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class="vector-toc-numb">2</span> <span>Clinical assessment</span> </div> </a> <ul id="toc-Clinical_assessment-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Urine_tests" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Urine_tests"> <div class="vector-toc-text"> <span class="vector-toc-numb">3</span> <span>Urine tests</span> </div> </a> <ul id="toc-Urine_tests-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Blood_tests" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Blood_tests"> <div class="vector-toc-text"> <span class="vector-toc-numb">4</span> <span>Blood tests</span> </div> </a> <button aria-controls="toc-Blood_tests-sublist" class="cdx-button cdx-button--weight-quiet cdx-button--icon-only vector-toc-toggle"> <span class="vector-icon mw-ui-icon-wikimedia-expand"></span> <span>Toggle Blood tests subsection</span> </button> <ul id="toc-Blood_tests-sublist" class="vector-toc-list"> <li id="toc-Glomerular_filtration_rate" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Glomerular_filtration_rate"> <div class="vector-toc-text"> <span class="vector-toc-numb">4.1</span> <span>Glomerular filtration rate</span> </div> </a> <ul id="toc-Glomerular_filtration_rate-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Medical_imaging" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Medical_imaging"> <div class="vector-toc-text"> <span class="vector-toc-numb">5</span> <span>Medical imaging</span> </div> </a> <ul id="toc-Medical_imaging-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Kidney_function_in_disease" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Kidney_function_in_disease"> <div class="vector-toc-text"> <span class="vector-toc-numb">6</span> <span>Kidney function in disease</span> </div> </a> <button aria-controls="toc-Kidney_function_in_disease-sublist" class="cdx-button cdx-button--weight-quiet cdx-button--icon-only vector-toc-toggle"> <span class="vector-icon mw-ui-icon-wikimedia-expand"></span> <span>Toggle Kidney function in disease subsection</span> </button> <ul id="toc-Kidney_function_in_disease-sublist" class="vector-toc-list"> <li id="toc-Chronic_kidney_disease_stages" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Chronic_kidney_disease_stages"> <div class="vector-toc-text"> <span class="vector-toc-numb">6.1</span> <span>Chronic kidney disease stages</span> </div> </a> <ul id="toc-Chronic_kidney_disease_stages-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-See_also" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#See_also"> <div class="vector-toc-text"> 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src="//upload.wikimedia.org/wikipedia/commons/thumb/2/2b/Physiology_of_Nephron.png/300px-Physiology_of_Nephron.png" decoding="async" width="300" height="350" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/2/2b/Physiology_of_Nephron.png/450px-Physiology_of_Nephron.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/2/2b/Physiology_of_Nephron.png/600px-Physiology_of_Nephron.png 2x" data-file-width="1046" data-file-height="1221" /></a><figcaption>Diagram showing a schematic nephron and its blood supply. The basic physiologic mechanisms of handling fluid and electrolytes by the nephron - filtration, secretion, reabsorption, and excretion - are labelled.</figcaption></figure> <p><b>Assessment of kidney function</b> occurs in different ways, using the presence of <a href="/wiki/Symptoms" class="mw-redirect" title="Symptoms">symptoms</a> and <a href="/wiki/Medical_sign" class="mw-redirect" title="Medical sign">signs</a>, as well as measurements using urine tests, blood tests, and medical imaging. </p><p><a href="/wiki/Renal_physiology" title="Renal physiology">Functions of a healthy kidney</a> include maintaining a person's <a href="/wiki/Fluid_balance" title="Fluid balance">fluid balance</a>, maintaining an <a href="/wiki/Acid-base_balance" class="mw-redirect" title="Acid-base balance">acid-base balance</a>; regulating electrolytes <a href="/wiki/Sodium" title="Sodium">sodium</a>, and other <a href="/wiki/Electrolyte" title="Electrolyte">electrolytes</a>; <a href="/wiki/Clearance_(medicine)" class="mw-redirect" title="Clearance (medicine)">clearing</a> <a href="/wiki/Toxin" title="Toxin">toxins</a>; regulating <a href="/wiki/Blood_pressure" title="Blood pressure">blood pressure</a>; and regulating <a href="/wiki/Hormone" title="Hormone">hormones</a>, such as <a href="/wiki/Erythropoietin" title="Erythropoietin">erythropoietin</a>; and activation of <a href="/wiki/Vitamin_D" title="Vitamin D">vitamin D</a>. The kidney is also involved in maintaining blood pH balance. </p> <meta property="mw:PageProp/toc" /> <div class="mw-heading mw-heading2"><h2 id="Description">Description</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Assessment_of_kidney_function&action=edit&section=1" title="Edit section: Description"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <style data-mw-deduplicate="TemplateStyles:r1236090951">.mw-parser-output .hatnote{font-style:italic}.mw-parser-output div.hatnote{padding-left:1.6em;margin-bottom:0.5em}.mw-parser-output .hatnote i{font-style:normal}.mw-parser-output .hatnote+link+.hatnote{margin-top:-0.5em}@media print{body.ns-0 .mw-parser-output .hatnote{display:none!important}}</style><div role="note" class="hatnote navigation-not-searchable">Main