CC1 Lab > Kidney Function Tests > Flashcards

Kidney Function Tests Flashcards

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1
Q

These are the tests to assess your kidney.

A

RENAL FUNCTION TESTS

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2
Q

are bean-shaped organs

A

Kidneys

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3
Q

Functional unit of your kidney are the ____.

A

Nephrons

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4
Q

2 regions of Nephrons

A

The outer region - cortex
Inner region - medulla

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5
Q

Nephrons have 2 types:

A
  • in the medulla
  • Loop of Henle may extend up to the cortex
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6
Q

Kidneys have several functions in the body:

A
  • Elimination of waste products
  • Maintenance of blood volume
  • Maintenance of electrolyte balance
  • Maintenance of Acid-Base Balance
  • Endocrine Function (renin-erythropoietin
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7
Q

General assessments for kidney function

A
  • GFR (Glomerular Filtration Rate)
  • Tubular Function
  • Renal Function
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8
Q

GFR tests

A
  • Clearance Tests
  • Cystatin C
  • Beta Trace Protein
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9
Q

Tubular function tests

A

Excretion Tests
Concentration Test

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10
Q

Renal blood flow

A
  • BUN
  • Creatinine
  • BUA
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11
Q

Usually the test is clearance test - It will determine
if your kidneys, particularly your glomerulus
are able to filter out.

A

Glomerular Filtration Rate (GFR)

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12
Q

Removal of the substance from plasma into
urine in a fixed time. It will represent the
volume of plasma that would contribute all the
solute excreted. what we use in this clearance test is 24 hr. urine.

A

Clearance Test

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13
Q

Sample used in GFR clearance test

A

24 hour urine

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14
Q

There are 3 types of clearance test:

A

Inulin Clearance
Creatinine Clearance
Urea Clearance

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15
Q

Reference method.It is not routinely done because of the necessity for continuous IV infusion.

A

Inulin Clearance

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16
Q

Each kidney contains approximately ___ nephrons.

A

’ 1 million

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17
Q

Each nephron is a complex apparatus composed of five basic parts

A
  • The glomerulus
  • The proximal convoluted tubule
  • The long loop of Henle
  • The distal convoluted tubule
  • The collecting duct
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18
Q

—a capillary tuft surrounded by the expanded end of a renal tubule known as Bowman’s capsule

A

glomerulus

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19
Q

has an afferent arteriole that carries the blood in and an efferent arteriole carrying the blood out. The efferent arteriole branches into peritubular capillaries that supply the tubule.

A

Glomerulus

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20
Q

the distal and proximal convoluted tubule is located in the

A

Cortex

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21
Q

-composed of the thin descending limb, which spans the medulla, and the ascending limb, which is located in both the medulla and the cortex, composed of a region that is thin and then thick.

A

The long loop of Henle

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22
Q

formed by two or more distal convoluted tubules as they pass back down through the cortex and the medulla to collect the urine that drains from each nephron

A

collecting duct

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23
Q

Collecting ducts eventually merge and empty their contents into the ?

A

renal pelvis.

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24
Q

There are three basic renal processes:

