Your dialysis bloodwork results,... huh?

By TinaMarie Cerreta

Dialysis Bloodwork: Translated


Hey Guys!

Do you understand the results from your last round of labs? Does your Renal Dietician give you a report card after each of them and explain where you fall in the grand scheme of things?(my amazing dietician doe and I got a gold star!! She decorates them with smiley faces 😁 and stars🌟! And let me tell you, it makes a difference) Do they do blood draws approximately once each month with duplicates and special ones in that month. (DISCLAIMER: FIRST,I AM NOT A PROFESSIONAL and SECOND, YOU SHOULD ALWAYS CHECK WITH YOUR CARE TEAM FOR YOUR SPECIFIC NUMBERS BECAUSE DIFFERENT MODALITIES HAVE DIFFERENT REQUIREMENTS AND YOUR CARE TEAM WOULD KNOW THE BEST FOR YOU) Let's look a little closer:


Hemodialysis lab tests are vital tools that show how well your treatments are cleaning your blood, balancing your body's chemistry, and managing your overall health and prognosis. Tracking these numbers helps your medical team fine-tune your dialysis schedule and medications to keep you feeling your best. (Your dialysis nephrologist and renal dietician will inform you of this information periodically)[1, 2, 3, 4, 5]

The most important hemodialysis blood test numbers are explained below in simple, easy-to-understand terms:
1. Dialysis Adequacy (Kt/V):
This is a mathematical formula that acts as a report card for your dialysis treatment. [1, 2]
  • What it means: It measures how well the dialysis machine is cleaning your blood of toxins (specifically urea).
  • Goal: A number greater than 1.2 for hemodialysis.
  • What it shows: Higher numbers generally mean a better prognosis and a lower buildup of waste products in your body. [1, 2]
  • URR (Urea Reduction Ratio): This shows the percentage of waste removed during a treatment. Your target goal is at least 65%. [1, 2]

2. Hemoglobin (Hgb):
Hemoglobin is the part of your red blood cell that carries oxygen all over your body. [1, 2]
  • What it means: Healthy kidneys naturally produce a hormone that tells your body to make red blood cells. Since your kidneys aren't working, your body might not make enough, leading to anemia (low Hgb). [1, 2]
  • Goal: Usually between 10 to 11.5 g/dL. [1, 2]
  • What it shows: If your hemoglobin is too low, you will feel constantly tired and short of breath. If it's in the target range, it indicates that your anemia is well managed with medications (like EPO) and iron. [1, 2, 3, 4]

3. Serum Albumin:
Albumin is a protein found in your blood. [1]
  • What it means: It is one of the most reliable predictors of overall health, nutrition, and survival for dialysis patients.
  • Goal: 4.0 g/dL or higher.
  • What it shows: A high level shows you are eating well and getting enough protein. Consistently low levels are a strong warning sign of malnutrition or chronic inflammation, which can affect your long-term prognosis. [1, 2, 3, 4]

4. Potassium:
Potassium is an important mineral that controls your heart rhythm and muscle strength. [1]
  • What it means: Because your kidneys can't remove excess potassium, it can easily build up between dialysis sessions.
  • Goal: 3.5 to 5.5 mEq/L.
  • What it shows: Keeping this in check is crucial. High levels can cause muscle weakness, numbness, and dangerous, irregular heartbeats that can be life-threatening. [1, 2]

5. Phosphorus & Calcium and PTH:
These two minerals work together to keep your bones strong and healthy and the third is to control the levels of 5he first two. [1, 2]
  • What it means: Damaged kidneys have trouble filtering out phosphorus, which leads to high phosphorus and low calcium in the blood.
  • Goal: For phosphorus, 3.5 to 5.5 mg/dL. For calcium, 8.4 to 9.5 mg/dL.
  • What it shows: If your phosphorus goes too high, it causes your body to pull calcium from your bones, making them weak and leading to heart or blood vessel problems over time. 
  • PTH (Parathyroid Hormone) is a hormone that controls calcium and phosphorus levels. Dialysis patients usually aim to keep this within a specific, elevated target range rather than "normal." The target range for intact parathyroid hormone (iPTH) in dialysis patients is typically 150 to 600 pg/mL, with the most commonly targeted sweet spot being 150 to 300 pg/mL. [1, 2, 3, 4] [1] 