article: <a href="/wiki/Renal_physiology" title="Renal physiology">Renal physiology</a></div> <p>The functions of the kidney include maintenance of <a href="/wiki/Acid-base_balance" class="mw-redirect" title="Acid-base balance">acid-base balance</a>; regulation of <a href="/wiki/Fluid_balance" title="Fluid balance">fluid balance</a>; regulation of <a href="/wiki/Sodium" title="Sodium">sodium</a>, <a href="/wiki/Potassium" title="Potassium">potassium</a>, and other <a href="/wiki/Electrolyte" title="Electrolyte">electrolytes</a>; <a href="/wiki/Clearance_(medicine)" class="mw-redirect" title="Clearance (medicine)">clearance</a> of <a href="/wiki/Toxin" title="Toxin">toxins</a>; absorption of <a href="/wiki/Glucose" title="Glucose">glucose</a>, <a href="/wiki/Amino_acid" title="Amino acid">amino acids</a>, and other small molecules; regulation of <a href="/wiki/Blood_pressure" title="Blood pressure">blood pressure</a>; production of various <a href="/wiki/Hormone" title="Hormone">hormones</a>, such as <a href="/wiki/Erythropoietin" title="Erythropoietin">erythropoietin</a>; and activation of <a href="/wiki/Vitamin_D" title="Vitamin D">vitamin D</a>. </p><p>The <a href="/wiki/Glomerular_filtration_rate" title="Glomerular filtration rate">Glomerular filtration rate</a> (GFR) is regarded as the best overall measure of the kidney's ability to carry out these numerous functions. An estimate of the GFR is used clinically to determine the degree of kidney impairment and to track the progression of the disease. The GFR, however, does not reveal the source of the kidney disease. This is accomplished by urinalysis, measurement of urine protein excretion, kidney imaging, and, if necessary, kidney biopsy.<sup id="cite_ref-1" class="reference"><a href="#cite_note-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup> </p><p>Much of renal physiology is studied at the level of the <a href="/wiki/Nephron" title="Nephron">nephron</a> – the smallest functional unit of the kidney. Each nephron begins with a <a href="#Filtration">filtration</a> component that filters the <a href="/wiki/Blood" title="Blood">blood</a> entering the kidney. This filtrate then flows along the length of the nephron, which is a tubular structure lined by a single layer of specialized <a href="/wiki/Cell_(biology)" title="Cell (biology)">cells</a> and surrounded by <a href="/wiki/Capillary" title="Capillary">capillaries</a>. The major functions of these lining cells are the <a href="/wiki/Reabsorption" title="Reabsorption">reabsorption</a> of water and small molecules from the filtrate into the blood, and the <a href="#Secretion">secretion</a> of wastes from the blood into the <a href="/wiki/Urine" title="Urine">urine</a>.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (November 2021)">citation needed</span></a></i>]</sup> </p><p>Proper function of the kidney requires that it receives and adequately filters blood. This is performed at the microscopic level by many hundreds of thousands of filtration units called <a href="/wiki/Renal_corpuscle" title="Renal corpuscle">renal corpuscles</a>, each of which is composed of a <a href="/wiki/Glomerulus_(kidney)" title="Glomerulus (kidney)">glomerulus</a> and a <a href="/wiki/Bowman%27s_capsule" title="Bowman's capsule">Bowman's capsule</a>. A global assessment of renal function is often ascertained by estimating the rate of filtration, called the <a href="/wiki/Glomerular_filtration_rate" title="Glomerular filtration rate">glomerular filtration rate</a> (GFR). </p> <div class="mw-heading mw-heading2"><h2 id="Clinical_assessment">Clinical assessment</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Assessment_of_kidney_function&action=edit&section=2" title="Edit section: Clinical assessment"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Clinical assessment can be used to assess the function of the kidneys. This is because a person with abnormally functioning kidneys may have symptoms that develop. For example, a person with chronic kidney disease may develop <a href="/wiki/Oedema" class="mw-redirect" title="Oedema">oedema</a> due to failure of the kidneys to regulate water balance. They may develop evidence of chronic kidney disease, that can be used to assess its severity, for example <a href="/wiki/Hypertension" title="Hypertension">high blood pressure</a>, <a href="/wiki/Osteoporosis" title="Osteoporosis">osteoporosis</a> or <a href="/wiki/Anaemia" class="mw-redirect" title="Anaemia">anaemia</a>. If the kidneys are unable to excrete <a href="/wiki/Urea" title="Urea">urea</a>, a person may develop a widespread <a href="/wiki/Itch" title="Itch">itch</a> or <a href="/wiki/Confusion" title="Confusion">confusion</a>.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (July 2020)">citation needed</span></a></i>]</sup> </p> <div class="mw-heading mw-heading2"><h2 id="Urine_tests">Urine tests</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Assessment_of_kidney_function&action=edit&section=3" title="Edit section: Urine tests"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Part of the assessment of kidney function includes the measurement of urine and its contents. Abnormal kidney function may cause too much or too little urine to be produced. The ability of the kidneys to filter protein is often measured, as <a href="/wiki/Urine_albumin" class="mw-redirect" title="Urine albumin">urine albumin</a> or <a href="/wiki/Urine_protein" class="mw-redirect" title="Urine protein">urine protein</a> levels,<sup id="cite_ref-Stevens2013_2-0" class="reference"><a href="#cite_note-Stevens2013-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup> measured either at a single instance or, because of variation throughout the day, as 24-hour urine tests.