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Renal Phys 4

WVSOM -- Renal Phys -- measuring clearance and transport

What is clearance? volume of plasma cleared of a substance per unit time
What is the equation for clearance? Ux/Px X V
What do you know if you know GFR and clearance? any difference between GFR and clearance of X tells you something about net secretion or reabsorption
What is the units of clearance? ml/min
If urine Na is 810 mEq/L, plasma Na is 138 mEq/L and urin flow is 1 ml/min what is the clearance of Na? (810/138) x 1 = 5.87 ml/min
If substance X is filtered and completely reabsorbed what is the clearance of X? ZERO
What makes inulin a good indicator for GFR? it is freely filtered by the glomerulus and it is not reabsorbed or secreted.
Why are calcium, phosphate and magnesium not freely filtered? they are bound to protein
What is freely filtered mean/ concentration of X in bowman’s capsule is the same as that in blood plasma
Why is creatine used to estimate GFR? has properties like inulin and is exported to the blood continuously by skeletal muscle. It is freely filtered and not reabsorbed with only a small amount secreted so the clearance is only slightly higher than GFR
Creatinine clearance is mostly _________________ of urine flow. independant
When will the clearance of creatine be off? if the patient has a non-steady state as in hyperthermia or other muscle wasting conditions or damage.
What is normal plasma value of creatinine? 1mg/dl
What kind of relationship between plasma creatinine and GFR? inverse
If GFR dramatically decreases, plasma creatinine will? increase
What is BUN? Blood Urea Nitrogen
What does renal urea reabsorption depend on? urine flow. Low flow, more urea reabsorbed
In renal disease, low GFR leads to…. low urine flow, increase in urea retention nd increased BUN
What happens with volume depletion? urine flow BIG decline, urea excretion drops even out of proportion to the fall in GFR, High BUN, BUN/Creatinine ratio increases
Why does BUN/Creatinine ratio increase with volume depletion? urea excretion is flow dependant but creatinine is not
What confirms dehydration? BUN
Filtered load = GFR x Px
Excretion rate = Ux X V
Amount excreted = amount filtered – amount reabsorbed + amount secreted
Filtration Fraction = GFR/RPF
Increased FF means what in regards to bowman’s capsule? more fluid into bowman’s capsule
Reabsorption rate = filtered load – excretion rate
Secretion rate = excretion rate – filtered load
Clearance = Ux/Px X V
GFR in regards to inulin clearance. equal to each other
Clearance of PAH is what compared to GFR? greater
NFP = Pgc - ∏gc – Pbc + ∏bc
Created by: tjamrose



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