2%20Lecture%20Notes%20-%201%20per%20page

2%20Lecture%20Notes%20-%201%20per%20page - Glomerular...

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Glomerular Filtration Rate (GFR) otal volume of filtrate formed by all Total volume of filtrate formed by all nephrons of kidneys per minute Normal value: 125 mL/min Females are slightly lower
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MDRD Creatinine Clearance Equation asic formula for creatinine in mg/dL: Basic formula for creatinine in mg/dL: eGFR = 186 x S Creatinine -1.154 x Age -0.203 x [ 1.210 if black ] x [ 0.742 if female ] More detailed formula for creatinine in mg/dL: eGFR = 170 x S Creatinine -0.999 x Age -0.176 x [ 0.762 if female ] x [ 1.180 if black ] x UN -0.170 lbumin +0.318 BUN x Albumin
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Blood Urea Nitrogen (BUN) itrogen in the form of urea in the blood Nitrogen in the form of urea in the blood The most prevalent of nonprotein nitrogenous compounds in blood ommonly used as a measure of renal Commonly used as a measure of renal function ormal: 10 0 mg/dL Normal: 10–20 mg/dL
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reatinine Creatinine (Cr) Breakdown product of muscle metabolism Normal value: Males: 0.6 – 1.2 mL/dL Females: 0.5 – 1.1 mL/dL
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UN:Cr Ratio BUN:Cr Ratio BUN:Cr Ratio (mg/dL) Location of Renal Disorder Mechanism > 20:1 Pre-renal Disease efore lomeruli) Reduced flow causes elevated Cr and UN due to decreased GFR. (before glomeruli) BUN due to decreased GFR. Additionally, BU reabsorption is increased because of the lower flow; BUN is disproportionally elevated lative to Cr. relative to Cr. 10 – 20:1 Normal or Post- renal Disease (within ureter) Normal range. In some instances, can be Post-Renal, as backflow from obstruction causes elevated BUN absorption within kidney; Cr is not reabsorption within kidney; Cr is not reabsorbed, therefore BUN:Cr ratio increases < 10:1 Intrarenal Disease Renal damage causes reduced BUN (within kidneys) re-absorption, therefore lowering BUN:Cr ratio
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ajor Causes of Azotemia Major Causes of Azotemia An abnormal increase in concentration of urea and other nitrogenous enal failure cute/chronic) substances in the blood plasma Renal failure (acute/chronic) eart failure Heart failure I bleeding GI bleeding
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cute Renal Failure Acute Renal Failure sudden and rapid deterioration of A sudden and rapid deterioration of renal function A deviation from a steady state, sulting in nitrogen retention and resulting in nitrogen retention and fluid and electrolyte imbalance
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auses of ARF Causes of ARF re nal trinsic (renal) Pre-renal Severe dehydration Circulatory collapse Intrinsic (renal) Acute tubular necrosis rauma surgery Post-renal (obstruction) Trauma, surgery, sepsis Nephrotoxicity Antibiotics, contrast Benign prostatic hypertrophy Carcinoma of the agents Vascular diseases Bilateral renal farct bladder or prostate Ureterovesical stricture infarct Acute glomerulo- nephritis
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hronic Kidney Disease Chronic Kidney Disease yndrome of progressive and irreversible Syndrome of progressive and irreversible loss of the excretory, endocrine and metabolic functions of the kidney secondary to kidney damage ultiple causes lead to fairly uniform set of Multiple causes lead to fairly uniform set of problems
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2%20Lecture%20Notes%20-%201%20per%20page - Glomerular...

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