Glomerular Filtration Rate
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Glomerular Filtration Rate
Renal functions include maintaining an acid–base balance; regulating fluid balance; regulating sodium, potassium, and other electrolytes; clearing 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. One of the measures of kidney function is the glomerular filtration rate (GFR). Glomerular filtration rate describes the flow rate of filtered fluid through the kidney. Creatinine clearance rate (CCr or CrCl) is the volume of blood plasma that is cleared of creatinine per unit time and is a useful measure for approximating the GFR. Creatinine clearance exceeds GFR due to creatinine secretion, which can be blocked by cimetidine. Both GFR and CCr may be accurately calculated by comparative measurements of substances in the blood and urine, or estimated by formulas using just a blood test result (eGFR and eCCr) The results of these tests are used ...
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Inulin
Inulins are a group of naturally occurring polysaccharides produced by many types of plants, industrially most often extracted from chicory. The inulins belong to a class of dietary fibers known as fructans. Inulin is used by some plants as a means of storing energy and is typically found in roots or rhizomes. Most plants that synthesize and store inulin do not store other forms of carbohydrate such as starch. In the United States in 2018, the Food and Drug Administration approved inulin as a dietary fiber ingredient used to improve the nutritional value of manufactured food products. Using inulin to measure kidney function is the "gold standard" for comparison with other means of estimating glomerular filtration rate. Origin and history Inulin is a natural storage carbohydrate present in more than 36,000 species of plants, including agave, wheat, onion, bananas, garlic, asparagus, Jerusalem artichoke, and chicory. For these plants, inulin is used as an energy reserve and for r ...
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Chronic Kidney Disease
Chronic kidney disease (CKD) is a type of kidney disease in which a gradual loss of kidney function occurs over a period of months to years. Initially generally no symptoms are seen, but later symptoms may include leg swelling, feeling tired, vomiting, loss of appetite, and confusion. Complications can relate to hormonal dysfunction of the kidneys and include (in chronological order) high blood pressure (often related to activation of the renin–angiotensin system system), bone disease, and anemia. Additionally CKD patients have markedly increased cardiovascular complications with increased risks of death and hospitalization. Causes of chronic kidney disease include diabetes, high blood pressure, glomerulonephritis, and polycystic kidney disease. Risk factors include a family history of chronic kidney disease. Diagnosis is by blood tests to measure the estimated glomerular filtration rate (eGFR), and a urine test to measure albumin. Ultrasound or kidney biopsy may be performe ...
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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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Creatine Phosphate
Phosphocreatine, also known as creatine phosphate (CP) or PCr (Pcr), is a phosphorylated form of creatine that serves as a rapidly mobilizable reserve of high-energy phosphates in skeletal muscle, myocardium and the brain to recycle adenosine triphosphate, the energy currency of the cell. Chemistry In the kidneys, the enzyme AGAT catalyzes the conversion of two amino acids — arginine and glycine — into guanidinoacetate (also called glycocyamine or GAA), which is then transported in the blood to the liver. A methyl group is added to GAA from the amino acid methionine by the enzyme GAMT, forming non-phosphorylated creatine. This is then released into the blood by the liver where it travels mainly to the muscle cells (95% of the body's creatine is in muscles), and to a lesser extent the brain, heart, and pancreas. Once inside the cells it is transformed into phosphocreatine by the enzyme complex creatine kinase. Phosphocreatine is able to donate its phosphate group to convert ad ...
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Filtration Fraction
In renal physiology, the filtration fraction is the ratio of the glomerular filtration rate (GFR) over the renal plasma flow (RPF). Filtration Fraction, FF = GFR/RPF, or FF = \frac. The filtration fraction, therefore, represents the proportion of the fluid reaching the kidneys that passes into the renal tubules. It is normally about 20%. GFR on its own is the most common and important measure of renal function. However, in conditions such as renal artery stenosis, blood flow to the kidneys is reduced. Filtration fraction must therefore be increased in order to perform the normal functions of the kidney. Loop diuretics and thiazide diuretics decrease filtration fraction. Catecholamines (norepinephrine and epinephrine) increase filtration fraction by vasoconstriction of afferent arteriole, afferent and efferent arterioles, possibly through activation of alpha-1 adrenergic receptors. Severe hemorrhage will also result in an increased filtration fraction. References

Ren ...
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Minute
The minute is a unit of time usually equal to (the first sexagesimal fraction) of an hour, or 60 seconds. In the UTC time standard, a minute on rare occasions has 61 seconds, a consequence of leap seconds (there is a provision to insert a negative leap second, which would result in a 59-second minute, but this has never happened in more than 40 years under this system). Although not an SI unit, the minute is accepted for use with SI units. The SI symbol for ''minute'' or ''minutes'' is min (without a dot). The prime symbol is also sometimes used informally to denote minutes of time. History Al-Biruni first subdivided the hour sexagesimally into minutes, seconds, thirds and fourths in 1000 CE while discussing Jewish months. Historically, the word "minute" comes from the Latin ''pars minuta prima'', meaning "first small part". This division of the hour can be further refined with a "second small part" (Latin: ''pars minuta secunda''), and this is where the word "second" comes ...
