医学优质课件精选——《肾功能检验》.ppt
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1、,肾功能检验,执教教师:XXX,Anatomy of Kidney,Functions of the kidney,Excretion of Metabolite Waste: urea, uric acid, creatinineUrine Production, regulation of homeostasis, water, acid base balanceEndocrine Function: renin, erythropoietin, 1,25 -dihydroxycholecalciferol,Renal function tests,Detect renal damageM
2、onitor functional damageDistinguish between impairment and failure,Kidney Function,A plumbers view,How do you know its broken?,NO Urine!Clinical symptomsTests,Where can it break?,Pre-renalRenalPost-renal,Laboratory tests of renal function,Glomerular Function TestsRenal Tubular Function Tests,Section
3、 1 Investigation of Glomerular Function,Renal Blood Flow: 1200-1400ml/minRenal Plasma : 600-800ml/min20% of plasma: glomerular filtration GFR:Glomerular Filtrtion Rate Concept,Renal Clerance,Concept Virtual volume of plasma from which the substance in question has been completely removed during a gi
4、ven time interval. C=UV/P U:urine concentrtion P:plasma con. V:urine flow rate,Usefulness of Renal Clerance,Freely filtrated, neither secreted, nor reabsorbed: Inulin: GFR DeterminationFreely Filtrated, small amounts secreted, without reabsorption: Cretinine:GFRFree filtrated, completely reabsorptio
5、n: Glucose Tubular Maxima Reabsorption Rate,Inulin Clerance,Polymer of fructoseMW:5500Free filtration, without secretion and reabsorptionGFRMethod Reference Interval: 2.0-2.3ml/min,Endogenous Creatinine Clearance,100g,98% stored in musle,MW:113Cretine phosphate-cretinecretinineFreely filtration, sma
6、ll mounts: secretionExogenous and Endogenous CreatinineGrossly Investigate the GFR,Method 24h urine collection method modified 4h urine collection method Clerance Correction: Ccr x SBSA/IBSA,Plasma urea,Secreted and reabsorbed by tubules, freely filtratedquick, simple measurementwide reference range
7、 3 - 8 mmol/Lsensitive but non-specific index of illness,Urea excretion,filtered at glomerulusabout 40% filtered urea is reabsorbed by renal tubules in healthmore urea is reabsorbed if rate of tubular flow is slowtubular flow rate is slow when there is renal hypoperfusion,Increased plasma urea,GI bl
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- 医学 优质 课件 精选 肾功能 检验
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