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Evaluation of the results of the biochemical study of the functional condition of kidneys

For biochemical assessment of renal function serum creatinine used and speed clubockova filtering (SCF).

Creatinine. Normal values of creatinine in the serum:

50-115 µmol/l. Depending on a number of factors, determination of the concentration of serum creatinine is inadequate to assess kidney function. The concentration of serum creatinine depends on products, secretion, vnepočečnoj creatinine excretion .

Creatinine, circulating in the blood, formed in muscle tissue. The average rate of creatinine is higher in men, young, the streets of the black race. This leads to

differences in concentrations of serum creatinine, depending on age, sex and race. Muscular exhaustion accompanied by a decrease in creatinine education, that causes it to lower concentrations, than one would expect on the level of FAS, in patients with protein-energy deficiency in chronic kidney disease (CHA).

On the formation of creatinine is also affected by eating meat. In patients, located at nizkobelkovoj (vegetarian) diet, serum creatinine below, than you might expect, based on SCF.

SCF.The most accurate indicator, reflecting the functional condition of kidneys, is the SCF. SCF may be measured using endogenous (inulin) and exogenous markers filtering, calculated by klirensu of endogenous markers filtering (creatinine) or formulas, based on the syvorotočnom level of endogenous markers (creatinine, Cystatin c).

Sample Rehberg-Renal Function. Measurement of 24-hour creatinine clearance for a certain period of time, that is often accompanied by errors and burdensome for the patient. This method of assessing the SCF does not have advantages in comparison with the calculation formula.

The exception to this is the definition of FAS streets with unusual diet or abnormalities in muscle mass, because these factors were not taken into account when designing formulas. The use of serum creatinine to assess patient's condition stable implies SCF, Therefore, the results are not reliable, If the SCF level is changing rapidly — in acute renal failure (ΟΠΗ), If muscle mass is unusually big or small — from athletes or malnourished persons, or if creatine intake from food is little large or unusual streets, users with creatine supplements or vegetarians. Thus, sample Rehberg-renal function can give a better assessment of the SCF, What payment methods in the following clinical situations:

ü Pregnancy

ü Extremes of age and body size

ü Severe protein-energy malnutrition

ü Diseases of skeletal muscle

ü Paraplegia and tetraplegia

ü Vegetarian diet

ü Rapidly changing function of kidneys

ü Before assigning nefrotoksicnah drugs

Payment methods for the evaluation of FAS and creatinine clearance. In adults, the most widely used formula Cockcroft-Ngo (Cockroft-Gault) and the formula, obtained in the study of CREATININE CLEARANCE (Modification of Diet in Disease Based Study)

Cockcroft Formula-Ngo (mL/min)

SCF = (140-age (years)) X body weight (kg) X 0,85 (for women)
0,81 X serum creatinine (mkmol/l)

Benefits of formula of CREATININE CLEARANCE (mL/min per 1.73 m2) are, that it is derived from a large group of patients as white, and Negroid races, with a wide range of kidney disease. Formula allows us to estimate the SCF, based on body surface area.

There are two variations of the formula of CREATININE CLEARANCE: full and abridged. For the calculation of the SCF for the full (original) the formula requires a number of biochemical indicators along with serum kreatininom. To use an abbreviated formula of CREATININE CLEARANCE needed

only demographic data (Paul, age, race, weight, growth) and the level of serum creatinine. The results of the, by applying both formulas, comparable.

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