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (July 2020)">citation needed</span></a></i>]</sup> </p> <div class="mw-heading mw-heading2"><h2 id="Blood_tests">Blood tests</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Assessment_of_kidney_function&action=edit&section=4" title="Edit section: Blood tests"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Blood tests are also used to assess kidney function. These include tests that are intended to directly measure the function of the kidneys, as well as tests that assess the function of the kidneys by looking for evidence of problems associated with abnormal function. One of the measures of kidney function is the glomerular filtration rate (GFR). Other tests that can assess the function of the kidneys include assessment of <a href="/wiki/Electrolyte" title="Electrolyte">electrolyte</a> levels such as <a href="/wiki/Potassium" title="Potassium">potassium</a> and <a href="/wiki/Phosphate" title="Phosphate">phosphate</a>, assessment of acid-base status by the measurement of <a href="/wiki/Bicarbonate" title="Bicarbonate">bicarbonate</a> levels from a vein, and assessment of the <a href="/wiki/Full_blood_count" class="mw-redirect" title="Full blood count">full blood count</a> for <a href="/wiki/Anaemia" class="mw-redirect" title="Anaemia">anaemia</a>.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (July 2020)">citation needed</span></a></i>]</sup> </p> <div class="mw-heading mw-heading3"><h3 id="Glomerular_filtration_rate">Glomerular filtration rate</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Assessment_of_kidney_function&action=edit&section=5" title="Edit section: Glomerular filtration rate"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236090951"><div role="note" class="hatnote navigation-not-searchable">Main article: <a href="/wiki/Glomerular_filtration_rate" title="Glomerular filtration rate">Glomerular filtration rate</a></div> <p>The glomerular filtration rate (GFR) describes the volume of fluid filtered from the <a href="/wiki/Kidney" title="Kidney">renal</a> (kidney) <a href="/wiki/Glomerulus_(kidney)" title="Glomerulus (kidney)">glomerular</a> capillaries into the <a href="/wiki/Bowman%27s_capsule" title="Bowman's capsule">Bowman's capsule</a> per unit time.<sup id="cite_ref-3" class="reference"><a href="#cite_note-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup> Creatinine clearance (C<sub>Cr</sub>) is the volume of <a href="/wiki/Blood_plasma" title="Blood plasma">blood plasma</a> that is cleared of <a href="/wiki/Creatinine" title="Creatinine">creatinine</a> per unit time and is a useful measure for approximating the GFR. Creatinine clearance exceeds GFR due to creatinine secretion,<sup id="cite_ref-4" class="reference"><a href="#cite_note-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup> which can be blocked by <a href="/wiki/Cimetidine" title="Cimetidine">cimetidine</a>. Both GFR and C<sub>Cr</sub> may be accurately calculated by comparative measurements of substances in the blood and urine, or estimated by formulas using just a blood test result (<b>eGFR</b> and <b>eC<sub>Cr</sub></b>) The results of these tests are used to assess the excretory function of the kidneys. <a href="/wiki/Chronic_kidney_disease#Stages" title="Chronic kidney disease">Staging</a> of <a href="/wiki/Chronic_kidney_disease" title="Chronic kidney disease">chronic kidney disease</a> is based on categories of GFR as well as <a href="/wiki/Albuminuria" title="Albuminuria">albuminuria</a> and cause of <a href="/wiki/Kidney_disease" title="Kidney disease">kidney disease</a>.<sup id="cite_ref-Stevens2013_2-1" class="reference"><a href="#cite_note-Stevens2013-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup> </p><p>Central to the physiologic maintenance of GFR is the differential basal tone of the afferent and efferent arterioles (see diagram). In other words, the filtration rate is dependent on the difference between the higher blood pressure created by vasoconstriction of the input or afferent arteriole versus the lower blood pressure created by lesser vasoconstriction of the output or efferent arteriole. </p><p>GFR is equal to the <a href="/wiki/Renal_clearance_ratio" title="Renal clearance ratio">renal clearance ratio</a> when any solute is freely filtered and is neither reabsorbed nor secreted by the kidneys. The rate therefore measured is the quantity of the substance in the urine that originated from a calculable volume of blood. Relating this principle to the below equation – for the substance used, the product of urine concentration and urine flow equals the mass of substance excreted during the time that urine has been collected. This mass equals the mass filtered at the glomerulus as nothing is added or removed in the nephron. Dividing this mass by the plasma concentration gives the volume of plasma which the mass must have originally come from, and thus the volume of plasma fluid that has entered Bowman's capsule within the aforementioned period of time. The GFR is typically recorded in units of <i>volume per time</i>, e.g., milliliters per minute (<a href="/wiki/Millilitre" class="mw-redirect" title="Millilitre">mL</a>/<a href="/wiki/Minute" title="Minute">min</a>). Compare to <a href="/wiki/Filtration_fraction" title="Filtration fraction">filtration fraction</a>.