Measuring Kidney Function Flashcards

1
Q

what is used to measure kidney function

A

glomerular filtration rate

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2
Q

what is GFR

A

the amount of filtrate that is produced from the blood flow per unit time

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3
Q

what is the normal GFR

A

90-120 mL/min

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4
Q

what is the normal glomerular filtrate per day

A

140-180 L

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5
Q

what does the GFR depend on

A

gender, age, size of person, size of kidneys, pregnancy

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6
Q

how is the GFR different in babies

A

the GFR is lower as in uterus the mother removed waste products

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7
Q

when does a babies GFR become normal

A

by 18 months

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8
Q

how does the GFR change in old age

A

GFR declines as there is a loss of functioning nephrons

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9
Q

what is compensatory hypertrophy

A

when one kidney enlarges due to a reduction in nephron number in the other kidney

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10
Q

with compensatory hypertrophy is there an increase in nephron size or nephron number?

A

nephron size - although if it occurs early on in development you can get an increase in nephron number

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11
Q

does compensatory hypertrophy occur in old age when the kidneys get smaller

A

no

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12
Q

what are the risks of compensatory hypertrophy

A

the nephrons work hard so may wear out forming cortical scars in the kidney

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13
Q

what happens to the GFR in pregnancy

A

it increases by 50%

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14
Q

what does a fall in GFR mean?

A

kidney function in the individual has worsened

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15
Q

what does a rise in GFR mean?

A

kidney function has recovered

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16
Q

what happens to the GFR when kidney function declines slowly

A

individual nephrons hypertrophy so the GFR may not fall until significant kidney damage occurs

17
Q

what is clearance

A

the volume of plasma cleared of a substance per unit of time

18
Q

what is the clearance calculation

A

clearance = amount of substance removed from plasma / plasma concentration of substance

19
Q

what is the calculation for renal clearance

A

amount of substance in urine x urine volume / plasma concentration

20
Q

what characteristics should a substance being used to measure renal clearance have

A
  • must filter through glomerulus
  • not reabsorbed by nephron
  • not secreted by nephron
  • produced at a constant rate
21
Q

why is inulin not used to measure renal clearance

A

requires injection by IV, catheterisation and urine monitoring

22
Q

if a substance is completely cleared from the kidney what is it equal to

A

the GFR

23
Q

what radio active substance is used to measure clearance

A

51 Cr-EDTA

24
Q

why is clearance 10% with 51 Cr-EDTA

A

as some is reabsorbed

25
Q

when is 51 Cr-EDTA used

A

for children

for those undergoing kidney transplant

26
Q

what endogenous substance is used to measure GFR

A

creatinine

27
Q

why is creatinine not give an accurate GFR

A

creatinine is also secreted by the nephron so overestimates the GFR by 10-20%

28
Q

how is creatinine clearance measured

A

by collecting urine over 24 hours and getting a measurement of serum creatinine

29
Q

why is creatinine used in pregnancy

A

as you don’t want to give a radioactive substance to a pregnant woman

30
Q

what increases creatinine levels

A

meat, increased muscle mass

31
Q

as the GFR declines what happens to the renal secretion of creatinine

A

it increases

32
Q

what factors increase serum creatinine

A

male, black, muscular, meat

33
Q

are serum creatinine levels higher or lower nearly childhood

A

lower - as the creatinine is the same as the mothers at birth, but as the mother had a higher GFR, more creatinine was filtered

34
Q

how is GFR estimated from serum creatinine

A

using the eGFR (estimated GFR)

35
Q

why is eGFR less accurate with mild kidney disease

A
  • reduction in GFR
  • reduced nephron number leads to nephron hypertrophy so theres no change in GFR
  • reduced filtration of creatinine results in increased serum creatinine and increased secretion