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Overview of Renal Clearance Tests

Renal function tests measure the filtering and reabsorbing abilities of the kidneys. Clearance tests determine the rate at which kidneys clear substances from the blood. The creatinine clearance test is routinely used to estimate glomerular filtration rate (GFR) by measuring creatinine levels in urine and serum over 24 hours. The Cockcroft-Gault formula estimates creatinine clearance from serum creatinine levels and is commonly used in clinical practice. Other tests like inulin clearance directly measure GFR but are more complex to perform.

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56 views12 pages

Overview of Renal Clearance Tests

Renal function tests measure the filtering and reabsorbing abilities of the kidneys. Clearance tests determine the rate at which kidneys clear substances from the blood. The creatinine clearance test is routinely used to estimate glomerular filtration rate (GFR) by measuring creatinine levels in urine and serum over 24 hours. The Cockcroft-Gault formula estimates creatinine clearance from serum creatinine levels and is commonly used in clinical practice. Other tests like inulin clearance directly measure GFR but are more complex to perform.

Uploaded by

Daena Timtiman
Copyright
© All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PDF, TXT or read online on Scribd

Renal Function Tests

CLEARANCE TEST

- Standard test used to measure the filtering


capacity of the glomeruli

- Rate at which the kidneys are able to clear a


filterable substance in the blood
Criteria of Substance to be Used:
- Freely filtered by the glomeruli
- Completely excreted by the tubules
- Endogenous procedure
- Exogenous procedure

Urea Clearance Test


– earliest GFT
- Disadvantage ( 40% of filtered urea= absorbed)
Creatinine Clearance Test
- Routinely performed
- Endogenous procedure
- Reported in ml/min
C = U(mg/dl) X Volume (ml/min)
P (mg/dl)
- Used to predict the creatinine clearance
from serum creatinine
- Formula (Male)

- Crea clearance= 140-age X weight in Kg

- 72 x Serum Creat in mg/dl


- *** ave. Male weight is 72 kg.
 Simplified :

C cr= ____140- age_______


serum crea in mg/dl

If female multiply the result further by 0.85

*** estimates based on regression analysis


*** respondents 18-92 y.o. Male patients
Exogenous procedure

Inulin- a polymer of fructose

- Drawbacks = must be infused at constant


rate throughout the procedure
B2Microglobulin dissociates from human
leukocyte antigen and rapidly removed
from plasma

Increase B2 decrease GFR

Measured by RIA and EIA


- Measures the ability of the tubules to
reabsorbs the essential salts and water

- FISHBERG AND MOSENTHAL CONC. TEST


- Pt. Deprived of fluid for 24 hrs.
- Compare the [Link] of AM/PM sample
- Normal findings: after 16 hours of
deprivation = Sp. Gravity 1.025
- Overnight = 800mOsm
 Sp. Gravity = depends on the number and
the density of the particles present in a
solution

 Osmolarity= depends only on the


number of particles present in
solution
- freezing point osmometers
 Vapor pressure osmometers
 PAH ( p-aminohippuric acid test)
- Standard clearance formula is used.
 NV: effective renal plasma flow 600-700ml/min ave:
1200ml/min

 Titratable Acidity and Urinary ammonia level

pH = dependent on secretions of hydrogen ion and


production and secretion of ammonia

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