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Blood tests are also used to assess kidney function. These include tests that are intended to directly measure the function of the kidneys, as well as tests that assess the function of the kidneys by looking for evidence of problems associated with abnormal function. One of the measures of kidney function is the glomerular filtration rate (GFR).
Another estimation tool to calculate GFR is the Mayo Quadratic formula. This formula was developed by Rule et al., [32] in an attempt to better estimate GFR in patients with preserved kidney function. It is well recognized that the MDRD formula tends to underestimate GFR in patients with preserved kidney function.
Para-aminohippurate (PAH) clearance is a method used in renal physiology to measure renal plasma flow, which is a measure of renal function. [citation needed]PAH is completely removed from blood that passes through the kidneys (PAH undergoes both glomerular filtration and tubular secretion), and therefore the rate at which the kidneys can clear PAH from the blood reflects total renal plasma flow.
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.
Effective renal plasma flow (eRPF) is a measure used in renal physiology [1] to calculate renal plasma flow (RPF) and hence estimate renal function. Because the extraction ratio of PAH is high, it has become commonplace to estimate the RPF by dividing the amount of PAH in the urine by the plasma PAH level, ignoring the level in renal venous blood.
Therefore, creatinine concentrations in blood and urine may be used to calculate the creatinine clearance (CrCl), which correlates approximately with the glomerular filtration rate (GFR). Blood creatinine concentrations may also be used alone to calculate the estimated GFR (eGFR). The GFR is clinically important as a measurement of kidney function.
However, there is suggestive evidence that larger amounts may need to be given to women, smaller patients, malnourished patients, and patients with clinical problems. The recommended minimum Kt/V value changes depending on how many sessions per week are given, and is reduced for patients who have a substantial degree of residual renal function.
S and V differ markedly between small vs. large people and between men and women. A man and a woman of the same S will have similar levels of GFR, but their values for V may differ by 15-20%. Because standardized Kt/V incorporates residual renal function into the calculations, it makes the assumption that kidney function should scale by V.
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