BIOL 4376 Study Guide - Final Guide: Nephrotoxicity, Lisinopril, Gentamicin

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Published on 29 Jul 2020
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Look for 3 C’s: cells, cast, and crystals
Normal: 0 to trace formed elements present
Abnormalities and common causes
Cells: commonly seen with UTI, intrinsic and postrenal
disease
Casts: objects formed within renal tubules, composed
mostly of protein and cells
Cellular casts form when cells are trapped in the
tubules; signs of intrinsic renal disease
Crystals: commonly seen with nephrolithiasis (kidney
stone)
Glomerular Filtration Rate
Glomerular Filtration Rate (GFR)
Background
Estimates how much blood passes through the glomerulus every minutes
Provides excellent overall index of kidney function
Helpful in staging CKD
Issue: measurement of glomerular filtration rate (GFR) is complex, time consuming and
cumbersome to do in clinical practice
Solution: estimating the GFR
1. Modification of Diet in Renal Disease (MDRD) study equation (more accurate in
certain patient populations)
2. Creatinine clearance: 24-hour urine collection, Cockcroft-Gault (C-G) equation
(most common)
Modification of Diet in Renal Disease (MDRD) Study Equation - assumes steady state Scr
Equation:
Estimates GFR based on Scr and demographic and clinical variables
Tool to identify patients at risk for complicating arising from CKD
Does not provide accurate estimates of GFR in settings where the GFR is
changing rapidly (i.e. AKI)
Findings:
Normal GFR: >/= 90 mL/min/1.73m2 (normal body surface area)
Examples of abnormal GFR: < 60mL/min/1.73m2 consistent with kidney disease,
< 15mL/min/1.73m2 defined as kidney failure
Creatinine Clearance (CrCl)
Definition: volume of blood plasma that is cleared of creatinine per unit time (mL/min);
useful measure for approximating GFR
Normal CrCl: 80-130 mL/min
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