Renal Clearance Flashcards

1
Q

what is clearance?

A

the volume of plasm cleared of a substance by the kidney in a unit of time
amount excreted / plasma concentration
Cx = (Ux*V)/Px

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2
Q

what are characteristics of GFR markers?

A
  • freely filtered (filtrate conc = plasma conc)
  • neither reabsorbed or secreted
  • not metabolized by cells
  • accurately measureable
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3
Q

what are common GFR markers?

A

inulin
creatinin
cystatin C–NOT present in urine- degraded in tubules

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4
Q

what is the filtered amount?

A

GFR * plasma conc = filtered load

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5
Q

what is the definition of kidney failure in terms of GFR?

A

<25% of normal GFR

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6
Q

what is a draw back of using creatinine to measure GFR?

A

cannot detect acute renal failure because of a lag in measurements

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7
Q

what affects creatinine?

A

aging- decrease GFR
pregnancy- increase GFR
body composition- muscle mass present

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8
Q

what is fractional clearance?

A

ratio of substance clearance to inulin clearance

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9
Q

what is the fraction clearance of a GFR marker?

A

Cx / Cin = 1

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10
Q

what is the fractional clearance of a secreted substance?

A

Cx/ Cin > 1

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11
Q

what is the fractional clearance of an absorbed substance?

A

Cx / Cin < 1

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12
Q

what is tm? what substances have it?

A

saturation level of an organic substances- determined by the number of transporters present

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13
Q

what is PAH? what is it used for?

A

para-aminohippurate
used to measure renal plasma flow
Cpah = total RPF

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14
Q

what is the Fick method of renal plasma flow? why is it different?

A

takes into account the extraction efficiency for PAH
divides Upah * V by the difference in afferent and efferent arteriole concentrations of the substance (rather than plasma concentration)

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15
Q

how is the amount of water absorbed in the tubules determined?

A

U/P ratio for inulin
U/P = 1 no water reabsorption
U/P = 2 50% water absorbed
U/P = 100 99% of water reabsorbed

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16
Q

what is the percent of water reabsorbed?

A

100 - [100/(U/P)in]

17
Q

what is the normal range of water reabsorption?

A

U/P = 50-100

1% of filtered water is excreted

18
Q

what is free water clearance?

A

volume of plasma completely cleared of our water per unit time
CH2O = V - Cosm
Cosm = Uosm * V / Posm

19
Q

what is positive free water clearance?

A

urine is hyposmotic

remaining body fluids are concentrated

20
Q

what is negative free water clearance?

A

urine is hyperosmotic

remaining body fluids are diluted