General overview
12 important questions on General overview
How is the arterial input calculated?
--> concentration of X in the plasma = Px
--> RPFa is the arterial renal plasma flow
What is the mass balance in the kidney?
--> mass that enters the kidney should also go out, either via the veins or via the urine
What is the formula of the clearance equation?
--> Cx is the rate at which x is removed from the plasma (clearance), in ml/min
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What is special about the creatinine production?
What happens with the excretion and concentration of Cr, when GFR decreases with 50%?
Picture -> 2 to 1 kidney
What happens to the functionality of a kidney after a few months when for example one kidney is removed?
Sometimes it is not possible/handy to measure something in the urine, then formulas are used. Which formulas?
- Ccr = (140-age)*body weight*1.23 /C(cr, plasma)
- multiply with 0.85 when female
- GFR = 186*(serum creatine/88,4) - 1,154*age -0,203
- *0,742 (when female)
--> GFR = (Ucr * V) / Pcr => 24 hours urine collection
- V should be per minute
What are disadvantages of cockcroft and MDRD?
Based on body weight as a measure of muscle mass => overestimation of GFR in obesity; underestimation in elderly or immobile patients and those with muscle or rheumatic disease
MDRD:
More reliable between 20-60 ml/min/1.73 m2 is based on normal standard body weight. Better not to use in those with low BW (overestimation) or with extreme muscle mass (underestimation) because relation between body weight and muscle mass will be different from standard
Is glucose excreted or cleared?
--> diabetic patients
Sometimes the clearance of a given substance can be used to calculate the renal plasma flow (RPF), which substance can be used for example? And what are the requirements for such a substance?
requirements for such a substance are:
- plasma constituent
- filtered, secreted, and removed from the blood during one single passage
- not reabsorbed
- does not influence the kidney function
Where does the efferent arteriole in the kidney give rise to?
Which part of the nephron is located in the medulla and which part in the cortex?
Medulla = rest
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