Patient Quick-Reference · Companion to The Lab-to-Action Guide Mabilis na Sanggunian ng Pasyente · Kasama ng The Lab-to-Action Guide Paspas nga Reperensya sa Pasyente · Kauban sa The Lab-to-Action Guide Mabilis a Sanggunian ning Pasyente · Kayabe ning The Lab-to-Action Guide

The Lab-to-Action Card Ang Lab-to-Action Card Ang Lab-to-Action Card Ing Lab-to-Action Card

Your number changed — find it, read the color, do the action. One page, six labs, no guesswork. Nagbago ang inyong numero — hanapin ito, basahin ang kulay, gawin ang aksyon. Isang pahina, anim na lab, walang hula-hula. Nabag-o ang inyong numero — pangitaa kini, basaha ang kolor, buhata ang aksyon. Usa ka panid, unom ka lab, walay tag-an. Mibaltan ing numero yu — anapan ya, basan ing kulay, gawan ing aksyon. Metung a lawang, anam a lab, alang panghula.

PublishedNailathalaGipatikPepalwal: ReferencesMga SanggunianMga TinubdanReng Reperensya: 7 Read timeOras ng pagbasaOras sa pagbasaOras ning pamamasa:

How to Use This Card Paano Gamitin ang Card na Ito Giunsa Paggamit Ani nga Card Paano Gamitan Ing Card Á Iti

A lab report full of arrows and colors rarely comes with instructions. This card fixes that: find the value that just moved, match it to red (ER now), amber (call today), or green (routine, review at your next visit), then follow the short "do this" step underneath. It is a companion to The Lab-to-Action Guide — the full downloadable explainer at the bottom of this page — which walks through the "why" behind each number in plain language. Bihirang may kasamang tagubilin ang isang lab report na puno ng arrow at kulay. Inaayos ito ng card na ito: hanapin ang numerong kagagalaw lang, itugma ito sa pula (ER ngayon din), amber (tumawag ngayon), o berde (rutina, susuriin sa susunod na bisita), pagkatapos sundin ang maikling hakbang na "gawin ito" sa ibaba. Kasama ito ng The Lab-to-Action Guide — ang kumpletong madadownload na paliwanag sa ibaba ng pahinang ito — na tumatalakay sa "bakit" sa likod ng bawat numero sa simpleng pananalita. Panagsa ra adunay giubanan nga panudlo ang usa ka lab report nga puno sa arrow ug kolor. Gitul-id kini niini nga card: pangitaa ang numero nga bag-o lang nausab, itakda kini sa pula (ER karon), amber (tawag karon), o berde (rutina, susihon sa sunod nga bisita), unya sunda ang mubo nga lakang nga "buhata kini" sa ubos. Kauban kini sa The Lab-to-Action Guide — ang kompleto nga madaunload nga paliwanag sa ubos niini nga panid — nga naghisgot sa "ngano" sa likod sa matag numero sa yano nga pinulongan. Bihirang atin katung kayabe nang tuntunan ing metung a lab report a mapunu na king arrow at kulay. Iti ya ing card a mikakapagsalese kaniti: anapan ya ing numero a kaibat mag-bayu, itugma ya kaniya king malutu (ER ngeni na), amber (tawagan ngeni), o green (rutina, susian king kasunud a bisita), kaibat sundan ing maiksing hakbang a "gawan iti" king lalam. Kayabe ya iti ning The Lab-to-Action Guide — ing lubus a mapasibayus a paliwanag king lalam ning lawang á iti — a magsalese king "bakit" king lalam ning balang numero king dalumdum a amanu.

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Six labs, one system Anim na lab, isang sistema Unom ka lab, usa ka sistema Anam a lab, metung a sistema

Potassium (K⁺), bicarbonate (HCO₃⁻), ACR, hemoglobin (Hgb), phosphorus (PO₄), and creatinine/eGFR are covered below, in that order. Jump straight to the one on your report. Ang potassium (K⁺), bicarbonate (HCO₃⁻), ACR, hemoglobin (Hgb), phosphorus (PO₄), at creatinine/eGFR ay nakasaad sa ibaba, sa pagkakasunod-sunod na iyon. Direktang tumalon sa numerong nasa inyong report. Ang potassium (K⁺), bicarbonate (HCO₃⁻), ACR, hemoglobin (Hgb), phosphorus (PO₄), ug creatinine/eGFR gitabon sa ubos, niana nga han-ay. Diretso lang sa numero nga naa sa inyong report. Ing potassium (K⁺), bicarbonate (HCO₃⁻), ACR, hemoglobin (Hgb), phosphorus (PO₄), at creatinine/eGFR ya makasulat king lalam, king kasunuran a iti. Tuluk king numerong atiu king report yu.

