# Mbbs

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Mbbs
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Pgc

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GFR = Kf (net filtration pressure) = Kf (Pgc - Pbc - *gc ) Pgc *gc af ~~~~~~~~~~~~~~~ef
Pbc
Kf - water permeability - total surface area for filtration GFR= 120 ml/min ? liters/day Mesangial cells ECF , (TBW, 42 liters)

PeeSS RBF?

Arthur Vander

When renal sympathetic nerve is stimulated, the glomerular capillary hydrostatic pressure A. will increase B. will decrease C. may or may not decrease D. I don’t like Starling

D. this question stimulates my para-sympathetic and makes me want to pee

Net Filtration Pressure

GFR

gender body size age

ml/min per 1.73m2

microAlbuminuria;

30 - 300mg per day dipstick Proteinuria; > 300 mg/day

How much of urine do you Secrete and Excrete in a day?

GFR 180 liters/day
E=F-R

GFR, Clearance, Renal Autoreg,
Renal Handling of Glucose

Renal language
Freely filtered : solute filtered with the plasma water Px = BCx Filtered ‘Load’ : rate of filtration of a solute GFR multiply Px (mg/time)
Excreted Load : rate of excretion : Urine flow rate, V multiply Ux

Ux.V /Px

- What is excreted is cleared from the plasma into the urine -What is excreted must have originally come from the plasma
-What ‘volume of plasma’ has been cleared of this amount of excreted solute found in urine - ‘Renal clearance’

Unique Inulin
Filtered load = Excreted load GFR x PIN = V x UIN

GFR = =

UIN x V / PIN the excreted load ‘cleared’ of a volume of plasma/time

GFR = Renal Clearance of Inulin
(ml/min)

James Augustine Shannon 1904-1994

Inulin, a biologically inert polysaccharide, can be used to estimate the glomerular filtration rate since it is filtered, but not reabsorbed or secreted.

Renal Clearance…… is it Clear?
Clearance of plasma protein z _ E=z_ Clearance of glucose F = z_ z_ E= z_ _ /_ F = GFR x PG _ /_

E=F–R+S
Clearance = Excr load, UxV/ [Plasma]x = ml [plasma] / min

CCr = Ucr .V/ PCr

Muscle
metabolism

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