Prime Health Package-1

The kidneys are a pair of bean-shaped organs located on either side of the spinal column in the abdomen towards the back. The kidneys perform a number of important functions. The most important of these is that they filter the blood and separate the waste products generated out of regular metabolic activities of the body, primarily urea. Following the separation, the kidneys excrete the waste products out of the body through urine. They help in maintaining the normal pH level and water balance of the body. The kidneys also play essential roles in the synthesis of Vitamin D and Red Blood Cells (RBCs).

The Kidney Function Test includes the following tests to monitor kidney function:

·  Blood Urea Nitrogen (BUN)/ Urea:

Blood Urea Nitrogen is a test to measure the amount of urea nitrogen present in the blood. Urea is a nitrogenous by-product of the metabolism of protein, and its level in blood serves as an indication of the amount of nitrogen present in blood as urea. In simpler terms, BUN is the measure of the amount of nitrogen present in blood in the form of urea. High BUN levels in the blood can be caused as a result of kidney diseases, dehydration and obstruction in the urinary tract due to kidney stones, prostate gland enlargement, etc.

Urea test measures the level of urea in the blood. Urea is a final waste product formed from the breakdown of proteins. Urea is filtered out of the blood by the kidneys to excrete excess nitrogen present in the blood through urine. Excess of urea in blood is called uremia and can be caused by a number of conditions including kidney diseases.

·  Uric Acid:

This test measures the level of uric acid in the blood. Uric acid is a waste product formed from the breakdown of purines, which are essential building blocks of DNA. It is also produced by the metabolism of proteinaceous food, especially red meat. Uric acid is excreted from the body by the kidneys through urine and a small portion through stool. The uric acid test indicates the level of uric acid in the blood and serves as an indirect estimation of the proper functioning of the kidneys.

The presence of excess amounts of uric acid in the blood is called hyperuricemia, and causes gout due to the accumulation of uric acid crystals in the synovial fluid between joints. Hyperuricemia also causes the formation of hard lumps of uric acid crystals called tophi under the skin and at the top of the ears. Uric acid crystals can also accumulate in the kidneys and cause kidney stones.

·  Creatinine:

This test measures the level of Creatinine in blood. Creatinine is a waste product formed from the normal breakdown of muscles in the body. Creatinine is almost completely excreted by the kidneys, so their levels in the blood serve as an indication of kidney function.

Excess creatinine in the blood can be found due to decreased elimination from the kidneys as well as due to increased creatinine production by muscular breakdown, eating cooked meat, protein supplements, etc.

·  BUN/Creatinine Ratio:

BUN/Creatinine Ratio compares the levels of nitrogen as urea in blood to the levels of creatinine in the blood. This ratio serves as a more accurate representation of kidney function. It is also used to check for dehydration since the BUN level increases in dehydration while creatinine levels remain the same. Low BUN to creatinine ratio can be caused due to a low protein diet, liver cirrhosis, rhabdomyolysis (muscle disease), syndrome of inappropriate antidiuretic hormone secretion (SIADH) as well as during pregnancy.

IgE test measures the amount of IgE (immunoglobulin E) in the blood. It is an antibody produced by the immune system in response to danger. Normally, it is present in very small amounts in the blood. It belongs to the class of immunoglobulins which include five types of immunoglobulins:  IgA, IgG, IgM, IgD, and IgE. 

Immunoglobulins are produced by plasma cells (specific immune cells) when the body recognizes bacteria, viruses, other microorganisms or any other unknown substances as harmful foreign antigens to the immune system. 

The production of IgE is seen in cases of response to allergens such as asthma and response to parasitic infections. Other allergens can include plant pollen, eggs, peanuts, bee venom, strawberries, and other allergens substances. 

These IgE antibodies, once produced, bind to white blood cells and lead to the release of substances like histamine. This further causes constriction of bronchi in the lungs in allergic or asthmatic persons. Other signs and symptoms which can develop in these patients include running nose, skin itching, itchy eyes. 

The severity of the reaction depends upon the body’s exposure to allergens which can be observed from mild reddening and itching of skin to problems in breathing (respiratory distress) to vomiting and diarrhea to conditions of shock. 

