肾功能检验课件演示文稿.pptVIP

Laboratory tests of renal function Junfu Huang Southwestern Hospital TMMU Anatomy of Kidney Functions of the kidney Excretion of Metabolite Waste: urea, uric acid, creatinine Urine Production, regulation of homeostasis, water, acid base balance Endocrine Function: renin, erythropoietin, 1,25 -dihydroxycholecalciferol Renal function tests Detect renal damage Monitor functional damage Distinguish between impairment and failure Kidney Function A plumbers view How do you know it’s broken? NO Urine! Clinical symptoms Tests Where can it break? Pre-renal Renal Post-renal Laboratory tests of renal function Glomerular Function Tests Renal Tubular Function Tests Section 1 Investigation of Glomerular Function Renal Blood Flow: 1200-1400ml/min Renal Plasma : 600-800ml/min 20% of plasma: glomerular filtration GFR:Glomerular Filtrtion Rate Concept Renal Clerance Concept Virtual volume of plasma from which the substance in question has been completely removed during a given time interval. C=UV/P U:urine concentrtion P:plasma con. V:urine flow rate Usefulness of Renal Clerance Freely filtrated, neither secreted, nor reabsorbed: Inulin: GFR Determination Freely Filtrated, small amounts secreted, without reabsorption: Cretinine:GFR Free filtrated, completely reabsorption: Glucose Tubular Maxima Reabsorption Rate Inulin Clerance Polymer of fructose MW:5500 Free filtration, without secretion and reabsorption GFR Method Reference Interval: 2.0-2.3ml/min Endogenous Creatinine Clearance 100g,98% stored in musle,MW:113 Cretine phosphate---cretine—cretinine Freely filtration, small mounts: secretion Exogenous and Endogenous Creatinine Grossly Investigate the GFR Method 24h urine collection method modified 4h urine collection method Clerance Correction： Ccr x SBSA/IBSA Plasma urea Secreted and reabsorbed by tubules, freely filtrated quick, simple measurement wide reference range 3 - 8 mmol/L sensitive bu