Review literature: (Benninghoff, 1993) (Schmidt und Thews, 1995).
In the glomerulus, the primary urine is filtered from the blood, which flows through the capillaries of the glomerulus. With the exception of proteins over a molecular mass of 10 kDa, all components of the plasma are filtered into the primary urine. Subsequently, the active and passive reabsorption of important substances in the renal tubules from the primary urine is of elementary importance (see tubular reabsorption .
The renal blood flow is approximately 20% of the cardiac output at rest (1–1.2 l/min). About 10% of renal blood flow is filtered and make up the primary urine. The filtration speed of the primary urine is called glomerular filtration rate (GFR) and is approximately 120 ml/min.
The following variables increase the GFR: increased hydraulic pressure in the glomerular capillaries and the area (amount) of glomerular capillaries. The following variables decrease the GFR: increased hydraulic pressure in the Bowmann's capsule, increased colloid osmotic pressure in the glomerular capillaries, decreased permeability of the glomerular capillaries.
The glomerular filtration rate cannot be measured directly. For approximation, the elimination of a substance is measured, which is
Renal clearance is the virtual plasma volume per minute, from which a substance is completely eliminated. If a substance is chosen, which is not secreted or reabsorbed in the renal tubules, the measured clearance corresponds to the glomerular filtration rate (GFR).
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Calculation of the creatinine clearance |
An estimation of the creatinine clearance can be obtained using the formula of Cockroft and Gault using the serum concentration of creatinine (SKrea in mg/dl), gender (factor F=72 for men and F=85 for women), weight (kgKG in kg) and age (Alter in years):
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Estimation of the glomerular filtration rate using the formula of Cockroft and Gault |
Substances with exclusive glomerular filtration (without tubular secretion or reabsorption) as creatinine have serum concentrations in direct dependence of the glomerular filtration rate (GFR). A halving of GFR leads to a doubling of the serum creatinine concentration. This means, that a reduction of the GFR by 75% leads to a significant fourfold increase of the serum creatinine concentration. Further (only slight) reductions in GFR lead to dramatic increases creatinine concentrations [fig. creatinine concentration and GFR].
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fig. creatinine concentration in dependence of the glomerular filtration rate (GFR). Only a pronounced reduction of the GFR leads to a significant rise of the serum creatinine concentration. |
| Kidney, distal nephron | Index | Kidney, reabsorption |
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Deutsche Version: Physiologie der Nieren: Glomeruläre Filtrationsrate und Kreatininclearance.
Last update:
Dr. med. Dirk Manski (E-Mail)