2010 Mark Tuttle

Renal Physiology Equations

Name

Equation

CX=
Clearanc
e

CX

Filtered
Load

FL X

Amount
excreted
EX

Units

Comments
X is any substance not metabolized
by the kidney

[U ] X V
excretionrate
=
[ P] X
serum concentration

x is any substance not metabolized by the kidney

Cx = Clearance of substance x
[U]X = Urine concentration of x
V = Urine flow
[P]X = Plasma concentration of x

F L X =GFR [ X ]serum

EX = amt. filtered + amt. secreted amt.

reabsorbed

C Inulin=C Creatinine =GFR

ml/mi
n

Creatinine is filtered (20%), but not

reabsorbed or secreted.
Actually is secreted in small
amounts by PT overestimates
GFR by 10-20%
Inulin is filtered, but not
reabsorbed/secreted.

mg

Amount of substance X that is

filtered through the
glomerulus

mg

Amount of substance X that is

found in the urine
Of the filtered amount of X,
what ratio is found in the
urine.
Determines net
reabsorbtion/secretion:
-

Fractiona
l
Excretion

FE X

FE X

< 100% net

reabsorption of X

E
C
amount excreted
FE X = X =
= X
FLX amount filtered C Inulin

FE X

< 100% net secretion

of X
In renal failure (oliguria):
-

Na+
FE

< 1% Prerenal

disease
+

Na
FE

> 2% Acute tubular

necrosis

Net
reabsorpti
onor
secretion

FL X E X

Excretion
Rate

ER X =[U ] X V

Filtration
Fraction

FF=

ER X

FF

GFR
RPF

mg

If positive, there is net

reabsorption of X.
If negative, there s net secretion
of X.

mg/mi
n

Rate at which X accumulates

in the urine

Normal is 0.2

2010 Mark Tuttle

Renal
Plasma
Flow

RPF

Renal
Blood
Flow

R B F=

RBF

FreeWater
Clearanc
e

CH

ml/mi
n

RPF
1Hematocrit

ml/mi
n

1 -Hct is fraction of blood

volume that is plasma

ml/mi
n

If positive, free water is

excreted
If negative, free water is
reabsorbed

C H O=V C Osm=V V
2

U Osm
POsm

*Underestimates RPF by 10%

(because its really only 90%
excreted)

Determines if the kidney is

concentrating or diluting urine

CockroftGault

PAH is 100%* excreted

[U ] PAH V
[ P]PAH

RPF C PAH =

CCr =

A ( 140age ) (kg)
72[P ]Creatinine

ml/mi
n

A=1 for males, 0.85 for females

Henderso
nHasselba
lch

HC O3

pH= pk +log

Fluid Compartment Markers

Compartment

Substance

% Total body
weight

TBW: Total Body Water

60%

ICF:

TBW - ECF

40%

20%

Intracellular Fluid

ECF: Extracellular Fluid

D2O
Titrated H2O
Sulfate
Inulin
Mannitol

ISF: Interstitial Fluid

ECF - Plasma

Plasma

Risa
Evans blue
Radioactive albumin

Normal Serum Levels

Substance

Normal Range

Significance

[BUN]

4-8 mmol/L

indicates azotemia

BUN:Creatinine

10

> 20:1 Prerenal azotemia

1:1 Acute renal failure

2010 Mark Tuttle

Blood pH

7.38 7.42

pCO2

40 mmHg

[HCO3-]

24 mEq/L

Indicates acidosis/alkalosis

to replace [HCO3-] in metabolic

acidosis

Serum Anion Gap

[Na+]-([HCO3-]+[Cl-])
Unmeasured ions include
phosphate, citrate, sulfate, and
protein.

12 mEq/L
mEq/L)

(8-16

Urinary Anion Gap

[Na+]+[K+]-[Cl-]
Unmeasured ions include
ammonium.

Near zero or positive

If anion gap is increased, there is an increase in

an unmeasured ion, usually (phosphate, lactate,
-hydroxybutyrate)
If anion gap is normal in metabolic acidosis, Clhas likely taken the place of HCO3-, called
hyperchloremic metabolic acidosis.
In metabolic acidosis, the excretion of the NH4+
(which is excreted with Cl- ) should increase
markedly if renal acidification is intact. Because of
the rise in urinary Cl- , the urine anion gap which is
also called the urinary net charge, becomes
negative, ranging from -20 to more than -50
meq/L. The negative value occurs because the Clconcentration now exceeds the sum total of Na +
and K+.
In contrast, if there is an impairment in kidney
function resulting in an inability to increase
ammonium excretion (i.e. Renal Tubular Acidosis),
then Cl- ions will not be increased in the urine and
the urine anion gap will not be affected and will be
positive or zero.