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An estimate of the GFR is used clinically to determine the degree of kidney impairment and to track the progression of the disease. The GFR, however, does not reveal the source of the kidney disease. This is accomplished by urinalysis, measurement of urine protein excretion, kidney imaging, and, if necessary, kidney biopsy. [1]
The severity of chronic kidney disease (CKD) is described by six stages; the most severe three are defined by the MDRD-eGFR value, and first three also depend on whether there is other evidence of kidney disease (e.g., proteinuria): 0) Normal kidney function – GFR above 90 mL/min/1.73 m 2 and no proteinuria
Figure 1. Normal adult kidney. Measurement of kidney length on the US image is illustrated by ‘+’ and a dashed line. *Column of Bertin; ** pyramid; *** cortex; **** sinus. [1] The length of the adult kidney is normally 10–12 cm, and the right kidney is often slightly longer than the left kidney.
Normal adult right kidney as seen on abdominal ultrasound with a pole to pole measurement of 9.34 cm A CT scan of the abdomen showing the position of the kidneys. The left cross-section in the upper abdomen shows the liver on the left side of scan (right side of body).
The Standardized Kt/V is based on body water volume (V). The Glomerular filtration rate, an estimate of normal kidney function, is usually normalized to body surface area (S). S and V differ markedly between small vs. large people and between men and women.
The fractional excretion of sodium (FE Na) is the percentage of the sodium filtered by the kidney which is excreted in the urine.It is measured in terms of plasma and urine sodium, rather than by the interpretation of urinary sodium concentration alone, as urinary sodium concentrations can vary with water reabsorption.
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Free water clearance can be used as an indicator of how the body is regulating water. A free water clearance of zero means the kidney is producing urine isosmotic with respect to the plasma. Values greater than zero imply that the kidney is producing dilute urine through the excretion of solute-free water.