Renal

Renal function
function Tests
Tests
 Renal
Renal function
function tests
tests

Groups of laboratory assays

designed to detect renal damage
and at the same time help in
determining the etiology.
 Kidney
Kidney Function
Function
Input
Arterial

Filter

Processor

Output Output
Venous Urine
 Where
Where can
can itit break?
break?
Input
Arterial
 Pre-renal

 Renal
Filter
(intrarenal)
Processor

 Post-renal
Output Output (obstruction)
Venous Urine
 Tests
Tests of
of renal
renal function
function

 Glomerular Functions:
• Urine analysis
• Glomerular filtration rate ( clearance)
• Serum creatinine
• Blood urea
 Tests
Tests of
of renal
renal function
function

 Tubular Functions:
• Serum electrolytes
• ABG
• Urine concentration test
• Urine dilution test
 Glomerular
Glomerular Filtration
Filtration Rate
Rate

It is the major physiologic responsibility

of kidney and it is used as index of
overall excretory function.
 Glomerular
Glomerular filtration
filtration rate
rate

 Methods of estimation:
 By calculation of inulin or creatinine clearance
by the following equation:
C=VXU/P
 Clearance ???
 Blood
Blood urea
urea
 It is a product of protein catabolism (urea
cycle) synthesized by liver, majority excreted
by kidney, partially reabsorbed in tubules.
 Normal range: 20-40 mg /dl.
 Plasma concentration increases with
decreased GFR
 Inaccurate.
 Most useful when considered along with
creatinine.
 BUN
BUN

 Nitrogenrepresents 40 % of urea
molecular weight. So,
 BUN = urea level X 0.466
 Urea = BUN X 2.14
 Normal range: 8-25 mg %
 Plasma
Plasma creatinine
creatinine

 Normal range: 0.2-1.1 mg % but normal serum

creatinine varies with the subject's body muscle
mass.
 It is a main storage compound of high energy
phosphate needed for muscle metabolism.
 It is stable, endogenous and is not affected by
diet. So, it is more specific.
 BUN:
BUN: creatinine
creatinine ratio
ratio

  BUN: Cr ratio is >20 in pre-renal disorders.

 BUN: Cr ratio is 10-20:1 (Normal range) in normal
conditions or post renal disease.
 BUN: Cr ratio is <10:1 in (within kidney) Renal
damage.
 Other
Other blood
blood tests
tests
 Serum electrolytes:
 Serum K (Normal level 3.5-5 mEq / l)
 Phosphate (Normal level 2.5 – 4.5 mg %)

 ABG:
 PH (Normal level 7.35 – 7.45)
 HCO3 (Normal level 22 – 28)