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (July 2020)">citation needed</span></a></i>]</sup> </p> <dl><dd><span class="mwe-math-element"><span class="mwe-math-mathml-inline mwe-math-mathml-a11y" style="display: none;"><math xmlns="http://www.w3.org/1998/Math/MathML" alttext="{\displaystyle GFR={\frac {{\mbox{Urine Concentration}}\times {\mbox{Urine Flow}}}{\mbox{Plasma Concentration}}}}"> <semantics> <mrow class="MJX-TeXAtom-ORD"> <mstyle displaystyle="true" scriptlevel="0"> <mi>G</mi> <mi>F</mi> <mi>R</mi> <mo>=</mo> <mrow class="MJX-TeXAtom-ORD"> <mfrac> <mrow> <mrow class="MJX-TeXAtom-ORD"> <mstyle displaystyle="false" scriptlevel="0"> <mtext>Urine Concentration</mtext> </mstyle> </mrow> <mo>×</mo> <mrow class="MJX-TeXAtom-ORD"> <mstyle displaystyle="false" scriptlevel="0"> <mtext>Urine Flow</mtext> </mstyle> </mrow> </mrow> <mstyle displaystyle="false" scriptlevel="0"> <mtext>Plasma Concentration</mtext> </mstyle> </mfrac> </mrow> </mstyle> </mrow> <annotation encoding="application/x-tex">{\displaystyle GFR={\frac {{\mbox{Urine Concentration}}\times {\mbox{Urine Flow}}}{\mbox{Plasma Concentration}}}}</annotation> </semantics> </math></span><img src="https://wikimedia.org/api/rest_v1/media/math/render/svg/2e07a0b49a41a3bf26e9c432ccc310c2ea950a3b" class="mwe-math-fallback-image-inline mw-invert skin-invert" aria-hidden="true" style="vertical-align: -2.005ex; width:44.001ex; height:5.509ex;" alt="{\displaystyle GFR={\frac {{\mbox{Urine Concentration}}\times {\mbox{Urine Flow}}}{\mbox{Plasma Concentration}}}}"></span></dd></dl> <p>There are several different techniques used to calculate or estimate the glomerular filtration rate (GFR or eGFR). The above formula only applies for GFR calculation when it is equal to the Clearance Rate. </p><p>The normal range of GFR, adjusted for <a href="/wiki/Body_surface_area" title="Body surface area">body surface area</a>, is 100–130 average 125 (mL/min)/(1.73 m<sup>2</sup>) in men and 90–120 (mL/min)/(1.73 m<sup>2</sup>) in women younger than the age of 40. In children, GFR measured by inulin clearance is 110 (mL/min)/(1.73 m<sup>2</sup>) until 2 years of age in both sexes, and then it progressively decreases. After age 40, GFR decreases progressively with age, by 0.4–1.2 mL/min per year.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (January 2013)">citation needed</span></a></i>]</sup> </p><p>Estimated GFR (eGFR) is now recommended by clinical practice guidelines and regulatory agencies for routine evaluation of GFR whereas measured GFR (mGFR) is recommended as a confirmatory test when more accurate assessment is required.<sup id="cite_ref-naturerev_5-0" class="reference"><a href="#cite_note-naturerev-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Medical_imaging">Medical imaging</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Assessment_of_kidney_function&action=edit&section=6" title="Edit section: Medical imaging"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>The kidney function can also be assessed with <a href="/wiki/Medical_imaging" title="Medical imaging">medical imaging</a>. Some forms of imaging, such as <a href="/wiki/Kidney_ultrasound" class="mw-redirect" title="Kidney ultrasound">kidney ultrasound</a> or <a href="/wiki/Computed_tomography_of_the_abdomen_and_pelvis" title="Computed tomography of the abdomen and pelvis">CT scans</a>, may assess kidney function by indicating chronic disease that can impact function, by showing a small or shrivelled kidney.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (July 2020)">citation needed</span></a></i>]</sup>. Other tests, such as <a href="/wiki/Nuclear_medicine" title="Nuclear medicine">nuclear medicine</a> tests, directly assess the function of the kidney by measuring the perfusion and excretion of radioactive substances through the kidneys.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (July 2020)">citation needed</span></a></i>]</sup> </p> <div class="mw-heading mw-heading2"><h2 id="Kidney_function_in_disease">Kidney function in disease</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Assessment_of_kidney_function&action=edit&section=7" title="Edit section: Kidney function in disease"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>A decreased renal function can be caused by many types of <a href="/wiki/Kidney_disease" title="Kidney disease">kidney disease</a>. Upon presentation of decreased renal function, it is recommended to perform a <a href="/wiki/Medical_history" title="Medical history">history</a> and <a href="/wiki/Physical_examination" title="Physical examination">physical examination</a>, as well as performing a <a href="/wiki/Renal_ultrasound" class="mw-redirect" title="Renal ultrasound">renal ultrasound</a> and a <a href="/wiki/Urinalysis" title="Urinalysis">urinalysis</a>.