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A major measure of kidney function is the glomerular filtration rate (GFR). The glomerular filtration rate is the flow rate of filtered fluid through the kidney. The creatinine clearance rate (C Cr or CrCl) is the volume of blood plasma that is cleared of creatinine per unit time and is a useful measure for approximating the GFR.
Algorithms to estimate GFR from creatinine concentration and other parameters are discussed in the renal function article. Unfortunately, the MDRD Study equation was developed in people with chronic kidney disease, and its major limitations are imprecision and systematic underestimation of measured GFR (bias) at higher/normal values. [20]
The Glomerular filtration rate (GFR) is regarded as the best overall measure of the kidney's ability to carry out these numerous functions. 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.
A glomerular filtration rate (GFR) ≥ 60 mL/min/1.73 m 2 is considered normal without chronic kidney disease if there is no kidney damage present. Kidney damage is defined as signs of damage seen in blood, urine, or imaging studies which include lab albumin/creatinine ratio (ACR) ≥ 30. [ 62 ]
This illustration demonstrates the normal kidney physiology, including the Proximal Convoluted Tubule (PCT), Loop of Henle, and Distal Convoluted Tubule (DCT). It also includes illustrations showing where some types of diuretics act, and what they do. Renal physiology (Latin renes, "kidneys") is the study of the physiology of the kidney.
To clinically stage the degree of damage in this (and any) kidney disease, the serum creatinine is determined and used to calculate the estimated glomerular filtration rate . Normal eGFR is equal to or greater than 90ml/min/1.73 m 2. [34] On biopsy, the following classification has been suggested by Tervaert et al.: [35]
Rapidly progressive glomerulonephritis - This is a syndrome of the kidney that is characterized by rapid loss of kidney function (usually >50% decline in glomerular filtration rate (GFR) within 3 months) [23] with glomerular crescent formation frequently seen on kidney biopsy.
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.
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