RENAL FUNCTION TEST - rmc.gov.bdrmc.gov.bd/notice_panel/upload_notices/RENAL_FUNCTION_TEST.pdf · renal function test dr. md. mahbubur rahman mbbs, m. phil , mbt (new delhi) dept.

RENAL FUNCTION TEST

DR. MD. MAHBUBUR RAHMAN

MBBS, M. Phil , MBT (New Delhi)

DEPT. OF BIOCHEMISTRY

RAJSHAHI MEDICAL COLLEGE

NEPHRON

STRUCTURAL UNIT OF KIDNEY.

NEPHRON

Definition of Renal Function test

the group of test by which we can assess the function of kidney is known as Renal Function Test.

Function of kidney

Formation of urine

Maintenance of water balance

Maintenance of electrolyte balance

Maintenance of acid base balance

Excreation of waste product e.g. Urea., uric acid

Endocrine function e.g. Erythropoietin, vit –D3

Maintenance of osmotic balance

FUNCTION OF

KIDNEY

Regulation of water, electrolyte & acid-base balance.

Excretion of the products of protein and nucleic acid metabolism e.g. urea,

creatinin, creatin ,uric acid, sulphate, and phosphate.

RENAL FUNCTION TEST

It is convenient to discuss renal function in terms of the assessment of glomerular and tubular function

RENAL FUNCTION TEST

1. Test of glomerular function

2. Test of tubular function.

TEST OF GLOMERULAR

FUNCTION

Clearence : This is the volume of plasma which would be completely ‘cleared’ of the substance in the time specified to give the amount seen in urine.

U X V

volume of plasma=

P

U =Urine concentration of creatinine P =Serum or Plasma concentration of creatinine V = Volume of urine

Serum creatinine & urea

mesurment

Normal value of serum creatinine

male: 60-130µmol/L(0.7-1.4 mg/dl)

Female: 40-60µmol/L(0.4-1.2mg/dl)

Normal value of serum urea

Adults: 3.3-7.7mmol/L(20-50mg/dl)

Infants: 1.3-5.8mmol/L(8-35mg/dl)

serum creatinine is better

than serum urea because----

Creatinine is derived from

muscle creatine

serum urea level is altered

by dietary protein, tissue

breakdown, hemorrhage,

dehydration.

Proteinuria:

Passes of protein more than 300 mg/day is

called proteinuria.

Normal level protein in urine 150-

200 mg/day.

Cause of proteinuria

Nephritic syndrom

Chronic glomerulonephritis

Toxaemia of pregnancy

Severe lower urinary tract infection

Pyogenic or tuberculous pyelonephritis

Diabetic nephropathy

Hypertension

MICROALBUMINURIA

Albumin excretion in the range

25-300mg/day is termed microalbuminuria

Test of tubular function

Osmolarity mesurments in the plasma and urine & there ratio.[Normal1-3]

Specific proteinuria: β2 microglobulin α2 microglobulin

Glycosuria

Aminoaciduria