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (September 2019)">citation needed</span></a></i>]</sup> The most relevant items in the history are <a href="/wiki/Pharmaceutical_drug" class="mw-redirect" title="Pharmaceutical drug">medications</a>, <a href="/wiki/Edema" title="Edema">edema</a>, <a href="/wiki/Nocturia" title="Nocturia">nocturia</a>, gross <a href="/wiki/Hematuria" title="Hematuria">hematuria</a>, <a href="/wiki/Family_history_(medicine)" title="Family history (medicine)">family history</a> of kidney disease, <a href="/wiki/Diabetes" title="Diabetes">diabetes</a> and <a href="/wiki/Polyuria" title="Polyuria">polyuria</a>. The most important items in a physical examination are signs of <a href="/wiki/Vasculitis" title="Vasculitis">vasculitis</a>, <a href="/wiki/Lupus_erythematosus" title="Lupus erythematosus">lupus erythematosus</a>, <a href="/wiki/Diabetes" title="Diabetes">diabetes</a>, <a href="/wiki/Endocarditis" title="Endocarditis">endocarditis</a> and <a href="/wiki/Hypertension" title="Hypertension">hypertension</a>.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (September 2019)">citation needed</span></a></i>]</sup> </p><p>A urinalysis is helpful even when not showing any pathology, as this finding suggests an extrarenal etiology. <a href="/wiki/Proteinuria" title="Proteinuria">Proteinuria</a> and/or <a href="/wiki/Urinary_sediment" class="mw-redirect" title="Urinary sediment">urinary sediment</a> usually indicates the presence of <a href="/w/index.php?title=Glomerular_disease&action=edit&redlink=1" class="new" title="Glomerular disease (page does not exist)">glomerular disease</a>. <a href="/wiki/Hematuria" title="Hematuria">Hematuria</a> may be caused by glomerular disease or by a disease along the <a href="/wiki/Urinary_tract" class="mw-redirect" title="Urinary tract">urinary tract</a>.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (September 2019)">citation needed</span></a></i>]</sup> </p><p>The most relevant assessments in a <a href="/wiki/Renal_ultrasound" class="mw-redirect" title="Renal ultrasound">renal ultrasound</a> are renal sizes, <a href="/wiki/Echogenicity" title="Echogenicity">echogenicity</a> and any signs of <a href="/wiki/Hydronephrosis" title="Hydronephrosis">hydronephrosis</a>. Renal enlargement usually indicates diabetic nephropathy, <a href="/wiki/Focal_segmental_glomerular_sclerosis" class="mw-redirect" title="Focal segmental glomerular sclerosis">focal segmental glomerular sclerosis</a> or <a href="/wiki/Myeloma" class="mw-redirect" title="Myeloma">myeloma</a>. Renal atrophy suggests longstanding chronic renal disease.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (September 2019)">citation needed</span></a></i>]</sup> </p> <div class="mw-heading mw-heading3"><h3 id="Chronic_kidney_disease_stages">Chronic kidney disease stages</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Assessment_of_kidney_function&action=edit&section=8" title="Edit section: Chronic kidney disease stages"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236090951"><div role="note" class="hatnote navigation-not-searchable">Main article: <a href="/wiki/Chronic_kidney_disease" title="Chronic kidney disease">Chronic kidney disease</a></div> <p>Risk factors for kidney disease include diabetes, high blood pressure, family history, older age, ethnic group and smoking. For most patients, a GFR over 60 (mL/min)/(1.73 m<sup>2</sup>) is adequate. But significant decline of the GFR from a previous test result can be an early indicator of kidney disease requiring medical intervention. The sooner kidney dysfunction is diagnosed and treated the greater odds of preserving remaining nephrons, and preventing the need for dialysis. </p> <table class="wikitable" style="float:right; margin-left:5px"> <tbody><tr> <th>CKD stage </th> <th>GFR level <small>((mL/min)/(1.73 m<sup>2</sup>))</small> </th></tr> <tr> <td>Stage 1 </td> <td style="text-align:center">≥ 90 </td></tr> <tr> <td>Stage 2 </td> <td style="text-align:center">60–89 </td></tr> <tr> <td>Stage 3 </td> <td style="text-align:center">30–59 </td></tr> <tr> <td>Stage 4 </td> <td style="text-align:center">15–29 </td></tr> <tr> <td>Stage 5 </td> <td style="text-align:center">< 15 </td></tr></tbody></table> <p>The <a href="/wiki/Chronic_kidney_disease#Stages" title="Chronic kidney disease">severity of chronic kidney disease</a> (CKD) is described by six stages; the most severe three are defined by the MDRD-eGFR value, and first three also depend on whether there is other evidence of kidney disease (e.g., <a href="/wiki/Proteinuria" title="Proteinuria">proteinuria</a>): </p> <dl><dd>0) Normal kidney function – GFR above 90 (mL/min)/(1.73 m<sup>2</sup>) and no <a href="/wiki/Proteinuria" title="Proteinuria">proteinuria</a></dd> <dd>1) CKD1 – GFR above 90 (mL/min)/(1.73 m<sup>2</sup>) with evidence of kidney damage</dd> <dd>2) CKD2 (mild) – GFR of 60 to 89 (mL/min)/(1.73 m<sup>2</sup>) with evidence of kidney damage</dd> <dd>3) CKD3 (moderate) – GFR of 30 to 59 (mL/min)/(1.73 m<sup>2</sup>)</dd> <dd>4) CKD4 (severe) – GFR of 15 to 29 (mL/min)/(1.73 m<sup>2</sup>)</dd> <dd>5) CKD5 kidney failure – GFR less than 15 (mL/min)/(1.73 m<sup>2</sup>) Some people add CKD5D for those stage 5 patients requiring dialysis; many patients in CKD5 are not yet on dialysis.</dd></dl> <p>Note: others add a "T" to patients who have had a transplant regardless of stage. </p><p>Not all clinicians agree with the above classification, suggesting that it may mislabel patients with mildly reduced kidney function, especially the elderly, as having a disease.