and is the most important test to indicate future morbidity. Calcium and phosphate levels give us an indication of bone metabolism. Hemoglobin levels indicate the degree of anemia (low blood strength) and act as a guide to adjust treatment (blood transfusion/erythropoietin injections).Blood Sugar levels are important in diabetics. Tests for HIV and Hepatitis B & C viruses are done as a routine on admission into the dialysis unit and every 3-4months thereafter.There are other important tests that are done less frequently and include lipid levels, liver function tests, iron studies,etc.
- Creatinine: This is the waste produced by muscles. A high creatinine level may indicate that not enough dialysis is being done
- Potassium: This mineral is normally present in the blood. If the level gets too high or low it can cause the heart to stop. The normal level is 3.5-5.0 mmols/l. Crisis levels are less than 2 or greater than 6.5.
- Urea: Urea is produced when the food we eat is broken down. The normal level is 20-40mg/dl/l, but in dialysis patients urea levels are much higher. A high urea level will often cause sickness(nausea & vomiting)
- Phosphate: Phosphate is one of the substances in the blood necessary to keep bones healthy. The normal level is 3-4.5mg/dl. A high level can cause itching and bone disease. Diet and phosphate binders can help to control the level.
- Calcium: This mineral is needed to keep bones healthy. The normal level of calcium in the blood is 9 - 11 mg/dl.
- Glucose: The normal level of blood glucose is 100-140mg/dl. For diabetics on HD it is important to remember that apart from high glucose levels, hypoglycemia (low sugars) may also occur