Formation of
urine as the
waste product
Excretion of
NPN
substances
Regulation of
salt & water
balance
Regulation of
acid-...
Assessment of the
extent of renal
damage
Monitoring the
progression of renal
damage
Monitoring and
adjusting the dose
of r...
Renal blood
flow
GFR
Renal glomeruli
function
Renal tubular
function
Urinary output
RFTs give information regarding…….
1. Urine analysis
2. Tests for assessment of glomerular function
3. Tests to measure renal plasma flow
4. Tests for assess...
Physical
examination
Chemical
examination
Microscopic
examination
Renal clearance
test
Blood urea and
serum creatinine
Proteinuria Haematuria
RFT
Renal clearance of a substance is defined as the
volume of plasma from which the substance is
completely cleared by the ki...
• Endogenous creatinine and urea
• Exogenous inulin
Substances used for clearance test
Renal clearance test used to assess...
Creatinine
• Based on the rate of excretion by the kidneys
of metabolically produced creatinine
Creatinine clearance test
...
Normal
↓Creatinine
clearance
90-
120ml/min
↓GFR
Creatinine clearance test
Normal
Sensitivity of
the test is
less
75ml/min
40% filtered
urea is
reabsorbed
Urea clearance test
Normal
Method of choice
for determination
of GFR
120ml/min
Freely filtered &
neither reabsorbed
nor secreted by
tubules
In...
Renal clearance
test
Proteinuria Haematuria
RFT
Blood urea 20-
40mg/dl
S. creatinine 0.6-
1.2mg/dl
Renal clearance
test
Blood urea and
serum creatinine
Haematuria
RFT
• Proteinuria in urine is an indicator of leaky
glomeruli
• 30-300mg/day is called microalbuminuria
• Microalbuminuria is ...
Renal clearance
test
Blood urea and
serum creatinine
Proteinuria
RFT
Intact glomerulus does not allow the passage of
RBC.
Glomerular damage, RBC leakage occurs
Urine concentration test
Urine dilution test
Specific proteinuria or Tubular proteinuria
Glycosuria
Amino aciduria
Renal function tests ppt BIOCHEMISTRY
Renal function tests ppt BIOCHEMISTRY
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Renal function tests ppt BIOCHEMISTRY

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  • Cx = (UxV)/PCx is clearance of a substance x, Ux and Px are concentrations of the substance in urine and plasma respectively, and V the volume of urine per unit time.In estimating clearance, concentration and volume units must be consistent. For example, if urine creatinine concentration is 70 mg/dL and volume is 2000 mL/day, urine creatinine must also be expressed in mg/mL, not mg/dL. So the total amount excreted is: 0.7 mg/mL × 2000 mL/day = 1400 mg/day.A clearance in mL/24 hours can be converted to a clearance in mL/min by dividing the value by 1440, since 24 hours equals 1440 minutes.Quick Formulas for the Calculation of ClearanceWhen calculating a 24-hour clearance in mL/min, urine creatinine excretion may be expressed in g/24 hours instead of mg/24 hours while expressing the plasma creatinine as mg/dL instead of mg/mL. The incorrect use of these units can be rectified by multiplying the final result by 1000 (for using g instead of mg) and then by 100 (for using mg/dL instead of mg/mL). A further correction requires dividing the value by 1440 in order to convert a 24-hour clearance value to a value in mL/min as follows ( Carroll, 1989 ):(14-7) Cx = UxV (g/24 hours)/Px (mg/dL) × 100 000 × 1/1440Since 100 000/1440 = 70:(14-8) Cx (mL/min) = Ux (g/day) × 70/Px (mg/dL)
  • Renal function tests ppt BIOCHEMISTRY

    1. 1. Formation of urine as the waste product Excretion of NPN substances Regulation of salt & water balance Regulation of acid-base balance Production of Hormones Functions of KIDNEY
    2. 2. Assessment of the extent of renal damage Monitoring the progression of renal damage Monitoring and adjusting the dose of renal toxic drugs Renal Function Tests –required for……
    3. 3. Renal blood flow GFR Renal glomeruli function Renal tubular function Urinary output RFTs give information regarding…….
    4. 4. 1. Urine analysis 2. Tests for assessment of glomerular function 3. Tests to measure renal plasma flow 4. Tests for assessment of tubular function
    5. 5. Physical examination Chemical examination Microscopic examination
    6. 6. Renal clearance test Blood urea and serum creatinine Proteinuria Haematuria RFT
    7. 7. Renal clearance of a substance is defined as the volume of plasma from which the substance is completely cleared by the kidneys per minute
    8. 8. • Endogenous creatinine and urea • Exogenous inulin Substances used for clearance test Renal clearance test used to assess the rate of glomerular filtration and renal blood flow
    9. 9. Creatinine • Based on the rate of excretion by the kidneys of metabolically produced creatinine Creatinine clearance test Creatinine
    10. 10. Normal ↓Creatinine clearance 90- 120ml/min ↓GFR Creatinine clearance test
    11. 11. Normal Sensitivity of the test is less 75ml/min 40% filtered urea is reabsorbed Urea clearance test
    12. 12. Normal Method of choice for determination of GFR 120ml/min Freely filtered & neither reabsorbed nor secreted by tubules Inulin clearance test
    13. 13. Renal clearance test Proteinuria Haematuria RFT
    14. 14. Blood urea 20- 40mg/dl S. creatinine 0.6- 1.2mg/dl
    15. 15. Renal clearance test Blood urea and serum creatinine Haematuria RFT
    16. 16. • Proteinuria in urine is an indicator of leaky glomeruli • 30-300mg/day is called microalbuminuria • Microalbuminuria is the earliest sign of renal damage Small amount of protein usually less than 30mg/day, is found in urine
    17. 17. Renal clearance test Blood urea and serum creatinine Proteinuria RFT
    18. 18. Intact glomerulus does not allow the passage of RBC. Glomerular damage, RBC leakage occurs
    19. 19. Urine concentration test Urine dilution test Specific proteinuria or Tubular proteinuria Glycosuria Amino aciduria
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