<sup id="cite_ref-6" class="reference"><a href="#cite_note-6"><span class="cite-bracket">[</span>6<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-7" class="reference"><a href="#cite_note-7"><span class="cite-bracket">[</span>7<span class="cite-bracket">]</span></a></sup> A conference was held in 2009 regarding these controversies by Kidney Disease: Improving Global Outcomes (KDIGO) on CKD: Definition, Classification and Prognosis, gathering data on CKD prognosis to refine the definition and staging of CKD.<sup id="cite_ref-8" class="reference"><a href="#cite_note-8"><span class="cite-bracket">[</span>8<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="See_also">See also</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Assessment_of_kidney_function&action=edit&section=9" title="Edit section: See also"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <style data-mw-deduplicate="TemplateStyles:r1184024115">.mw-parser-output .div-col{margin-top:0.3em;column-width:30em}.mw-parser-output .div-col-small{font-size:90%}.mw-parser-output .div-col-rules{column-rule:1px solid #aaa}.mw-parser-output .div-col dl,.mw-parser-output .div-col ol,.mw-parser-output .div-col ul{margin-top:0}.mw-parser-output .div-col li,.mw-parser-output .div-col dd{page-break-inside:avoid;break-inside:avoid-column}</style><div class="div-col div-col-rules" style="column-width: 20em;"> <ul><li><a href="/wiki/Bowman%E2%80%93Heidenhain_hypothesis" title="Bowman–Heidenhain hypothesis">Bowman–Heidenhain hypothesis</a></li> <li><a href="/wiki/Clearance_(medicine)" class="mw-redirect" title="Clearance (medicine)">Clearance</a></li> <li><a href="/wiki/Kidney_dialysis" title="Kidney dialysis">Dialysis</a></li> <li><a href="/wiki/Filtration_fraction" title="Filtration fraction">Filtration fraction</a></li> <li><a href="/wiki/Kt/V" title="Kt/V">Kt/V</a></li> <li><a href="/wiki/Pharmacokinetics" title="Pharmacokinetics">Pharmacokinetics</a></li> <li><a href="/wiki/Renal_clearance_ratio" title="Renal clearance ratio">Renal clearance ratio</a></li> <li><a href="/wiki/Renal_failure" class="mw-redirect" title="Renal failure">Renal failure</a></li> <li><a href="/wiki/Standardized_Kt/V" title="Standardized Kt/V">Standardized Kt/V</a></li> <li><a href="/wiki/Tubuloglomerular_feedback" title="Tubuloglomerular feedback">Tubuloglomerular feedback</a></li> <li><a href="/wiki/Urea_reduction_ratio" title="Urea reduction ratio">Urea reduction ratio</a></li></ul></div> <div class="mw-heading mw-heading2"><h2 id="References">References</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Assessment_of_kidney_function&action=edit&section=10" title="Edit section: References"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <style data-mw-deduplicate="TemplateStyles:r1239543626">.mw-parser-output .reflist{margin-bottom:0.5em;list-style-type:decimal}@media screen{.mw-parser-output .reflist{font-size:90%}}.mw-parser-output .reflist .references{font-size:100%;margin-bottom:0;list-style-type:inherit}.mw-parser-output .reflist-columns-2{column-width:30em}.mw-parser-output .reflist-columns-3{column-width:25em}.mw-parser-output .reflist-columns{margin-top:0.3em}.mw-parser-output .reflist-columns ol{margin-top:0}.mw-parser-output .reflist-columns li{page-break-inside:avoid;break-inside:avoid-column}.mw-parser-output .reflist-upper-alpha{list-style-type:upper-alpha}.mw-parser-output .reflist-upper-roman{list-style-type:upper-roman}.mw-parser-output .reflist-lower-alpha{list-style-type:lower-alpha}.mw-parser-output .reflist-lower-greek{list-style-type:lower-greek}.mw-parser-output .reflist-lower-roman{list-style-type:lower-roman}</style><div class="reflist reflist-columns references-column-width" style="column-width: 30em;"> <ol class="references"> <li id="cite_note-1"><span class="mw-cite-backlink"><b><a href="#cite_ref-1">^</a></b></span> <span class="reference-text"><style data-mw-deduplicate="TemplateStyles:r1238218222">.mw-parser-output cite.citation{font-style:inherit;word-wrap:break-word}.mw-parser-output .citation q{quotes:"\"""\"""'""'"}.mw-parser-output .citation:target{background-color:rgba(0,127,255,0.133)}.mw-parser-output .id-lock-free.id-lock-free a{background:url("//upload.wikimedia.org/wikipedia/commons/6/65/Lock-green.svg")right 0.1em center/9px no-repeat}.mw-parser-output .id-lock-limited.id-lock-limited a,.mw-parser-output .id-lock-registration.id-lock-registration a{background:url("//upload.wikimedia.org/wikipedia/commons/d/d6/Lock-gray-alt-2.svg")right 0.1em center/9px no-repeat}.mw-parser-output .id-lock-subscription.id-lock-subscription a{background:url("//upload.wikimedia.org/wikipedia/commons/a/aa/Lock-red-alt-2.svg")right 0.1em center/9px no-repeat}.mw-parser-output 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class="mw-editsection-bracket">]</span></span></div> <div class="mw-heading mw-heading3"><h3 id="Online_calculators">Online calculators</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Assessment_of_kidney_function&action=edit&section=12" title="Edit section: Online calculators"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <ul><li><a rel="nofollow" class="external text" href="https://web.archive.org/web/20141129024226/http://nkdep.nih.gov/lab-evaluation/gfr-calculators.shtml">Online GFR Calculator</a></li> <li><a rel="nofollow" class="external text" href="http://www-users.med.cornell.edu/~spon/picu/calc/crclschw.htm">Schwartz