RFT renal function Laboratory report ppt

Renal function test

1. Renal Function Test RFT By: Fatima Ali

2. Renal function test(RFT), also called Kidney function test is a group of tests used to assess the functions of kidney What is RFT ?

3. To assess functional capacity of kidneys To diagnose renal impairment To assess the severity and progression of renal impairment To assess the effectiveness of treatment Why Renal F unction Tests needed ?

4. Can be divided into two categories: Test for glomerular function Serum Urea Serum Creatinine Clearance tests Tests for tubular function Urine concentration test Dilution test Para amino hippuric acid clearance test Acidification test Urine examination: Important for assessing both glomerular and tubular function Renal function test

5. The following parameters are commonly included in assessing glomerular function Serum Urea ( 10-45 mg/dl) Serum Creatinine (0.6 –1.2 mg/dl) Serum Uric acid (males 3.5-7.2 mg/dl, females 2.6-6 mg/dl) Total protein ( 6.0-8.0 g/dl) Serum albumin ( 3.0-5.0 g/dl ) Serum electrolytes Na ( 135-150 mEq /L) K ( 3.5-5.0 mEq /L) Phosphate (2.8-4 mg/dl) Calcium (8.0-10.2 mg/dl) Test for glomerular function

6. Measurement of urea is used to : evaluate renal function to assess hydration status to determine nitrogen balance to aid in the diagnosis of renal disease and to verify adequacy of dialysis. Serum Urea

7. Azotemia : elevated conc. of urea in blood . Uremia : very high plasma urea concentration accompanied by renal failure. Causes of blood urea elevations are: Pre-renal Renal and post-renal Disease Correlations

8. Anything that produces a decrease in functional blood volume, include: Congestive heart failure, Shock, Hemorrhage, Dehydration High protein diet or increased catabolism (Fever, major illness, stress) Pre-Renal Azotemia:

9. Decreased renal function causes increased blood urea due to poor excretion Acute & Chronic renal failure Glomerulonephritis Tubular necrosis & other Intrinsic renal disease Renal Azotemia:

10. Post-Renal Azotemia Obstruction of urine flow Renal calculi Tumors of bladder or prostate Severe infections

11. Decreased blood urea Low protein dietary intake Liver disease (lack of synthesis ) Severe vomiting and/or diarrhea(loss)

12. Creatinine is the waste product of creatine phosphate, a compound found in the skeletal muscle tissue . It is excreted entirely by the kidneys . The creatinine level is affected primarily by renal dysfunction and is thus very useful in evaluating renal function . Increased levels of creatinine indicate a slowing of the glomerular filtration rate. Female: 0.6–1.2 mg/dL Male: 0.8–1.4 mg/dL Serum Creatinine

13. Possible Meanings of Abnormal Values: Congestive heart failure Glomerulonephritis Nephritis Pyelonephritis Renal failure Urinary obstruction Dehydration

14. it is filtered by the glomerulus and secreted by the distal tubules into the urine, in which most uric acid is reabsorbed in the proximal tubules and reused. Serum Uric Acid

15. Possible Meanings of Abnormal Values: Increased ( hyperuricemia ): Congestive heart failure Glomerulonephritis Alcoholism Gout Dehydration Trauma and surgery . Administration of certain drugs (diuretics, cyclosporine, etc .)

16. Decreased ( hypouricemia ) Liver disease Renal tubular defects Defectivetubular reabsorption( Fanconi syndrome ) Chemotherapy with azathioprine or 6mercaptopurine Overtreatment with allopurinol

17. Sodium is decreased ( hyponatremia ) and potassium is increased (hyperkalemia) in chronic kidney disease (CKD) as kidney reabsorb sodium in exchange of potassium Chloride and phosphate is increased in CKD Calcium is decreased as vitamin D is deficient Serum electrolytes

18. 1. Hypernatremia : Its defined as an increased sodium concentration in plasma water, and is generally diagnosed at serum sodium levels >145 mmol/L. Hypernatremia is always associated with an increased effective plasma osmolality, and hence with a reduced cell volume. Sodium disorders:

19. 2. Hyponatremia : Is defined as reduced plasma sodium concentration to a value less than 135 mmol/L. The five most common causes of Hyponatremia are overhydration, diuretics, SIADH, diabetic hyperosmolarity and Addison’s disease. Sodium disorders

20. 1. Hypokalemia: Is a plasma K concentration below the lower limit of the reference range. Hypokalemia can occur with GI or urinary loss of K or with increased cellular uptake of K. Potassium disorders:

21. Hyperkalemia may be caused by one of three mechanisms: (1) shift of potassium from the cells to the ECF (2) increased potassium intake (3) reduced renal potassium excretion. Hyperkalemia:

22. Any question? 24

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