A

Glomerular filtration
Tubular reabsorption
Tubular secretion

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25
is filtered and secreted, but not reabsorbed;
NH3
26
is filtered and a portion reabsorbed:
Glucose
27
are filtered and completely reabsorbed (not shown).
Amino Acids
28
It would provide an estimate of the amount of plasma that flows through the kidney, glomerulus of the kidney particularly. It is commonly performed. It is an excellent measure of renal function
Creatinine Clearance
29
It can actually demonstrate progression of renal disease or response to therapy.
urea clearance
30
Is a low molecular weight protease inhibitor and produced at a constant rate by all nucleated cells.
Cystatin C
31
In Cystatin C, only ___ is in-charged.
glomerulus
32
It is a low molecular-weight lipoprotein, it actually belongs to lipocalin family. It is not commonly nerformed and also Cvstatin Cl
Beta Trace Protein
33
Para-Amino Hippurate Test It measures renal plasma flow.
Excretion Test
34
The dye you can use for Excretion Test
Para-Amino Hippurate, Phenolsulfonphthalein Dye Test.
35
It reflects the function of the B. collecting tubules and the loops of Henle. It will assess the quantity of solutes present in urine, which reflects the ability the kidney to concentrated urine.
Concentration Test
36
Specimen used in concentration test
first morning urine
37
Concentration Test will check the ability of kidney to produce concentrated urine so you can use ___ or ____.
specific gravity (simplest) or osmolality (more sensitive than the specific gravity)
38
Measures the production of NPNs - Nonprotein Nitrogenous Compound.
RENAL BLOOD FLOW
39
Used to monitor the renal function, will increase in the bloodstream if there is a problem in the kidney.
Nonprotein Nitrogenous Compound
40
NPNs are actually eliminated, filtered in the ___ and then and secreted in the ___.
filtered in the kidney and then and secreted in the urine.
41
are breakdown products of your protein and breakdown of nucleic acids. amino acids.
Nonprotein Nitrogenous Compound.
42
a low-molecular-weight protein produced at a steady rate by most body tissues
Cystatin C
43
Cystatin C is freely filtered by the ___, reabsorbed, and catabolized by the ____.
freely filtered by the glomerulus, reabsorbed, and catabolized by the proximal tubule.
44
appear to be unaffected by diet, gender, race, age, and muscle mass.
Cystatin C
45
derived by mathematically relating the serum creatinine concentration to the urine creatinine concentration excreted during a period of time, usually 24 hours.
Creatinine clearance
46
assess glomerular filtration or tubular secretion.
inulin, or p-aminohippurate
47
was one of the first clearance tests performed; however, it is no longer widely used since it does not accurately provide a full clearance assessment.
Urea clearance
48
has become the standard laboratory method for determining the GFR
creatinine clearance
49
rate at which creatinine and urea are removed or cleared from the blood into the urine is termed
clearance
50
When you breakdown protein, it will become ____, your amino acid will become ______ and since ammonia is toxic to the body, it will be converted or breakdown by the liver into ___.
Protein → amino acid → ammonia → urea (liver)
51
Several NPNs we excrete in our urine.
Urea Amino acid Uric acid Creatinine Creatine Ammonia
52
The most numerous NPN is the
Urea
53
Almost ___ of the total NPN is UREA.
45%
54
The fewest NPN
Ammonia
55
Major product of protein catabolism
BLOOD UREA NITROGEN (BUN)
56
Formed in the liver, First metabolite to increase in kidney disease
BLOOD UREA NITROGEN (BUN)
57
BLOOD UREA NITROGEN (BUN) Reference values:
8-23 mg/dL
58
If you exceed BUN reference values (8-23 mg/dL) the possible reasons are:
- chronic renal disease - stress - burn - high protein diet - If Diet not because of a disease. - dehydration.
59
BUN: Creatinine ratic
10:1 - 20:1
60
Lab considerations (reject samples)
Non hemolyzed serum/plasma Non fasting sample No citrate or fluoride
61
For the plasma, refrain from using ___ or ____ because these two can inhibit urease
fluoride, citrate
62
how to get urea
BUN x 2.14
63
The first method and it is also called the Chemical Method because you are using a chemical
Direct Method
64
Chemical used for direct method
Diacetyl Monoxime Method
65
Another name for Diacetyl Monoxime Method
Fearon's reaction
66
your Diacetyl Monoxime is hydrolyzed and it will breakdown into
diacetyl + hydroxylamine
67
The Diacetyl form will react with your urea and will now form _____ this would be the one measured
Yellow Diazine Derivative
68
DAM + H20 → diacetyl + hydroxylamine Diacetyl + Urea → Yellow Diazine Derivative
Direct method
69
You are actually measuring the Urea Nitrogen. This time you have to multiply it by 2.14. It is also your Enzymatic Method.
Indirect Method
70
Can you use citrate or fluoride in DAM
Yes
71
The basic principle of your Enzymatic Method/Indirect Method - the Urea is hydrolyzed first to yield ____ and ____.
ammonia ions and bicarbonate ions.
72
If Enzymatic and Urease is included, can you use fluoride or citrate?
No
73
Principle: First, it hydrolyzed the Urea using the Urease enzyme and forms ammonia and bicarbonate ions. The formed ammonia ions will let 2-oxoglutarate to react and NADH with the presence of other enzyme GLDH to form glutamate and water. Your NADH + H+ will be NAD+.
Coupled Ureasel Glutamate Dehyrogenase (GLD) Method - UV Enzymatic Method
74
proposed reference method of determination because it is very sensitive. It is expensive.
Isotope Dilution Mass Spectrometry (IDMS)
75
specific and rapid method of determination
conductimetric method
76
enzymatic methods used on many automated Instruments; best as kinetic measurement
GLDH coupled enzymatic
77
enzymatic methods Used In automated systems, multilayer film reagents, and dry reagent strips
GLDH coupled enzymatic
78
Used in automated systems, multilayer film reagents, and dry reagent strips
Indicator dye
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