formula</a> for estimating pediatric renal function</li> <li><a rel="nofollow" class="external text" href="http://www.mdcalc.com/creatinine-clearance-cockcroft-gault-equation/">Creatinine clearance calculator</a> (Cockcroft-Gault Equation)- by <a href="/wiki/MDCalc" title="MDCalc">MDCalc</a></li> <li><a rel="nofollow" class="external text" href="http://www.mdcalc.com/mdrd-gfr-equation/">MDRD GFR Equation</a></li> <li><a rel="nofollow" class="external text" href="https://www.evidencio.com/models/show/1182">GFR calculator using Cystatin C</a></li></ul> <div class="mw-heading mw-heading3"><h3 id="Reference_links">Reference links</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Assessment_of_kidney_function&action=edit&section=13" title="Edit section: Reference links"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <ul><li><a rel="nofollow" class="external text" href="https://web.archive.org/web/20120224110305/http://www.nkdep.nih.gov/professionals/index.htm">National Kidney Disease Education Program website.</a> Includes professional references and GFR calculators</li> <li>eGFR at <a rel="nofollow" class="external text" href="http://labtestsonline.org/understanding/analytes/gfr/tab/test">Lab Tests Online</a></li></ul> <div class="navbox-styles"><style data-mw-deduplicate="TemplateStyles:r1129693374">.mw-parser-output .hlist dl,.mw-parser-output .hlist ol,.mw-parser-output .hlist ul{margin:0;padding:0}.mw-parser-output .hlist dd,.mw-parser-output .hlist dt,.mw-parser-output .hlist li{margin:0;display:inline}.mw-parser-output .hlist.inline,.mw-parser-output .hlist.inline dl,.mw-parser-output .hlist.inline ol,.mw-parser-output .hlist.inline ul,.mw-parser-output .hlist dl dl,.mw-parser-output .hlist dl ol,.mw-parser-output .hlist dl ul,.mw-parser-output .hlist ol dl,.mw-parser-output .hlist ol ol,.mw-parser-output .hlist ol ul,.mw-parser-output .hlist ul dl,.mw-parser-output .hlist ul ol,.mw-parser-output .hlist ul ul{display:inline}.mw-parser-output .hlist .mw-empty-li{display:none}.mw-parser-output .hlist dt::after{content:": "}.mw-parser-output .hlist dd::after,.mw-parser-output .hlist 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.navbox-abovebelow{background-color:#e6e6ff}.mw-parser-output .navbox-even{background-color:#f7f7f7}.mw-parser-output .navbox-odd{background-color:transparent}.mw-parser-output .navbox .hlist td dl,.mw-parser-output .navbox .hlist td ol,.mw-parser-output .navbox .hlist td ul,.mw-parser-output .navbox td.hlist dl,.mw-parser-output .navbox td.hlist ol,.mw-parser-output .navbox td.hlist ul{padding:0.125em 0}.mw-parser-output .navbox .navbar{display:block;font-size:100%}.mw-parser-output .navbox-title .navbar{float:left;text-align:left;margin-right:0.5em}body.skin--responsive .mw-parser-output .navbox-image img{max-width:none!important}@media print{body.ns-0 .mw-parser-output .navbox{display:none!important}}</style></div><div role="navigation" class="navbox" aria-labelledby="Physiology_of_the_kidneys_and_acid–base_physiology" style="padding:3px"><table class="nowraplinks mw-collapsible autocollapse navbox-inner" style="border-spacing:0;background:transparent;color:inherit"><tbody><tr><th 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4em}html.skin-theme-clientpref-night .mw-parser-output .navbar li a abbr{color:var(--color-base)!important}@media(prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .navbar li a abbr{color:var(--color-base)!important}}@media print{.mw-parser-output .navbar{display:none!important}}</style><div class="navbar plainlinks hlist navbar-mini"><ul><li class="nv-view"><a href="/wiki/Template:Renal_physiology" title="Template:Renal physiology"><abbr title="View this template">v</abbr></a></li><li class="nv-talk"><a href="/wiki/Template_talk:Renal_physiology" title="Template talk:Renal physiology"><abbr title="Discuss this template">t</abbr></a></li><li class="nv-edit"><a href="/wiki/Special:EditPage/Template:Renal_physiology" title="Special:EditPage/Template:Renal physiology"><abbr title="Edit this template">e</abbr></a></li></ul></div><div id="Physiology_of_the_kidneys_and_acid–base_physiology" style="font-size:114%;margin:0 4em"><a href="/wiki/Renal_physiology" title="Renal physiology">Physiology of the kidneys</a> and <a href="/wiki/Acid%E2%80%93base_homeostasis" title="Acid–base homeostasis">acid–base physiology</a></div></th></tr><tr><th scope="row" class="navbox-group" style="width:1%">Creating <a href="/wiki/Urine" title="Urine">urine</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%">Secretion</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Clearance_(pharmacology)" title="Clearance (pharmacology)">Clearance</a></li> <li><a href="/wiki/Pharmacokinetics" title="Pharmacokinetics">Pharmacokinetics</a></li> <li><a href="/wiki/Drugs_secreted_in_the_kidney" title="Drugs secreted in the kidney">Clearance of medications</a></li> <li><a href="/wiki/Urine_flow_rate" title="Urine flow rate">Urine flow rate</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Reabsorption</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Solvent_drag" title="Solvent drag">Solvent drag</a></li> <li><a href="/wiki/Renal_sodium_reabsorption" title="Renal sodium reabsorption">Sodium</a></li> <li><a href="/wiki/Renal_chloride_reabsorption" title="Renal chloride reabsorption">Chloride</a></li> <li><a