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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.
Using inulin to measure kidney function is the "gold standard" for comparison with other means of estimating glomerular filtration rate. [6] In 2018, the French pharmacovigilance agency withdrew inulin and sinistrin -based products from the market after some patients experienced hypersensitivity reactions including a fatal outcome. [ 7 ]
The renal clearance ratio or fractional excretion is a relative measure of the speed at which a constituent of urine passes through the kidneys. [ 1 ] [ 2 ] It is defined by following equation: c l e a r a n c e r a t i o o f X = C x C i n {\displaystyle clearance\ ratio\ of\ X={\frac {C_{x}}{C_{in}}}}
Kt/V and standardized Kt/V are not the same. Kt/V is a ratio of the pre- and post-dialysis urea concentrations. Standardized Kt/V is an equivalent clearance defined by the initial urea concentration (compare equation 8 and equation 10).
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.
GFR on its own is the most common and important measure of renal function. However, in conditions such as renal artery stenosis, blood flow to the kidneys is reduced. Filtration fraction must therefore be increased in order to perform the normal functions of the kidney. Loop diuretics and thiazide diuretics decrease filtration fraction.
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A better estimate of kidney function is given by calculating the estimated glomerular filtration rate (eGFR). eGFR can be calculated without a 24-hour urine collection, using serum creatinine concentration and some or all of the following variables: sex, age, and weight, as suggested by the American Diabetes Association. [19]