Extraction Ratio
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Extraction Ratio
Extraction ratio is a measure in renal physiology, primarily used to calculate renal plasma flow in order to evaluate renal function. It measures the percentage of the compound entering the kidney that was excreted into the final urine.Renal Mathematics
Texas Tech University Health Sciences Center Measured in concentration in , it may thus be expressed as: :Extraction \ ratio = \frac , where Pa is the concentration in , and Pv is the concentration in the

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Renal Physiology
Renal physiology (Latin ''rēnēs'', "kidneys") is the study of the physiology of the kidney. This encompasses all functions of the kidney, including maintenance of acid-base balance; regulation of fluid balance; regulation of sodium, potassium, and other electrolytes; clearance of toxins; absorption of glucose, amino acids, and other small molecules; regulation of blood pressure; production of various hormones, such as erythropoietin; and activation of vitamin D. Much of renal physiology is studied at the level of the nephron, the smallest functional unit of the kidney. Each nephron begins with a filtration component that filters the blood entering the kidney. This filtrate then flows along the length of the nephron, which is a tubular structure lined by a single layer of specialized cells and surrounded by capillaries. The major functions of these lining cells are the reabsorption of water and small molecules from the filtrate into the blood, and the secretion of wastes f ...
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Renal Plasma Flow
In the physiology of the kidney, renal blood flow (RBF) is the volume of blood delivered to the kidneys per unit time. In humans, the kidneys together receive roughly 25% of cardiac output, amounting to 1.2 - 1.3 L/min in a 70-kg adult male. It passes about 94% to the cortex. RBF is closely related to renal plasma flow (RPF), which is the volume of blood plasma delivered to the kidneys per unit time. While the terms generally apply to arterial blood delivered to the kidneys, both RBF and RPF can be used to quantify the volume of venous blood exiting the kidneys per unit time. In this context, the terms are commonly given subscripts to refer to arterial or venous blood or plasma flow, as in RBFa, RBFv, RPFa, and RPFv. Physiologically, however, the differences in these values are negligible so that arterial flow and venous flow are often assumed equal. Renal plasma flow Renal plasma flow is the volume of plasma that reaches the kidneys per unit time. Renal plasma flow is given ...
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Renal Function
Assessment of kidney function occurs in different ways, using the presence of symptoms and signs, as well as measurements using urine tests, blood tests, and medical imaging. Functions of a healthy kidney include maintaining a person's fluid balance, maintaining an acid-base balance; regulating electrolytes including sodium, potassium, and other electrolytes; clearing toxins; regulating blood pressure; and regulating hormones, such as erythropoietin; and activation of vitamin D. Introduction The functions of the kidney include maintenance of acid-base balance; regulation of fluid balance; regulation of sodium, potassium, and other electrolytes; clearance of toxins; absorption of glucose, amino acids, and other small molecules; regulation of blood pressure; production of various hormones, such as erythropoietin; and activation of vitamin D. Much of renal physiology is studied at the level of the nephron, the smallest functional unit of the kidney. Each nephron begins w ...
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Blood Plasma
Blood plasma is a light amber-colored liquid component of blood in which blood cells are absent, but contains proteins and other constituents of whole blood in suspension. It makes up about 55% of the body's total blood volume. It is the intravascular part of extracellular fluid (all body fluid outside cells). It is mostly water (up to 95% by volume), and contains important dissolved proteins (6–8%; e.g., serum albumins, globulins, and fibrinogen), glucose, clotting factors, electrolytes (, , , , , etc.), hormones, carbon dioxide (plasma being the main medium for excretory product transportation), and oxygen. It plays a vital role in an intravascular osmotic effect that keeps electrolyte concentration balanced and protects the body from infection and other blood-related disorders. Blood plasma is separated from the blood by spinning a vessel of fresh blood containing an anticoagulant in a centrifuge until the blood cells fall to the bottom of the tube. The blood plasma is t ...
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Renal Artery
The renal arteries are paired arteries that supply the kidneys with blood. Each is directed across the crus of the diaphragm, so as to form nearly a right angle. The renal arteries carry a large portion of total blood flow to the kidneys. Up to a third of total cardiac output can pass through the renal arteries to be filtered by the kidneys. Structure The renal arteries normally arise at a 90° angle off of the left interior side of the abdominal aorta, immediately below the superior mesenteric artery. They have a radius of approximately 0.25  cm, 0.26 cm at the root. The measured mean diameter can differ depending on the imaging method used. For example, the diameter was found to be 5.04 ± 0.74 mm using ultrasound but 5.68 ± 1.19 mm using angiography. Due to the anatomical position of the aorta, the inferior vena cava, and the kidneys, the right renal artery is normally longer than the left renal artery. * The right passes behind the inferior vena cava, ...
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Renal Vein
The renal veins are large-calibre veins that drain blood filtered by the kidneys into the inferior vena cava. There is one renal vein draining each kidney. Because the inferior vena cava is on the right half of the body, the left renal vein is longer than the right one. Structure One renal vein drains each kidney. A renal vein is situated anterior to its corresponding accompanying renal artery. The renal veins empty into the inferior vena cava, entering it at nearly a 90° angle. Due to the right-ward displacement of the inferior vena cava from the midline, the left renal vein is some 3 times longer than the right one (~7.5 cm and ~2.5 cm, respectively). The renal vein divides into 4 divisions upon entering the kidney: * the anterior branch which receives blood from the anterior portion of the kidney and, * the posterior branch which receives blood from the posterior portion. Tributaries Because the tributaries of the inferior vena cava are not bilaterally symmetrical, the l ...
