Renal Function Tests

CLEARANCE TEST

- Standard test used to measure the filtering

capacity of the glomeruli

- Rate at which the kidneys are able to clear a

filterable substance in the blood
Criteria of Substance to be Used:
- Freely filtered by the glomeruli
- Completely excreted by the tubules
- Endogenous procedure
- Exogenous procedure

Urea Clearance Test

– earliest GFT
- Disadvantage ( 40% of filtered urea= absorbed)
Creatinine Clearance Test
- Routinely performed
- Endogenous procedure
- Reported in ml/min
C = U(mg/dl) X Volume (ml/min)
P (mg/dl)
- Used to predict the creatinine clearance
from serum creatinine
- Formula (Male)

- Crea clearance= 140-age X weight in Kg

- 72 x Serum Creat in mg/dl

- *** ave. Male weight is 72 kg.
 Simplified :

C cr= ____140- age_______

serum crea in mg/dl

If female multiply the result further by 0.85

*** estimates based on regression analysis

*** respondents 18-92 y.o. Male patients
Exogenous procedure

Inulin- a polymer of fructose

- Drawbacks = must be infused at constant

rate throughout the procedure
B2Microglobulin dissociates from human
leukocyte antigen and rapidly removed
from plasma

Increase B2 decrease GFR

Measured by RIA and EIA

- Measures the ability of the tubules to
reabsorbs the essential salts and water

- FISHBERG AND MOSENTHAL CONC. TEST

- Pt. Deprived of fluid for 24 hrs.
- Compare the sp.gravity of AM/PM sample
- Normal findings: after 16 hours of
deprivation = Sp. Gravity 1.025
- Overnight = 800mOsm
 Sp. Gravity = depends on the number and
the density of the particles present in a
solution

 Osmolarity= depends only on the

number of particles present in
solution
- freezing point osmometers
 Vapor pressure osmometers
 PAH ( p-aminohippuric acid test)
- Standard clearance formula is used.
 NV: effective renal plasma flow 600-700ml/min ave:
1200ml/min

 Titratable Acidity and Urinary ammonia level

pH = dependent on secretions of hydrogen ion and

production and secretion of ammonia