Renal Function Tests Why Test Renal Function? To identify renal dysfunction. To diagnose renal disease. To monitor disease progress. To monitor response to treatment. To assess changes in function that may impact on therapy (e.g.Digoxin, chemotherapy). Renal Functions Production of urine Elimination of metabolic end products (Urea/Creatinine) Elimination of foreign materials (Drugs) Control of volume & composition of ECF Water and electrolyte balance Acid/Base status Endocrine Functions Vit D, Epo, Renin Renal Functions Production of urine: - Excretion of water soluble waste : - End products of metabolism (urea, creatinine) Foreign materials (drugs etc) Control of volume & composition of ECF Water and electrolyte balance Acid/Base status Renal functions Endocrine functions: - Vitamin D Erythropoietin Renin/angiotensin/aldosterone axis Signs and Symptoms of Renal Failure Symptoms of Uraemia (nausea, vomiting, lethargy) Disorders of Micturation (frequency, nocturia, retention, dysuria) Disorders of Urine volume (polyuria, oliguria, anuria) Alterations in urine composition (haematuria, proteinuria, bacteriua, leujocyturia, calculi) Pain Oedema (hypoalbuminaemia, salt and water retention) Biochemical Tests of Renal Function Urinalysis Appearance Specific gravity and osmolality pH Glucose Protein Urinary sediments? Measurement of GFR Clearance tests Plasma creatinine Tubular function tests Role of Biochemical Testing Presentation of patients:...

Review of Organic Chemistry & Biomolecules Primordial Biomolecules Water is the “cradle of life” - All organisms are about 2/3 water. Pathway metabolites are simple. Of the 21 metabolites involved in glycolysis, gluconeogenesis and TCA cycle, all are 6 carbons - “Small is better” Three major biomolecules/ fuels/nutrients : Carbohydrate Lipid Protein Early ( 18 hr) starvation fuel: Carbohydrate (liver glycogen) Late starvation fuel: Lipid (adipose tissue) and protein (muscle) Other biomolecules include: DNA/RNA, vitamins, xenobiotics (alcohol, etc.)