腎功能檢查英文課件

1、1 2 Generation urine Drain water, metabolites, waste and keep useful material Regulating water and osmotic pressure Regulating electrolyte and acid-base balance Make some important physiological active substances, such as renin, EPO. 3 4 5 6 Glomerular filtration rate (GFR) is reflected glomerular f

2、iltration function objective index, with unit time two renal generated ultrafiltrate quantity namely former urine generation to said Renal clearance is refers to the double kidney in unit time (min) inside, can how much ml plasma contains a substance to clear all, results to ml/min or L / 24 h 7 pri

3、nciple Plasma creatinine categories: endogenous and exogenous Plasma creatinine metabolism: mostly from the glomerular filtration, not by renal tubule heavy absorption, and renal tubule of shedding capacity is very few 8 Condition: in the strict control diet and muscle activity under the condition o

4、f relatively stable, plasma creatinine of generation and in the urine discharge is constant, the content change is mainly affected by the influence of the endogenous creatinine 9 Endogenous creatinine clearance rate (Ccr) : refers to the renal unit time, clear how many ml plasma of endogenous creati

5、nine 10 The preparation for the patient The patient continuous eating low protein food 3 days, every protein intake 40 g, fast meat, forbidden to drink strong tea, coffee, avoid strenuous exercise Methods 11 Specimen collection(標(biāo)本收集標(biāo)本收集) The fourth day morning 8 start collecting 24 hour urine (join

6、toluene anticorrosive), the blood in any time 2 ml and urine (measurement of urine volume) at the same time cleared Calculation formula（計(jì)算公式計(jì)算公式） Every minute creatinine clearance = urine creatinine concentration every minute urine volume/plasma creatinine concentration (unit: ml/min) Methods It tak

7、es a long time 12 Normal Range Adult :80-120 ml/min Neonatal :40 65 ml/min Increased in and decreased decreased inin. Page278 Acute or chronicrenal failure,decreased renal blood flow(shock,hemorrhage,dehydration, CHF).drugs:nephrotoxic drugs. 13 Clinical significance 1. Are early reflect glomerular

8、filtration function of the sensitive index.(the majority of acute glomerulonephritis Ccr low to normal below 80%, but serum BUN, Cr is still in the normal range) 14 2. Preliminary appraisal renal damage 70 51 ml/min mild damage 50 31 ml/min moderate damage 30 ml/min severe damage Chronic renal failu

9、re patients Ccr if: 20 11 ml/min early renal failure 10 6 ml/min advanced renal failure 5 ml/min end-stage renal failure 15 3. Guide therapy(指導(dǎo)治療指導(dǎo)治療) 30 40 ml/min should limit protein intake 30 10 ml/min thiazide diuretics treatment often invalid 10 ml/min should dialysis In addition, renal failure

10、 by renal metabolism or all the renal discharge drug can reduce degree according to the Ccr to adjust the use quantity and decided to use time. 16 Principle（原理）（原理） Blood urea nitrogen (BUN) and serum creatinine (Scr) mainly by glomerular filtration and urine, in the renal parenchyma damaged, glomer

11、ular filtration rate is reduced, cause BUN and Scr increasing concentration in blood 17 BUN: 1.78 7.14 mmol/L Scr: Male 44 132 mol/L, Female 70 106 mol/L 18 Clinical significance All kinds of serious kidney disease Reduces kidney function . Upper gastrointestinal bleeding, severe infections and diet

12、ary protein is overmuch, can also lead to a temporary increase in BUN; 19 Because of serum creatinine by other effects are smaller, more can reflect renal patients, Cr increased significantly(明顯地明顯地), indicating that the prognosis（預(yù)后）（預(yù)后） is poor. 20 principle UA is an end product of, most of the gl

13、omerular filtration, in proximal renal tubule in 98-100% is absorped, the normal circumstances of UA lower clearance 21 Males: 150416 mol/L Females: 89357 mol/L Normal person the uric acid in the formation and excretion rate is constant. For smaller solubility, the body content when too much can form urinary stones or gout. 22 Clinical significance Increase in : gout, acute or chronic leukemia, multiple myeloma(MM), pernicious anemia(惡性貧血惡性貧血), kidney failure, liver failure, eryt