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Para Aminohippuric Acid
Aminohippuric acid or ''para''-aminohippuric acid (PAH), a derivative of hippuric acid, is a diagnostic agent useful in medical tests involving the kidney used in the measurement of renal plasma flow. It is an amide derivative of the amino acid glycine and ''para''-aminobenzoic acid that is not naturally found in humans; it needs to be IV infused before diagnostic use. Uses Diagnostics PAH is useful for the measurement of renal plasma flow. The renal extraction ratio of PAH in a normal individual is approximately 0.92. This means that unlike inulin and creatinine, which are filtered in the glomerulus and ignored by the rest of the kidney, aminohippuric acid is both filtered and secreted, being almost entirely removed from the bloodstream in a normal kidney. Pharmaceuticals Aminohippuric acid is often used as the sodium salt sodium ''para''-aminohippurate. During World War II, ''para''-aminohippurate was given along with penicillin in order to prolong the time penicillin circu ...
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PAH Clearance
Para-aminohippurate (PAH) clearance is a method used in renal physiology to measure renal plasma flow, which is a measure of renal function. PAH is completely removed from blood that passes through the kidneys (PAH undergoes both glomerular filtration and tubular secretion), and therefore the rate at which the kidneys can clear PAH from the blood reflects total renal plasma flow. The concentration of PAH is measured in one arterial blood sample (PPAH) and one urine sample(UPAH). The urine flow (V) is also measured. Renal perfusion flow is then calculated by: :RPF = \frac V What is calculated is the effective renal plasma flow (eRPF). However, since the renal extraction ratio of PAH almost equals 1, then eRPF almost equals RPF. Precision The renal extraction ratio of PAH in a normal individual is approximately 0.92, and thus not exactly 1.0. Thus, this method usually underestimates RPF by approximately 10%. This margin of error is generally acceptable considering the ease ...
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Hepatocytes
A hepatocyte is a cell of the main parenchymal tissue of the liver. Hepatocytes make up 80% of the liver's mass. These cells are involved in: * Protein synthesis * Protein storage * Transformation of carbohydrates * Synthesis of cholesterol, bile salts and phospholipids * Detoxification, modification, and excretion of exogenous and endogenous substances * Initiation of formation and secretion of bile Structure The typical hepatocyte is cubical with sides of 20-30  μm, (in comparison, a human hair has a diameter of 17 to 180 μm).The diameter of human hair ranges from 17 to 181 μm. The typical volume of a hepatocyte is 3.4 x 10−9 cm3. Smooth endoplasmic reticulum is abundant in hepatocytes, in contrast to most other cell types. Microanatomy Hepatocytes display an eosinophilic cytoplasm, reflecting numerous mitochondria, and basophilic stippling due to large amounts of smooth endoplasmic reticulum and free ribosomes. Brown lipofuscin granules are also observed ( ...
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Propranolol
Propranolol, sold under the brand name Inderal among others, is a medication of the beta blocker class. It is used to treat high blood pressure, a number of types of irregular heart rate, thyrotoxicosis, capillary hemangiomas, performance anxiety, and essential tremors, as well to prevent migraine headaches, and to prevent further heart problems in those with angina or previous heart attacks. It can be taken by mouth or by injection into a vein. The formulation that is taken by mouth comes in short-acting and long-acting versions. Propranolol appears in the blood after 30 minutes and has a maximum effect between 60 and 90 minutes when taken by mouth. Common side effects include nausea, abdominal pain, and constipation. It should not be used in those with an already slow heart rate and most of those with heart failure. Quickly stopping the medication in those with coronary artery disease may worsen symptoms. It may worsen the symptoms of asthma. Caution is recommended in those ...
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Opiates
An opiate, in classical pharmacology, is a substance derived from opium. In more modern usage, the term ''opioid'' is used to designate all substances, both natural and synthetic, that bind to opioid receptors in the brain (including antagonists). Opiates are alkaloid compounds naturally found in the opium poppy plant ''Papaver somniferum''. The psychoactive compounds found in the opium plant include morphine, codeine, and thebaine. Opiates have long been used for a variety of medical conditions with evidence of opiate trade and use for pain relief as early as the eighth century AD. Opiates are considered drugs with moderate to high abuse potential and are listed on various "Substance-Control Schedules" under the Uniform Controlled Substances Act of the United States of America. In 2014, between 13 and 20 million people used opiates recreationally (0.3% to 0.4% of the global population between the ages of 15 and 65). According to the CDC, from this population, there were 47,000 ...
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Lignocaine
Lidocaine, also known as lignocaine and sold under the brand name Xylocaine among others, is a local anesthetic of the amino amide type. It is also used to treat ventricular tachycardia. When used for local anaesthesia or in nerve blocks, lidocaine typically begins working within several minutes and lasts for half an hour to three hours. Lidocaine mixtures may also be applied directly to the skin or mucous membranes to numb the area. It is often used mixed with a small amount of adrenaline (epinephrine) to prolong its local effects and to decrease bleeding. If injected intravenously, it may cause cerebral effects such as confusion, changes in vision, numbness, tingling, and vomiting. It can cause low blood pressure and an irregular heart rate. There are concerns that injecting it into a joint can cause problems with the cartilage. It appears to be generally safe for use in pregnancy. A lower dose may be required in those with liver problems. It is generally safe to use in those ...
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