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Millilitre
The litre (international spelling) or liter (American English spelling) (SI symbols L and l, other symbol used: ℓ) is a metric unit of volume. It is equal to 1 cubic decimetre (dm3), 1000 cubic centimetres (cm3) or 0.001 cubic metre (m3). A cubic decimetre (or litre) occupies a volume of (see figure) and is thus equal to one-thousandth of a cubic metre. The original French metric system used the litre as a base unit. The word ''litre'' is derived from an older French unit, the '' litron'', whose name came from Byzantine Greek—where it was a unit of weight, not volume—via Late Medieval Latin, and which equalled approximately 0.831 litres. The litre was also used in several subsequent versions of the metric system and is accepted for use with the SI,Bureau International des Poids et Me ...
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Clearance Rate (biochemistry)
In pharmacology, clearance is a pharmacokinetic measurement of the volume of plasma from which a substance is completely removed per unit time. Usually, clearance is measured in L/h or mL/min. The quantity reflects the rate of drug elimination divided by plasma concentration. Excretion, on the other hand, is a measurement of the amount of a substance removed from the body per unit time (e.g., mg/min, μg/min, etc.). While clearance and excretion of a substance are related, they are not the same thing. The concept of clearance was described by Thomas Addis, a graduate of the University of Edinburgh Medical School. Substances in the body can be cleared by various organs, including the kidneys, liver, lungs, etc. Thus, total body clearance is equal to the sum clearance of the substance by each organ (e.g., renal clearance + hepatic clearance + lung clearance = total body clearance). For many drugs, however, clearance is solely a function of renal excretion. In these cases, clearance is ...
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Bowman's Capsule
Bowman's capsule (or the Bowman capsule, capsula glomeruli, or glomerular capsule) is a cup-like sac at the beginning of the tubular component of a nephron in the mammalian kidney that performs the first step in the filtration of blood to form urine. A glomerulus is enclosed in the sac. Fluids from blood in the glomerulus are collected in the Bowman's capsule. Structure Outside the capsule, there are two "poles": * The vascular pole is the side with the afferent arteriole and efferent arteriole. * The urinary pole is the side with the proximal convoluted tubule. Inside the capsule, the layers are as follows, from outside to inside: *''Parietal layer''—A single layer of simple squamous epithelium. Does not function in filtration. *''Bowman's space (or "urinary space", or "capsular space")''—Between the visceral and parietal layers, into which the filtrate enters after passing through the filtration slits. *''Visceral layer''—Lies just above the thickened glomerular baseme ...
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Glomerulus (kidney)
The glomerulus (plural glomeruli) is a network of small blood vessels (capillaries) known as a ''tuft'', located at the beginning of a nephron in the kidney. Each of the two kidneys contains about one million nephrons. The tuft is structurally supported by the mesangium (the space between the blood vessels), composed of intraglomerular mesangial cells. The blood is filtered across the capillary walls of this tuft through the glomerular filtration barrier, which yields its filtrate of water and soluble substances to a cup-like sac known as Bowman's capsule. The filtrate then enters the renal tubule of the nephron. The glomerulus receives its blood supply from an afferent arteriole of the renal arterial circulation. Unlike most capillary beds, the glomerular capillaries exit into efferent arterioles rather than venules. The resistance of the efferent arterioles causes sufficient hydrostatic pressure within the glomerulus to provide the force for ultrafiltration. The glomerulus and ...
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Kidney
The kidneys are two reddish-brown bean-shaped organs found in vertebrates. They are located on the left and right in the retroperitoneal space, and in adult humans are about in length. They receive blood from the paired renal arteries; blood exits into the paired renal veins. Each kidney is attached to a ureter, a tube that carries excreted urine to the bladder. The kidney participates in the control of the volume of various body fluids, fluid osmolality, acid–base balance, various electrolyte concentrations, and removal of toxins. Filtration occurs in the glomerulus: one-fifth of the blood volume that enters the kidneys is filtered. Examples of substances reabsorbed are solute-free water, sodium, bicarbonate, glucose, and amino acids. Examples of substances secreted are hydrogen, ammonium, potassium and uric acid. The nephron is the structural and functional unit of the kidney. Each adult human kidney contains around 1 million nephrons, while a mouse kidney contains on ...
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Body Surface Area
In physiology and medicine, the body surface area (BSA) is the measured or calculated surface area of a human body. For many clinical purposes, BSA is a better indicator of metabolic mass than body weight because it is less affected by abnormal adipose mass. Nevertheless, there have been several important critiques of the use of BSA in determining the dosage of medications with a narrow therapeutic index, such as chemotherapy. Typically there is a 4–10 fold variation in drug clearance between individuals due to differing the activity of drug elimination processes related to genetic and environmental factors. This can lead to significant overdosing and underdosing (and increased risk of disease recurrence). It is also thought to be a distorting factor in Phase I and II trials that may result in potentially helpful medications being prematurely rejected. The trend to personalized medicine is one approach to counter this weakness. Uses Examples of uses of the BSA: * Renal clearan ...
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