KIDNEY FUNCTION TEST

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KIDNEY FUNCTION TEST

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KIDNEY FUNCTION TEST

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WHAT IS KIDNEY? KIDNEYS.THE BODYS NATURAL FILTRATION SYSTEM PERFORMING FOLLOWING MAJOR FUNCTIONS MAINTENANCE OF HOMEOSTASIS EXCRETION OF METABOLIC WASTE PRODUCTS RETENTION OF SUBSTANCES VITAL TO THE BODY HORMONAL FUNCTIONS

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NEPHRON NEPHRON IS A FUNCTIONAL UNIT OF KIDNEY. A STRUCTURE THAT ACTUALLY PRODUCES URINE IN THE PROCESS OF REMIVING WASTES . THERE ARE ABOUT 1,000,000 NEPHRONS IN EACH HUMAN KIDNEYS.

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FORMATION OF URINE GLOMERULAR FILTRATION TUBULAR REABSORPTION GLOMERULAR FILTRATION : IT S A PASSIVE PROCESS THAT RESULTS IN THE FORMTION OF ULTRAFILTRATE OF BLOOD. ALL THE CONSTITUENTS OF PLASMA WITH MOL.WT LESS THAN THAT 70,000 ARE PASSED INTO THE FILTRATE The blood supply to kidneys is relatively large. About 1200 ml of blood passes through the kidneys, every minute. From this about 120-125 ml is filtered per minute by the kidneys and this is referred to as glomerular filtration rate (GFR). Normal GFR 120-125 ml.min In adult 175-180 lits/day More than 99 % of the glomerular filtrate is reabsorbed by the kidneys/

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TUBULAR REABSORPTION THE RENAL TUBULES RETAIN WATER AND MOST OF THE SOLUBLE CONSTITUENTS OF THE GLOMERULAR FILTRATE BY REABSORPTION THIS MAY OCCUR EITHER PASSIVE OR ACTIVE PROCESS

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TESTS TO ASSESS RENAL FUNCTION IT IS DEVIDED IN TO FOUR GROUPS 1. GLOMERULAR FUNCTION TETS All the clearance tests are included (inulin,creatinine,urea) 2. TUBULAR FUNCTION TEST Urine concentration or dilution test, urine acidification test 3. ANALYSIS OF BLOOD AND SERUM Estimation of blood urea, serum creatinine,protein,electrolyte 4 . URINE EXAMINATION Urine volume,pH,specific gravity,osmolality, and certain abnormal constituents (protein.blood,ketone bodies,etc .)

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CLEARANCE TESTS CREATININE CLEARENCE TEST UREA CLEARENCE TEST Clearance in generaly,is defined as the volume of plasma that would be completely cleared of a substance per mint.In other words clearance of a substance refers to the ml of plasma which contains the amount of the substance excreted by kidney/min . Clearance expressed as ml/min Formula C = U x V / P U = Conc of the substance in urine V = Volume of urine in ml excreted per min. P = Conc of the substance in plasma

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CREATININE CLEARENCE TEST Creatinine is the excretory product derived from creatinine phosphate (largely present in the muscle). IT IS DEFINED AS THE VOLUME OF PLASMA THAT WOULD BE COMPLETELY CLEARED OF CREATININE / MIN. PROCEUDRE In traditional, creatinine content of a 24 hr urine collection and the plasma concentration in this period are estimated. FORMULA C = U x V/ P U = Urine concn of creatinine V = Urine output in ml/min (24 hr urine volume divided by 24 x 60) P = Plasma cocn of creatinine

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MODIFIED PROCEDURE COLLECT URINE FOR 1hr,AFTER GIVING WATER VOL UME OF URINE IS RECORDED CREATININE CONTENTS IN PLASMA AND URINE ARE ESTIMATED CREATININE CLEARENCE CALCUTED BY FORMULA NORMAL RANGE OF CREATININE CLEARENCE – 120-145 ml/min

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UREA CLEARENCE TEST UREA IS THE END PRODUCY OF PROTEIN METABOLSIM UREA CLEARENCE IS DEFINED AS THE VOLUME(ml) OF PLASMA THAT WOULD BE COMPLETELY CLEARED OF UREA PER MINT . FORMULA Cm = U x V / P Cm = MAXM. UREA CLEARENCE TEST U = UREA CONCENTRATION IN URINE (mg/ml) V = URINE EXCRETED PER MIN IN ML P = UREA CONC IN PLASMA (mg/ml) Above calculation is applicable if the output of urine is more than 2 ml/min .This referred to as MAXM UREA CLEARENCE . NORMAL VALUE 75ml/MIN

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STD UREA CLEARENCE THE UREA CLEARENCE DRASTICALLY CHANGES WHEN THE VOLUME OF URINE IS LESS THAN 2ml/min. THIS KNOWN AS STD UREA CLEARENCE . NORMAL VALUE 54 ml/min FORMULA Cs = U x√V /P

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UREA CONCENTRATION TEST PURPOSE : TO ASSCESS THE RENAL TUBULAR FUNCTION PROCEDURE IT INVOLVES THE ACCURATE MEASUREMENT OF SPECIFIC GRAVITY WHICH DEPEND UPON CONC OF THE SOLUTES IN URINE NORMAL VALUE : A SPECIFIC GRAVITY OF 1.020 IN EARLY MORNING URINE SAMPLE CONSIDERED AS NORMAL TUBULAR FUNCTION TEST : Urea conc. test is coming under tubular function test