Universal Safety Triage — Read This First Pangkalahatang Triage sa Kaligtasan — Basahin Muna Ito Kinatibuk-ang Triage sa Kaluwasan — Basaha Una Kini Pangkalahatang Triage King Kaligtasan — Basan Mu Nune Iti

🔴 RED — ER NOW

Chest pain, fainting, a very slow or irregular pulse, severe breathlessness, weakness you can't stand up through, confusion, or no urine for 12+ hours.

🟠 AMBER — CALL TODAY

One markedly abnormal value, a worsening trend, or new swelling / breathlessness / low urine — without red-flag symptoms.

🟢 GREEN — ROUTINE

Mildly off, stable, no new symptoms. Apply the food + medication steps; review at your next visit.

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The one rule that prevents most harm Ang isang panuntunang pumipigil sa karamihan ng pinsala Ang usa ka lagda nga nagpugong sa kadaghanan sa kadaot Ing metung a tuntunan a mangpigil king dakal a danio

Never start, stop, or change a prescription on your own because of a lab number. Many kidney-protective drugs (ACE inhibitors, ARBs, SGLT2 inhibitors, MRAs, diuretics) transiently nudge these numbers and are still doing their job. Bring the number to your doctor — the decision is a shared one. Huwag kailanman magsimula, magtigil, o magbago ng reseta nang mag-isa dahil lang sa isang numero ng lab. Maraming gamot na proteksyon sa bato (ACE inhibitors, ARBs, SGLT2 inhibitors, MRAs, diuretics) ang pansamantalang nagpapataas ng mga numerong ito at ginagampanan pa rin ang trabaho nito. Dalhin ang numero sa inyong doktor — magkasamang desisyon ito. Ayaw gyud pagsugod, pag-undang, o pag-usab sa reseta nga mag-inusara tungod lang sa usa ka numero sa lab. Daghang tambal nga proteksyon sa kidney (ACE inhibitors, ARBs, SGLT2 inhibitors, MRAs, diuretics) ang temporaryo nga nagpataas niini nga mga numero apan gibuhat gihapon ang trabaho niini. Dad-a ang numero sa imong doktor — hiniusa nga desisyon kini. 督e naman magumpisa, mag-tigil, o mibaltan ning reseta king sarili yu uli king metung a numero ning lab. Dakal a gamut a protection king bato (ACE inhibitors, ARBs, SGLT2 inhibitors, MRAs, diuretics) ing pasibayu na mitas king reng numerong iti at gagawa pa rin ning trabaju na. Dalan ing numero king doktor yu — mekasama a desisyon iti.

The Six Numbers, One at a Time Ang Anim na Numero, Isa-isa Ang Unom ka Numero, Usa-usa Ding Anam a Numero, Metung-metung

This section is kept in English for precise clinical values and drug names. Ang bahaging ito ay nasa Ingles para sa tumpak na klinikal na halaga at pangalan ng gamot. Kini nga seksyon gipabilin sa English alang sa sakto nga klinikal nga bili ug ngalan sa tambal. Ini nang seksyon ya nasa English para king tumpak a klinikal a value at lagyu ning gamut.

↑ Potassium (K⁺) normal 3.5–5.0 mmol/L

Heart-rhythm mineral. Too much can stop the heart with little warning.

>6.5 or ANY level with palpitations, faintness, weakness → ER
6.0–6.5, no symptoms → call today
5.1–5.9 stable in known CKD → tighten diet, review meds
Do nowStop buko/coconut water, banana/saba, oranges, and salt-substitute (it's potassium). Peel-soak-boil vegetables and discard the water.

Meds: Do NOT self-stop your ACEi/ARB/spironolactone — ask about a potassium binder instead. Stop NSAIDs (mefenamic acid, ibuprofen).

Read next: Potassium & Hyperkalemia · Kain Pa Rin: CKD Nutrition

↓ Bicarbonate (HCO₃⁻) normal 22–29 mmol/L

Your blood's antacid. Low means acid building up — silent, but wastes bone & muscle.

<12 or fast/deep breathing, drowsiness, vomiting → ER
12–17 or falling trend → call this week
18–21 stable → diet shift, recheck
Do nowMore vegetables & CKD-safe fruit (balanced against potassium); moderate excess meat. Take prescribed bicarbonate tablets as directed.

