EXPERIMENT NO.

16 FORMATION OF URINE IN MAN

MAIN OBJECTIVE To illustrate the renal response to fluid deprivation,water loading and isosmotic fluid expansion
To determine urine volume, flow rate, specific gravity and sodium concentration on all urine samples
2

A.urine sample was collected and Discarded. Time of collection was noted
RATIONALE: This is done to ensure that the following urine samples are not contaminated by previous water or food intake
3

B. First urine sample was taken which was labeled PRE INGESTION.
The sample was analyzed for: Volume and Flow Rate Specific Gravity Sodium Concentration RATIONALE: this specimen serves
4

C.Immediately after the collection ,the subject rapidly drinks either: Glucose Water 0.9% NaCl None
RATIONALE The ingestion of fluid serve as INTERVENTION. Glucose,water and 0.9% Isotonic NaCl have different tonicities that would alter urine volume and sodium concentration
5

D. Urine Sample was collected every 30 minutes for 3 determinations

This was subjected to specific gravity Urine volume Flow rate An aliquot of urine was prepared for Na concentration using the

WHAT IS RENAL CLEARANCE?

WHAT IS RENAL CLEARANCE?

It is the volume of plasma passing through the kidneys that has been totally 8 cleared of a solute

WHAT IS RENAL CLEARANCE?

Rate at which that solute disappears from the body by excretion

WHAT IS RENAL CLEARANCE? Na+ Cl

Glucose Albumin Creatinine

Inulin

10

11

WHAT IS RENAL CLEARANCE?

Clearance Helps Us Determine

Renal Handling
Clearance Is a Noninvasive Way

to Measure GFR
12

WHAT IS RENAL CLEARANCE?

Urine Flow Rate per minute (ml/min) Clearance (mL/min) Urine Plasma concentration of a concentration of a substance substance (mg/ml) 13 (mg/ml)

WHAT IS RENAL CLEARANCE?

Renal Clearance =

Urinary Excretion Rate Plasma Concentration

For a given plasma Concentration, renal clearance of a substance increases as the urinary excretion increases.
14

WHAT IS AN IDEAL SUBSTANCE USED IN RENAL CLEARANCE?

15

WHAT IS AN IDEAL SUBSTANCE USED IN RENAL CLEARANCE?

NOT REABSORBED NOT SECRETED NOT METABOLIZED FREELY FILTERED INERT
16

INULIN
Ideal substance that measure GFR Not clinically used Intravenous

17

WHAT IS AN IDEAL SUBSTANCE USED IN RENAL CLEARANCE?

CREATININE
Used Clinically Endogenous End product of muscle metabolism 10 % Secreted in the Proximal Tubule Amount filtered=amount excreted

18

Discuss the physiologic basis for the mathematical formula used for the computation of the creatinine clearance

19

FICKS PRINCIPLE

Pxa

x RPFa = ( Pxv x RPFv) + ( Ux V)

Concentratio n in the RENAL VEIN Concentratio n of substance in URINE

Concentratio n in the RENAL ARTERY

FLOW RATE in Artery

FLOW RATE in Vein

URINE FLOW RATE

INPUT

OUTPUT

20

21

22

VOLUME OF PLASMA FROM WHICH ALL THE CREATININE HAS BEEN REMOVED AND EXCRETED INTO THE URINE PER UNIT TIME.

23

What is the relationship between Creatinine Clearance and Glomerular Filtration Rate GFR?

24

Creatinine Clearance is used for routine assessment of GFR in hospitalized patients

25

BOTH MEASURE THE FILTERING CAPACITY

GFR

Creatinine Clearance Describes how many Describes how many milliliters of Plasma milliliters of plasma passing into the passing through the Bowman capsule per kidneys that have unit time been totally cleared of a solute in a given Inulin Clearance is period of time accurate but expensive Overestimates GFR but is inexpensive

26

PLASMA CREATININE AND GFR

27