Renal Panel Components
A renal panel is a group of blood tests that includes blood urea nitrogen (BUN), serum creatinine, estimated glomerular filtration rate (eGFR), and electrolytes (sodium, potassium, chloride, and bicarbonate) as the core components for assessing kidney function. 1, 2
Core Components
Primary Kidney Function Markers
- Serum creatinine is the primary marker for kidney function assessment and should be measured using a specific assay with calibration traceable to international standard reference materials 1
- Blood urea nitrogen (BUN) is measured alongside creatinine, as the BUN-to-creatinine ratio helps differentiate between prerenal, intrinsic renal, and postrenal causes of kidney dysfunction 1, 3
- Estimated glomerular filtration rate (eGFR) is calculated using the 2009 CKD-EPI equation and is preferred over relying on serum creatinine concentration alone 1, 2
Electrolytes
- Sodium, potassium, chloride, and bicarbonate are essential electrolytes included in the renal panel to evaluate electrolyte imbalances and acid-base status 1, 2
Additional Components Frequently Included
- Calcium and phosphorus levels are important for bone health and can be affected by kidney disease 2
- Albumin is a major protein in blood that can indicate nutritional status and kidney function 2
Clinical Applications
The renal panel serves multiple purposes 2:
- Initial assessment of kidney function
- Monitoring chronic kidney disease progression
- Evaluating electrolyte imbalances
- Assessing acid-base status
Normal Values and Interpretation
- eGFR >60 mL/min/1.73m² is typically considered normal, while values <60 mL/min/1.73m² indicate potential chronic kidney disease 2
- Creatinine is less influenced by extrarenal factors than BUN and is the more accurate test for kidney function 3
When Additional Testing Is Needed
If the basic renal panel shows abnormalities, additional tests may be warranted 2:
- Urinalysis with microscopy to detect proteinuria, hematuria, and cellular casts 1
- Urine protein quantification using spot urine albumin-to-creatinine ratio (ACR) or protein-to-creatinine ratio (PCR) 1
- Cystatin C as a confirmatory test when eGFR based on serum creatinine may be less accurate 1
- 24-hour urine collection for more precise measurement of protein excretion and creatinine clearance 1
Special Populations
- Patients with monoclonal gammopathies or multiple myeloma require specialized assessment including serum free light chain measurement, urine protein electrophoresis, and serum protein electrophoresis 1, 2
- Patients with chronic conditions like diabetes, hypertension, or heart failure should have regular monitoring of renal function with a renal panel 2