Meds: Oral sodium bicarbonate when persistently <18. Report new swelling/breathlessness (sodium load).

Read next: Metabolic Acidosis in CKD · CKD-MBD

↑ ACR (Albumin/Creatinine) A1<30 · A2 30–300 · A3>300 mg/g

Protein leaking through the filter — the earliest, strongest kidney & heart warning.

Sharp rise + visible blood, heavy swelling, breathlessness → urgent/ER
Moved A1→A2 or A2→A3, or rising → call this week
Stable A2 on treatment → confirm with morning sample
Do nowCut salt to ~5 g/day (2 g sodium): drop instant noodles, canned/processed meat, patis, toyo, bagoong. Get sugar & BP in range.

Meds: Maximize ACEi/ARB + SGLT2 inhibitor (± finerenone in diabetic kidney disease). A ~30% creatinine rise after starting is expected — not a reason to stop.

Read next: Proteins & Proteinuria · Diabetes & Your Kidneys

↓ Hemoglobin (Hgb) low <13 (M) / <12 (F) g/dL

Oxygen carrier. Weak kidneys make less EPO and mishandle iron → the heart strains.

<7, or chest pain / fainting, or black/bloody stool → ER
7–10 or steady fall → call this week (iron studies)
10–11.5 stable on treatment → continue plan
Do nowIron-rich food within kidney limits (lean meat, egg, fish; malunggay + vitamin C). Keep iron away from coffee/tea & binders.

Meds: Iron first, then ESA/HIF-PHI. Target ~10–11.5 g/dL — not "normal" (higher targets raised stroke/clot risk). Rule out bleeding.

Read next: Anemia in Kidney Disease · Iron: Fueling Every Red Cell

↑ Phosphorus (PO₄) normal 2.5–4.5 mg/dL

Silent mineral that calcifies arteries & weakens bone via the PTH-vitamin D axis.

Very high + numbness/tingling, cramps or spasms → urgent/ER
Persistently >5.5 or rising → call this week
Mildly high, stable on binders → reinforce timing
Do nowCut phosphate additives first — cola/softdrinks, hotdog, longganisa, ham, instant noodles, cheese. Choose fresh over processed.

Meds: Take phosphate binders WITH the first bites of every meal (useless on an empty stomach). Manage calcium, vitamin D & PTH together.

Read next: Phosphorus: The Silent Threat · CKD-MBD

↑ Creatinine / ↓ eGFR interpret vs YOUR baseline

Mirror of filtering power. A sudden jump may be reversible AKI on top of CKD.

No urine 12+ h, heavy swelling + breathless, or confusion → ER
Jumped >25–30% above baseline over days–weeks → call today
Small stable change, no symptoms → confirm hydration
Do nowIf dehydrated — drink fluids. If swollen/breathless/heart failure — do NOT load fluids, call first. Avoid herbal "kidney cleanses."

Meds: Stop NSAIDs. Ask about "sick-day" holding of ACEi/ARB, SGLT2i, diuretics & metformin during vomiting/diarrhea — and when to restart.

Read next: Taking Charge of CKD · Understanding Your Lab Results

The Numbers Talk to Each Other Nag-uusap ang mga Numero Nagstoryahanay ang mga Numero Mekapamagsalitaan Deng Numero

These six labs are not six separate problems but one system. Falling eGFR is the hub; the other five are spokes — which is why one well-chosen action often moves several numbers at once. Ang anim na lab na ito ay hindi anim na hiwalay na problema kundi isang sistema. Ang bumabagsak na eGFR ang gitna; ang iba pang lima ay mga sanga — kaya isang tamang pinili na aksyon ay madalas na gumagalaw ng ilang numero nang sabay-sabay. Kining unom ka lab dili unom ka bulag nga problema kondili usa ka sistema. Ang naghinay nga eGFR mao ang sentro; ang uban limang mga sanga — mao nga usa ka maayong napili nga aksyon kasagarang naglihok sa daghang numero sa samang higayon. Deng anam a lab a iti ali anam a magkalarung a problema nune metung a sistema. Ing menaknum a eGFR ing gitna; deng aliwang lima reng sanga — iyanya reng bakit ing metung a mayap a apiling aksyon ay malimit a gagalo king pilan a numero king mabilis.

