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Questions and Answers
The serum creatinine is not a useful biomarker for kidney function.
False
What are the primary functions of the kidneys?
What does GFR stand for?
Glomerular Filtration Rate
What equation is recommended by the FDA for estimating GFR in this course?
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The normal range of serum creatinine for adults is approximately ______ mg/dL.
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Which conditions can lead to a decline in GFR?
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What are some indices used to evaluate kidney function?
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Patients with stages 3 to 5 CKD may experience normocytic anemia.
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Match the following terms with their definitions:
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Study Notes
Overview of Kidney Functions
- The kidneys maintain homeostasis by regulating waste excretion, fluid balance, and electrolyte levels.
- Key functions include excretory (removal of urea, medications, toxins), endocrine (production of erythropoietin and renin), and metabolic (activation of vitamin D and drug metabolism).
Importance of Kidney Function
- Loss or reduction in kidney function impacts excretory, endocrine, and metabolic roles.
- Patients with diabetes and stages 4-5 chronic kidney disease (CKD) may have lower insulin needs and require vitamin D supplements.
- Stages 3-5 CKD patients may experience anemia, fatigue, dyspnea, and angina.
Quantification of Kidney Function
- Essential for diagnostic evaluations and assessing the kidneys' ability to eliminate drugs.
- Important for monitoring treatment success.
Indices of Kidney Function
- Serum creatinine (Scr) is used to estimate Glomerular Filtration Rate (GFR).
- Serum electrolytes (Na, K, Cl, HCO3) and urinalysis metrics (pH, glucose, protein, heme, WBC, nitrite, specific gravity, albumin-to-creatinine ratio) aid in evaluation.
- Kidney ultrasound can assist in diagnosing kidney disease.
Serum Creatinine (Scr)
- Scr serves as a primary biomarker for kidney health.
- Its concentration reflects muscle metabolism and kidney excretion; GFR decline leads to increased Scr levels.
- Normal Scr range: 0.5 to 1.2 mg/dL (44-106 μmol/L).
Glomerular Filtration Rate (GFR)
- GFR can be measured (mGFR) or estimated (eGFR).
- mGFR is the best indicator of kidney function used globally for kidney transplant evaluations.
- GFR declines with age and diseases like hypertension and diabetes, indicating progression towards end-stage renal disease (ESRD).
- Normal GFR values: 127 ± 20 mL/min/1.73 m² in men, 118 ± 20 mL/min/1.73 m² in women.
Measuring GFR (mGFR)
- Calculated using renal clearance of a substance that is filtered without reabsorption or secretion.
- Formula: mGFR = CLr = Ae / AUC0-t (Ae = amount excreted in urine).
- Commonly used markers: inulin, sinistrin, iothalamate, but they require advanced techniques.
Estimation of GFR (eGFR)
- Estimated using equations based on Scr and clinical factors (age, weight, race).
- Cockcroft-Gault formula is the recommended method for this course.
- Other equations include Jelliffe’s equation and Modification of Diet in Renal Disease (MDRD) study equation.
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Description
This quiz focuses on the pathophysiology of renal diseases within the context of integrated pharmacology and therapeutics. It covers the kidneys' vital roles in maintaining homeostasis and the implications for pharmacotherapy. Perfect for pharmacy practice students seeking deeper insights into renal functions.
