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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.
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.
Typically, in an adult human, the net filtration pressure is 10mmHg and Kf 12.5mL/min/mmHg, giving a glomerular filtration rate (GFR) of 125mL/min. A decrease in Kf due to reduced number of glomeruli or reduced permeability will reduce the GFR at a given filtration pressure [3]
Tubuloglomerular feedback is one of several mechanisms the kidney uses to regulate glomerular filtration rate (GFR). It involves the concept of purinergic signaling, in which an increased distal tubular sodium chloride concentration causes a basolateral release of adenosine from the macula densa cells. This initiates a cascade of events that ...
Diagram showing the basic physiologic mechanisms of the kidney. The kidney's ability to perform many of its functions depends on the three fundamental functions of filtration, reabsorption, and secretion, whose sum is called renal clearance or renal excretion.
In renal physiology, the filtration fraction is the ratio of the glomerular filtration rate (GFR) over the renal plasma flow (RPF). Filtration Fraction, FF = GFR/RPF, or =. The filtration fraction, therefore, represents the proportion of the fluid reaching the kidneys that passes into the renal tubules. It is normally about 20%.
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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]