LabOne-line meaningFastest patient actionThe drug conversation
High K⁺Heart-rhythm riskStop buko/saba & salt-substituteKeep RAASi + add binder, don't self-stop
Low HCO₃⁻Acid building upMore veg, less excess meatStart oral bicarbonate
Rising ACRFilter leakingCut salt to ~5 g/dayMaximize ACEi/ARB + SGLT2i (±finerenone)
Low HgbOxygen delivery downIron-rich food, treat bleedingIron first, then ESA/HIF-PHI to ~10–11.5
High PO₄Vessel/bone calcificationCut phosphate additives (cola, processed meat)Binders WITH meals; manage PTH/Vit D
High CreatinineFiltering fallingHydrate (unless swollen); stop NSAIDsSick-day hold of nephrotoxins; find cause

Want the Full Explanation? Gusto ang Buong Paliwanag? Gusto ang Bug-os nga Pagpasabot? Buri Ing Lubus a Paliwanag?

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The Lab-to-Action Guide — Free Companion PDF

The full explainer behind every number on this card — the cross-organ story, common causes, and the KDIGO/ADA/ACC guidance each recommendation is anchored to. Print it or save it to your phone.

Download PDF →
Glossary & abbreviationsTalahulugan at mga daglatTalaan sa mga pulong ug daglatTalatinigan ampo reng daglat terms used in this guide

Abbreviations

ACEi
Angiotensin-converting enzyme inhibitor — a blood pressure medicine that widens the outflow vessel of the kidney's filter.
ACR
Albumin-to-creatinine ratio — a urine test measuring how much protein is leaking.
ARB
Angiotensin receptor blocker — a blood pressure medicine with a similar effect to an ACE-inhibitor.
AKI
Acute kidney injury — a sudden, often reversible drop in kidney function.
CKD
Chronic kidney disease.
eGFR
Estimated glomerular filtration rate — a blood test estimating how well the kidneys filter.
EPO
Erythropoietin — the hormone the kidney makes to tell bone marrow to produce red blood cells.
ESA
Erythropoiesis-stimulating agent — a medicine that mimics EPO to raise hemoglobin.
HCO₃⁻
Bicarbonate — the blood's buffer against acid.
Hgb
Hemoglobin — the oxygen-carrying protein in red blood cells.
HIF-PHI
Hypoxia-inducible factor prolyl hydroxylase inhibitor — an oral medicine that raises the body's own EPO.
K⁺
Potassium — the mineral that keeps the heart's electrical rhythm steady.
KDIGO
Kidney Disease: Improving Global Outcomes — the nephrology guideline body.
MRA
Mineralocorticoid receptor antagonist (e.g., spironolactone, finerenone) — a blood-pressure and kidney-protective medicine.
NSAID
Non-steroidal anti-inflammatory drug — a common pain reliever (e.g., mefenamic acid, ibuprofen) that can injure the kidney.
PO₄
Phosphorus (phosphate) — a mineral in bone and every cell.
PTH
Parathyroid hormone — regulates calcium and phosphorus, and rises when phosphorus is chronically high.
SGLT2i
Sodium-glucose cotransporter-2 inhibitor — a newer diabetes medicine that also protects the kidney and heart.