Blood is made up of different types of cells suspended in a fluid called plasma. These include erythrocytes or red blood cells, leukocytes or white blood cells, and platelets. Blood cells are produced by the hematopoietic cells in bone marrow and are then released into circulation. RBCs carry oxygen to the tissues, platelets help in blood clotting at a site of injury, and leukocytes form a part of the immune system of the body. WBCs are of five primary types: neutrophils, basophils, eosinophils, monocytes, and lymphocytes. Lymphocytes are further of three types: B-Lymphocytes, T-Lymphocytes, and natural killer (NK) cells. Neutrophils, basophils, eosinophils are collectively called granulocytes since they contain granules in cytoplasm.

Depending on various factors like age, gender, health condition, environmental factors, etc., varying amounts of different types of WBCs circulate in the blood. The bone marrow increases the production of WBCs in response to an infection or inflammation anywhere in the body. These WBCs are called to the site by a series of chemical signals, where they work to treat the condition. During this time, the total leukocyte count remains high in blood. Once the infection or inflammation subsides, WBC production by bone marrow decreases and WBC count in circulation falls back to normal levels. A continuously elevated WBC count may thus be an indication of a chronic condition that is not resolving naturally and might need urgent attention.

Apart from an infection or inflammation, WBC count in blood can also be affected by other conditions like disorders of the immune system, autoimmune conditions, cancer, etc. WBC count may be higher or lower than normal in these cases.

WBC count test serves as an indication of a condition affecting the body. Further tests are performed to confirm a particular condition and direct treatment.

The hemoglobin test measures the amount of hemoglobin in the blood.

Hemoglobin (Hb) is a protein found in red blood cells (RBCs) that carries oxygen from the lungs to the body tissues, and to exchange the oxygen for carbon dioxide. Hemoglobin then carries the carbon dioxide back to the lungs and where it is exchanged for oxygen. Iron is an essential part of hemoglobin. Most blood cells, including red blood cells, are produced regularly in your bone marrow (present within the cavities of many of large bones). To produce hemoglobin and red blood cells, your body needs iron, vitamin B12, folate and other nutrients from the foods you eat.

A decrease in hemoglobin concentration in blood results in anemia. Anemia is a blood disorder characterized by a decrease in the total amount of red blood cells (RBCs) or hemoglobin in the blood or a lowered ability of the blood to carry oxygen to body organs and tissues. Anemia is the most common blood disorder, affecting about a third of the global population and can cause symptoms like tiredness (fatigue), weakness, shortness of breath etc.

The hemoglobin test is usually performed as a part of complete blood count (CBC) test.

CRP Test measures the levels of CRP in blood to detect the presence of an inflammation or to monitor the treatment and progress of an inflammatory condition. C-reactive Protein or CRP is an acute phase reactant protein which is produced and secreted by the liver in response to an inflammation in the body, which may be caused by tissue injury, infection, or autoimmune diseases. CRP levels increase in patients with trauma, heart attack, autoimmune diseases, bacterial infections, sepsis, post surgery, cancer, etc. CRP levels are often increased before the onset of other symptoms of inflammation such as pain, fever, etc. CRP levels in blood fall as the inflammation subsides.

It is a non-specific test. It can neither diagnose a condition by itself nor can it determine the location of a particular inflammation or disease. Other tests along with physical examination are performed to diagnose a particular condition and determine the location.

A variant of the CRP test is the High Sensitivity C-reactive Protein Test (hs-CRP) which is more sensitive for CRP levels and can detect blood CRP levels at a lower concentration than the standard CRP Test. The hs-CRP Test is performed usually to determine the risk of development of cardiovascular diseases in otherwise healthy individuals.

The Creatine Kinase Test measures the levels of Creatine Kinase in the blood. Creatine Kinase (CK) is an enzyme which is found in the brain, heart, skeletal muscle, and other tissues. In case of muscle damage, increased amounts of CK are released into the blood. 

In the blood, normally small amount of CK is present which comes from the skeletal muscles primarily. In case of any damage to the muscle or interference with the production of muscle, energy can lead to increased levels of CK. Also, these levels may rise if there is any change with the use of muscle energy. The examples of such conditions include strenuous exercise and myositis (inflammation of muscles). 

Muscle diseases (myopathies) such as muscle dystrophy can also lead to an increase in the levels of CK. However, significantly high levels of CK are observed in Rhabdomyolysis which there is an extreme breakdown of skeletal muscle tissue. 