href="/wiki/Renal_urea_handling" title="Renal urea handling">Urea</a></li> <li><a href="/wiki/Renal_glucose_reabsorption" title="Renal glucose reabsorption">Glucose</a></li> <li><a href="/wiki/Renal_oligopeptide_reabsorption" title="Renal oligopeptide reabsorption">Oligopeptides</a></li> <li><a href="/wiki/Renal_protein_reabsorption" title="Renal protein reabsorption">Protein</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Filtration" title="Filtration">Filtration</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Renal_blood_flow" title="Renal blood flow">Renal blood flow</a></li> <li><a href="/wiki/Ultrafiltration_(kidney)" title="Ultrafiltration (kidney)">Ultrafiltration</a></li> <li><a href="/wiki/Countercurrent_exchange" title="Countercurrent exchange">Countercurrent exchange</a></li> <li><a href="/wiki/Filtration_fraction" title="Filtration fraction">Filtration fraction</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Other functions</th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%">Hormones</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Vasopressin" title="Vasopressin">Antidiuretic hormone</a></li> <li><a href="/wiki/Aldosterone" title="Aldosterone">Aldosterone</a></li> <li><a href="/wiki/Atrial_natriuretic_peptide" title="Atrial natriuretic peptide">Atrial natriuretic peptide</a></li> <li><a href="/wiki/Renin" title="Renin">Renin</a></li> <li><a href="/wiki/Erythropoietin" title="Erythropoietin">Erythropoietin</a></li> <li><a href="/wiki/Calcitriol" title="Calcitriol">Calcitriol</a></li> <li><a href="/wiki/Prostaglandin" title="Prostaglandin">Prostaglandins</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Fluid_balance" title="Fluid balance">Fluid balance</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"><a href="/wiki/Body_water" title="Body water">Body water</a>: <a href="/wiki/Cytosol" title="Cytosol">Intracellular fluid/Cytosol</a> <ul><li><a href="/wiki/Extracellular_fluid" title="Extracellular fluid">Extracellular fluid</a></li> <li>(<a href="/wiki/Interstitial_fluid" class="mw-redirect" title="Interstitial fluid">Interstitial fluid</a></li> <li><a href="/wiki/Blood_plasma" title="Blood plasma">Plasma</a></li> <li><a href="/wiki/Transcellular_fluid" class="mw-redirect" title="Transcellular fluid">Transcellular fluid</a>)</li></ul></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Acid%E2%80%93base_homeostasis" title="Acid–base homeostasis">Acid–base balance</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <li><a href="/wiki/Darrow_Yannet_diagram" title="Darrow Yannet diagram">Darrow Yannet diagram</a></li> <li><a href="/wiki/Base_excess" title="Base excess">Base excess</a></li> <li><a href="/wiki/Davenport_diagram" title="Davenport diagram">Davenport diagram</a></li> <li><a href="/wiki/Anion_gap" title="Anion gap">Anion gap</a> (<a href="/wiki/Delta_ratio" title="Delta ratio">Delta ratio</a>)</li> <li><a href="/wiki/Winters%27s_formula" title="Winters's formula">Winters's formula</a></li> <li>Buffering <ul><li><a href="/wiki/Bicarbonate_buffer_system" title="Bicarbonate buffer system">Bicarbonate buffer system</a></li> <li><a href="/wiki/Respiratory_compensation" title="Respiratory compensation">Respiratory compensation</a></li> <li><a href="/wiki/Renal_compensation" title="Renal compensation">Renal compensation</a></li></ul></li> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a class="mw-selflink selflink">Assessment and measurement</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Glomerular_filtration_rate" title="Glomerular filtration rate">Glomerular filtration rate</a></li> <li><a class="mw-selflink selflink">Creatinine clearance</a></li> <li><a href="/wiki/Augmented_renal_clearance" title="Augmented renal clearance">Augmented renal clearance</a></li> <li><a href="/wiki/Renal_clearance_ratio" title="Renal clearance ratio">Renal clearance ratio</a></li> <li><a href="/wiki/Urea_reduction_ratio" title="Urea reduction ratio">Urea reduction ratio</a></li> <li><a href="/wiki/Kt/V" title="Kt/V">Kt/V</a></li> <li><a href="/wiki/Standardized_Kt/V" title="Standardized Kt/V">Standardized Kt/V</a></li> <li><a href="/wiki/Dialysis_adequacy" title="Dialysis adequacy">Dialysis adequacy</a> <ul><li><a href="/wiki/Hemodialysis_product" title="Hemodialysis product">Hemodialysis product</a></li></ul></li> <li><a href="/wiki/PAH_clearance" title="PAH clearance">PAH clearance</a> (<a href="/wiki/Effective_renal_plasma_flow" title="Effective renal plasma flow">Effective renal plasma flow</a></li> <li><a href="/wiki/Extraction_ratio" title="Extraction ratio">Extraction ratio</a>)</li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Other</th><td class="navbox-list-with-group navbox-list navbox-even hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Fractional_excretion_of_sodium" title="Fractional excretion of sodium">Fractional excretion of sodium</a></li> <li><a href="/wiki/Urea-to-creatinine_ratio" title="Urea-to-creatinine ratio">BUN-to-creatinine ratio</a></li> <li><a href="/wiki/Tubuloglomerular_feedback" title="Tubuloglomerular feedback">Tubuloglomerular feedback</a></li> <li><a href="/wiki/Natriuresis" title="Natriuresis">Natriuresis</a></li> <li><a href="/wiki/Urine" title="Urine">Urine</a></li></ul> </div></td></tr></tbody></table></div>    </div><noscript><img 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