Terms

Albuminuria
Albumin (a blood protein) leaking into the urine — an early, powerful marker of kidney and vessel damage.
Hyperkalemia
Too much potassium in the blood.
Metabolic acidosis
Acid building up in the blood because the kidneys can no longer make and reclaim enough bicarbonate.
Phosphate binder
A medicine taken with meals that traps dietary phosphate in the gut before it can be absorbed.
Vascular calcification
Hardening of blood vessels caused by mineral deposits, accelerated by chronically high phosphorus.
ReferencesMga SanggunianMga TinubdanReng Reperensya 7 sources
  1. Levin, A., Ahmed, S. B., Carrero, J. J., Foster, B., Francis, A., Hall, R. K., Herrington, W. G., Hill, G., Inker, L. A., Kazancıoğlu, R., Lamb, E., Lin, P., Madero, M., McIntyre, N., Morrow, K., Roberts, G., Sabanayagam, D., Schaeffner, E., Shlipak, M., ... Stevens, P. E. (2024). Executive summary of the KDIGO 2024 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease: Known knowns and known unknowns. Kidney International, 105(4), 684-701. https://doi.org/10.1016/j.kint.2023.10.016
  2. Kreitzer, N., Albert, N. M., Amin, A. N., Beavers, C. J., Becker, R. C., Fonarow, G., Gibler, W. B., Kwon, K. W., Mentz, R. J., Palmer, B. F., Pollack, C. V., & Piña, I. L. (2025). EMCREG-International multidisciplinary consensus panel on management of hyperkalemia in chronic kidney disease and heart failure. Cardiorenal Medicine, 15(1), 133-152. https://doi.org/10.1159/000543385
  3. Siddiqui, A. H., Batool, F., Khan, S., Rizvi, S. S., Usman, S., Jawed, H., Ali, M. H., Zehra, T., Adil, A. R., Anwar, M., Hanif, A., Hassan, S. K., Noble, M. W., Moeed, A., & Surani, S. (2025). Safety and efficacy of sodium bicarbonate for treating metabolic acidosis in chronic kidney disease: A systematic review and meta-analysis. World Journal of Nephrology, 14(1), 101078. https://doi.org/10.5527/wjn.v14.i1.101078
  4. Rossing, P., Caramori, M. L., Chan, J. C. N., Heerspink, H. J. L., Hurst, C., Khunti, K., Liew, A., Michos, E. D., Navaneethan, S. D., Olowu, W. A., Sadusky, T., Tandon, N., Tuttle, K. R., Wanner, C., Wilkens, K. G., Zoungas, S., Craig, J. C., Tunnicliffe, D. J., Tonelli, M. A., Cheung, M., Earley, A., & de Boer, I. H. (2022). Executive summary of the KDIGO 2022 Clinical Practice Guideline for Diabetes Management in Chronic Kidney Disease: An update based on rapidly emerging new evidence. Kidney International, 102(5), 990-999. https://doi.org/10.1016/j.kint.2022.06.013
  5. Babitt, J. L., Berns, J. S., Bozkurt, B., Cheung Khedairy, R. S., Cuevas, Y., Effa, E. E., Eisenga, M. F., Fishbane, S., Ginzburg, Y. Z., Haase, V. H., Hedayati, S. S., Kim, S., Moura-Neto, J. A., Nagler, E. V., Rossignol, P., Sahay, M., Tanaka, T., Yee-Moon Wang, A., Wheeler, D. C., ... Tonelli, M. (2026). Executive summary of the KDIGO 2026 Clinical Practice Guideline for the management of anemia in CKD. Kidney International, 109(1), 44-56. https://doi.org/10.1016/j.kint.2025.06.005
  6. Ketteler, M., Block, G. A., Evenepoel, P., Fukagawa, M., Herzog, C. A., McCann, L., Moe, S. M., Shroff, R., Tonelli, M. A., Toussaint, N. D., Vervloet, M. G., & Leonard, M. B. (2017). Executive summary of the 2017 KDIGO Chronic Kidney Disease-Mineral and Bone Disorder (CKD-MBD) guideline update: What's changed and why it matters. Kidney International, 92(1), 26-36. https://doi.org/10.1016/j.kint.2017.04.006
  7. Ostermann, M., Bellomo, R., Burdmann, E. A., Doi, K., Endre, Z. H., Goldstein, S. L., Kane-Gill, S. L., Liu, K. D., Prowle, J. R., Shaw, A. D., Srisawat, N., Cheung, M., Jadoul, M., Winkelmayer, W. C., & Kellum, J. A. (2020). Controversies in acute kidney injury: Conclusions from a Kidney Disease: Improving Global Outcomes (KDIGO) conference. Kidney International, 98(2), 294-309. https://doi.org/10.1016/j.kint.2020.04.020
Dr. W Rivero, MD

W Rivero, MD, FPCP, DPSN

Specialist in Internal Medicine, Nephrology, and Clinical Nutrition. Practicing integrative and evidence-based nephrology across Quezon City, Pampanga, and Bulacan.Espesyalista sa Panloob na Medisina, Nefrolohiya, at Klinikal na Nutrisyon. Nagpapraktis ng integratibo at ebidensya-batay na nefrolohiya sa Quezon City, Pampanga, at Bulacan.Espesyalista sa Internal nga Medisina, Nefrolohiya, ug Klinikal nga Nutrisyon. Nagpraktis og integratibo ug ebidensya-base nga nefrolohiya sa Quezon City, Pampanga, ug Bulacan.Espesyalista king Panloob na Medisina, Nefrolohiya, at Klinikal na Nutrisyon. Nagpapraktis ning integratibo at ebidensya-base na nefrolohiya sa Quezon City, Pampanga, at Bulacan.

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