TUBULAR SECRETION

AND RENAL BLOOD

FLOW TESTS
Group 6
Andallasa, Trehcier
Gayam, Glydenne
Monto, Yeng
Nepomuceno, Ceypris
Sunico, Gale

Tubular Secretion and Renal Blood Flow

Tests

Test to measure tubular secretion

of nonfiltered substances and
renal blood flow = related to
TOTAL RENAL BLOOD FLOW
Measured by a substance that is
secreted rather than filtered
through the glomerulus

Tubular Secretion and Renal Blood Flow

Tests
Abnormal Result: Impaired tubular result
Inadequate presentation
of the substance to the
capillaries = Decrease in
renal blood Flow
p-aminohippuric acid (PAH) test - most
common test associated with tubular
secretion and renal blood flow

PAH Test(Para Amino

Acid)
Measure the amount of blood
flowing through the kidney.
The same as the clearance of
glomerular filtration.
To ensure the measurement of
the blood flow through the entire
nephron.

PAH Test(Para Amino Acid)

Standard Clearance Formula
CPAH= (mg/dL PAH) x V(mL/min urine)

P(mg/dLPAH)

HEMATOCRIT READINGS
Renal Plasma Flow Range
-600 to 700 m/min
Average Renal blood flow
-1200 ml/min
Actual measurement renal plasma flow rather
than renal blood flow
Amount of PAH infused must be monitored
careully to ensure accurate results.
Nuclear medicine procedures using radioactive
injection hippurate.

Tubular Secretion and Renal Blood Flow

Tests

TITRATABLE ACIDITY AND

URINARY AMMONIA
-the ability of the kidney to produce an
acid urine depends on the tubular
secretion of hydrogen ions and
production and secretion of ammonia
by the cells of the distal convoluted
tubule

TITRATABLE ACIDITY
AND URINARY AMMONIA
- the normal person excretes
approximately 70 mEq/day of
acid in the form of either
titrable acid (H+), hydrogen
phosphate ions (H2PO4) or
ammonium ions (NH4 +)

TITRATABLE ACIDITY AND

URINARY AMMONIA
Normal Person
Diurnal variation in urine acidity appears
shortly after arising and postprandially at
approximately 2 p.m. and 8 p.m.
Night lowest pH

TITRATABLE ACIDITY
AND URINARY AMMONIA
Renal Tubular Acidosis
inability to produce an acid urine in
the presence of metabolic acidosis
is called renal tubular acidosis.
impaired tubular secretion of
hydrogen ions associated with the
PCT or defects in ammonia
secretion associated with the DCT.

TITRATABLE ACIDITY
AND URINARY AMMONIA
Defective Function
determined through Urine pH, titratable
acidity, and urinary ammonia
measurements
run simultaneously on either fresh or
toluene preserved urine specimens
collected at 2-hour intervals from patients
who have been primed with an acid load
consisting of oral ammonium chloride.

TITRATABLE ACIDITY
AND URINARY AMMONIA
Ammonium concentration
calculated as the difference
between the titratable acidity
and the total acidity.
by titrating the amount of free H+
(titratable acidity) and then the
total acidity of the specimen

R
I

M N
P U

R
A

I
H

P
-

A
C

PARA AMINOHIPPURIC ACID

Substance used in calculating for
tubular secretion and renal blood flow

END