Magnesium is a mineral micronutrient which plays essential roles in body processes including enzyme functions, energy production by metabolism, contraction of muscles, and nerve functioning. It also helps in the metabolism of calcium and hence helps in the maintenance of healthy bones. Magnesium is supplied to the body from dietary sources and is absorbed in the small intestine and colon. It is subsequently absorbed into the bones and tissues. Only about 1% of the total amount of magnesium absorbed remains in the blood within a narrow normal range. The normal range of magnesium concentration is maintained in the body by utilizing the amount absorbed from food and excreting the excess through urination.

Deviation from the normal range of magnesium concentration causes Hypomagnesia (shortage of magnesium), or Hypermagnesia (excess of magnesium). Both these conditions impact normal body processes in the short term and may give rise to other conditions in the long term.

It gives us a measure of one of the components of the white blood cells , called Neutrophils. While all white blood cells help your body fight infections, neutrophils are important for fighting against bacterial infection.

The Phosphorus, Serum test is used to evaluate the level of phosphorus in your blood. Phosphorus is an inherent component of all living cells in the system and most, 85 percent, is located in the tissues of bones and teeth, while the remaining 15 percent is part of the blood and other soft tissues. Your body obtains its daily phosphorus requirements through dietary sources and under normal conditions, once the necessary amounts of phosphorus are absorbed by the cells and tissues, the remaining is eliminated via the urine.

Besides consuming a wholesome diet enriched with sufficient amounts of phosphorus, it is also important to ensure ample intake of calcium and vitamin D, to maintain overall health.

The absolute eosinophil count measures the number of eosinophils present in the blood. Eosinophils, a  type of white blood cells, helps in fighting the disease. These come into action for are said to be linked with certain infections and allergic diseases. The eosinophils are produced and mature in the bone marrow. They usually take about 8 days to mature and then are moved to blood vessels.

The eosinophils have varied functions which include the physiological role in organ formation such as the development of post-gestational mammary gland. Other functions include its movement to the areas of inflammation, trapping substances, killing cells, bactericidal and anti-parasitic activity. It also helps the treatment of immediate allergic reactions and modulation of inflammatory responses.

The platelet count measures the number of platelets present in the blood. Platelets are also known as thrombocytes which are tiny fragments of cells. These are formed from large cells which are found in the bone marrow known as megakaryocytes. After the platelets are formed, they are released into the blood circulation.

Whenever there is an injury to a tissue or blood vessel, bleeding starts. At this point, platelets help in stopping the bleeding in three ways:

• The platelets will adhere to the injury site

• The platelets will accumulate at the injury site 

• The platelets will release chemical compounds which stimulate gathering of other platelets

With these steps, a loose platelet connection forms at the site of injury. This process is known as primary hemostasis. The activated platelets start to support the coagulation cascade which involves a series of steps that includes the sequential activation of clotting factors. This process is known as secondary hemostasis which results in the formation of fibrin strands that knit through the loose platelet connection to form a fibrin net. After that, the connection is compressed to form a stable clot so that it remains in place until the injury heals. Once the injury is healed, other factors come into play and break it down so that it gets removed. 

In case the platelets are not sufficient in number or are not functioning properly, a stable clot might not form. These unstable clots can result in an increased risk of excessive bleeding. 

A Lipid Profile test assesses the level of specific fat molecules called lipids in the blood and helps determine the risk of heart ailments. This test determines the amount of different types of lipids, including total cholesterol, low-density lipoprotein (LDL) cholesterol, very-low-density lipoprotein (VLDL) cholesterol, high-density lipoprotein (HDL) cholesterol, and triglycerides. Lipids play a pivotal role in the functioning of the body. They are crucial components of the cell membranes and hormones, provide cushioning, and are a storehouse of energy. Any alterations in the lipid levels may lead to potential heart ailments, making their monitoring crucial.

About 99% of the total amount of calcium received by the body is bound as calcium complex in bones, and the remaining 1% lies in blood circulation. Of the amount of calcium circulating in the blood, about half remains bound to albumin protein or other ions and are metabolically inactive, while the remaining half remains free and metabolically active. Blood Calcium tests can be of two types: Total Calcium Test, used to measure the total calcium concentration in blood, including both the free and bound forms, and Ionized Calcium Test, used to measure the concentration of only the metabolically active form. Ionized calcium provides a more physiologically accurate assessment of calcium, especially in the presence of high protein concentrations, hyperparathyroidism and hypoparathyroidism.