6. Iron Levels (Ferritin and TSAT):
Iron is necessary to build healthy red blood cells. [1]
  • What it means: Your team will check Ferritin (how much iron is stored in your body) and TSAT (the iron currently available to use).
  • Goal: Ferritin generally 100 to 500 ng/mL.
  • What it shows: Keeping these in your target range helps your body produce enough red blood cells to fight off anemia and improve your energy levels. [1, 2, 3, 4, 5]


3 Tips to Keep Track of Your Labs
  1. Changes matter with more than one number: Your care team looks at the trends over several months rather than a single result.
  2. Review with your team: Bring your results to your renal dietitian or nephrologist and ask about specific dietary or medication adjustments.
  3. Use a tracker: Keep a notebook or use the Dialysis Patient Citizens Health Trackers to easily monitor your numbers over time. [1, 2, 3, 4, 5]

For more detailed guidance on how to decode your lab results and track your progress, check out the DaVita Education Center.The best resources for understanding and tracking your dialysis lab work include targeted educational guides from kidney care networks, digital patient portals, and dedicated medical facilities. [1, 2]
Top Educational Resources:
  • National Kidney Foundation: Provides comprehensive educational modules, including the Kidney School, which specifically breaks down how to understand kidney lab tests and your treatment goals. [1, 2]
  • American Association of Kidney Patients: Offers free downloadable guides like Understanding Key Lab Tests for Patients with Kidney Disease and a patient portal for tracking personal health data. [1, 2]
  • Fresenius Kidney Care: Provides an interactive guide to hemodialysis labs that explains exactly what different tests (such as URR and Kt/V) measure and how to discuss goals with your care team. [1, 2]
  • DaVita Kidney Care: Features an online guide on Understanding Your Labwork, which breaks down the symptoms, risk factors, and vital metrics relevant to dialysis patients. [1]

Patient Portals & Tracking Tools
  • Patient Portals: If you receive teatment at a major center, use your clinic's digital hub (such as Fresenius PatientHub) or DaVita Labs to securely view test results, check treatment progress, and securely message your care team. [1, 2]
Additional Support
If you have questions a:bout what your specific lab targets should be or if you aren't meeting your goals, always consult your nephrologist, dialysis nurse, or ask thesocial worker at your local dialysis center for help find your answers. They can provide personalized strategies to improve your results. Even the nurses and CCHT/ PCTs can assist you, just ask.[1, 2]

Here's my take on this topic(and I'm no pro): I always try to really listen to my renal dietician, nephrologists, nurses, and CCHT/PCTs when they talk about my bloodwork. It's super important for me to be as healthy as I can be, considering everything. I can't undo the kidney damage that's already there, but I can totally do my best to stay in the best health possible.
It's awesome that they can take blood from your access port, right? For someone like me who's a tough stick for regular blood draws (fluid restriction and rolling veins), this way is so much easier.
I totally trust my care team, and you should too with yours. They're looking after some amazing people, after all! You deserve to know what's going on with your lab results. It's a huge part of taking charge of your life and health and advocating for yourself.
Ask all the questions you need to feel safe and cared for. Do your research, but don't rely too much on "AI" searches (like "Dr. Google") because they might not always be accurate since we're a unique group with specific, uncommon needs. Go to reputable websites like DaVita Labs and the National Kidney Foundation.
So there you have it! Labwork for Dialysis 101. It's the basics, explained so anyone can understand. I hope this helps you feel more confident communicating with your care team, knowing you've got what we covered today to help you understand your results.

I want to know what you think. I'm all ears (well, actually eyes!). Tell me what you think, know, or feel about this topic. I'd love to know. EMAIL ME (if you can't get through this link, check the sidebar for another). I hope to hear from you!

Let's stop here. My wish for you today is to go easy on yourself today and tomorrow. It's almost the end of the week, and I, for one, get antsy when I approach time off from the rat race. Enjoy the final days of your week with a fevered pitch so that you finish the week better than you started it. Okay, just get through another day, and you're free and clear. 🤣 

Tina

My Quote For You:n

"Some days are tough. Others are fair. But you're here. And you're a fighter. That is what counts."
— Unknown

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