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Glomerular filtration rate (GFR) is the volume of fluid filtered from the renal (kidney) glomerular capillaries into the Bowman's capsule per unit time. [4] Central to the physiologic maintenance of GFR is the differential basal tone of the afferent (input) and efferent (output) arterioles (see diagram).
The functions of the kidney include maintenance of acid-base balance; regulation of fluid balance; regulation of sodium, potassium, and other electrolytes; clearance of toxins; absorption of glucose, amino acids, and other small molecules; regulation of blood pressure; production of various hormones, such as erythropoietin; and activation of vitamin D.
A glomerular filtration rate (GFR) ≥ 60 mL/min/1.73 m 2 is considered normal without chronic kidney disease if there is no kidney damage present. Kidney damage is defined as signs of damage seen in blood, urine, or imaging studies which include lab albumin/creatinine ratio (ACR) ≥ 30. [59]
In countries that do not use the CHEM-7 panel, a UEC typically does not include chloride or bicarbonate as standard components, but will often include an estimated glomerular filtration rate (eGFR), and in some laboratories, glucose is also not included but is available as a separate test.
Kidney failure, also known as renal failure or end-stage renal disease (ESRD), is a medical condition in which the kidneys can no longer adequately filter waste products from the blood, functioning at less than 15% of normal levels. [2]
Diagram showing the basic physiologic mechanisms of the kidney. The kidney's ability to perform many of its functions depends on the three fundamental functions of filtration, reabsorption, and secretion, whose sum is called renal clearance or renal excretion.
References range may vary with age, sex, race, pregnancy, [10] diet, use of prescribed or herbal drugs and stress. Reference ranges often depend on the analytical method used, for reasons such as inaccuracy , lack of standardisation , lack of certified reference material and differing antibody reactivity . [ 11 ]
The primary sign of augmented renal clearance is an increase in the creatinine clearance well above that which would be considered normal. Commonly, ARC is defined as a creatinine clearance of greater than 130 mL/min, but the effects of increased clearance on therapy are not directly correlated to a specific number.