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id="toc-Učinak_vezanja_proteina_u_plazmi-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Izvođenje_jednadžbe" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Izvođenje_jednadžbe"> <div class="vector-toc-text"> <span class="vector-toc-numb">3</span> <span>Izvođenje jednadžbe</span> </div> </a> <ul id="toc-Izvođenje_jednadžbe-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Rješenje_diferencijalne_jednadžbe" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Rješenje_diferencijalne_jednadžbe"> <div class="vector-toc-text"> <span class="vector-toc-numb">4</span> <span>Rješenje diferencijalne jednadžbe</span> </div> </a> <button aria-controls="toc-Rješenje_diferencijalne_jednadžbe-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>Uključi/isključi podsekciju Rješenje diferencijalne jednadžbe</span> </button> <ul id="toc-Rješenje_diferencijalne_jednadžbe-sublist" class="vector-toc-list"> <li id="toc-Stabilni_rastvor" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Stabilni_rastvor"> <div class="vector-toc-text"> <span class="vector-toc-numb">4.1</span> <span>Stabilni rastvor</span> </div> </a> <ul id="toc-Stabilni_rastvor-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Mjerenje_bubrežnog_klirensa" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Mjerenje_bubrežnog_klirensa"> <div class="vector-toc-text"> <span class="vector-toc-numb">5</span> <span>Mjerenje bubrežnog klirensa</span> </div> </a> <ul id="toc-Mjerenje_bubrežnog_klirensa-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Također_pogledajte" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Također_pogledajte"> <div class="vector-toc-text"> <span class="vector-toc-numb">6</span> <span>Također pogledajte</span> </div> </a> <ul id="toc-Također_pogledajte-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Reference" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Reference"> <div class="vector-toc-text"> <span class="vector-toc-numb">7</span> <span>Reference</span> </div> </a> <ul id="toc-Reference-sublist" class="vector-toc-list"> </ul> </li> </ul> </div> </div> </nav> </div> </div> <div class="mw-content-container"> <main id="content" class="mw-body"> <header class="mw-body-header vector-page-titlebar"> <nav aria-label="Sadržaj" class="vector-toc-landmark"> <div id="vector-page-titlebar-toc" class="vector-dropdown vector-page-titlebar-toc vector-button-flush-left" > <input type="checkbox" id="vector-page-titlebar-toc-checkbox" role="button" aria-haspopup="true" data-event-name="ui.dropdown-vector-page-titlebar-toc" class="vector-dropdown-checkbox " aria-label="Uključi/isključi sadržaj" > <label id="vector-page-titlebar-toc-label" for="vector-page-titlebar-toc-checkbox" class="vector-dropdown-label cdx-button cdx-button--fake-button cdx-button--fake-button--enabled cdx-button--weight-quiet cdx-button--icon-only " aria-hidden="true" ><span class="vector-icon mw-ui-icon-listBullet mw-ui-icon-wikimedia-listBullet"></span> <span class="vector-dropdown-label-text">Uključi/isključi sadržaj</span> </label> <div class="vector-dropdown-content"> <div id="vector-page-titlebar-toc-unpinned-container" class="vector-unpinned-container"> </div> </div> </div> </nav> <h1 id="firstHeading" class="firstHeading mw-first-heading"><span class="mw-page-title-main">Klirens (farmakologija)</span></h1> <div id="p-lang-btn" class="vector-dropdown mw-portlet mw-portlet-lang" > <input type="checkbox" id="p-lang-btn-checkbox" role="button" aria-haspopup="true" data-event-name="ui.dropdown-p-lang-btn" class="vector-dropdown-checkbox mw-interlanguage-selector" aria-label="Idi na članak na drugom jeziku. Dostupno na 22 jezika" > <label id="p-lang-btn-label" for="p-lang-btn-checkbox" class="vector-dropdown-label cdx-button cdx-button--fake-button cdx-button--fake-button--enabled cdx-button--weight-quiet cdx-button--action-progressive mw-portlet-lang-heading-22" aria-hidden="true" ><span class="vector-icon mw-ui-icon-language-progressive mw-ui-icon-wikimedia-language-progressive"></span> <span class="vector-dropdown-label-text">22 jezika</span> </label> <div class="vector-dropdown-content"> <div class="vector-menu-content"> <ul class="vector-menu-content-list"> <li class="interlanguage-link interwiki-ar mw-list-item"><a href="https://ar.wikipedia.org/wiki/%D8%AA%D8%B5%D9%81%D9%8A%D8%A9_(%D8%B7%D8%A8)" title="تصفية (طب) – arapski" lang="ar" hreflang="ar" data-title="تصفية (طب)" data-language-autonym="العربية" data-language-local-name="arapski" class="interlanguage-link-target"><span>العربية</span></a></li><li class="interlanguage-link interwiki-cs mw-list-item"><a href="https://cs.wikipedia.org/wiki/Clearance" title="Clearance – češki" lang="cs" hreflang="cs" data-title="Clearance" data-language-autonym="Čeština" data-language-local-name="češki" class="interlanguage-link-target"><span>Čeština</span></a></li><li class="interlanguage-link interwiki-en mw-list-item"><a href="https://en.wikipedia.org/wiki/Clearance_(pharmacology)" title="Clearance (pharmacology) – engleski" lang="en" hreflang="en" data-title="Clearance (pharmacology)" data-language-autonym="English" data-language-local-name="engleski" class="interlanguage-link-target"><span>English</span></a></li><li class="interlanguage-link interwiki-es mw-list-item"><a href="https://es.wikipedia.org/wiki/Depuraci%C3%B3n_(medicina)" title="Depuración (medicina) – španski" lang="es" hreflang="es" data-title="Depuración (medicina)" data-language-autonym="Español" data-language-local-name="španski" class="interlanguage-link-target"><span>Español</span></a></li><li class="interlanguage-link interwiki-fa mw-list-item"><a href="https://fa.wikipedia.org/wiki/%DA%A9%D9%84%DB%8C%D8%B1%D8%A7%D9%86%D8%B3" title="کلیرانس – perzijski" lang="fa" hreflang="fa" data-title="کلیرانس" data-language-autonym="فارسی" data-language-local-name="perzijski" class="interlanguage-link-target"><span>فارسی</span></a></li><li class="interlanguage-link interwiki-fi mw-list-item"><a href="https://fi.wikipedia.org/wiki/Puhdistuma" title="Puhdistuma – finski" lang="fi" hreflang="fi" data-title="Puhdistuma" data-language-autonym="Suomi" data-language-local-name="finski" class="interlanguage-link-target"><span>Suomi</span></a></li><li class="interlanguage-link interwiki-fr mw-list-item"><a href="https://fr.wikipedia.org/wiki/Clairance_(biologie)" title="Clairance (biologie) – francuski" lang="fr" hreflang="fr" data-title="Clairance (biologie)" data-language-autonym="Français" data-language-local-name="francuski" class="interlanguage-link-target"><span>Français</span></a></li><li class="interlanguage-link interwiki-id mw-list-item"><a href="https://id.wikipedia.org/wiki/Laju_ekskresi_renal" title="Laju ekskresi renal – indonezijski" lang="id" hreflang="id" data-title="Laju ekskresi renal" data-language-autonym="Bahasa Indonesia" data-language-local-name="indonezijski" class="interlanguage-link-target"><span>Bahasa Indonesia</span></a></li><li class="interlanguage-link interwiki-it mw-list-item"><a href="https://it.wikipedia.org/wiki/Clearance" title="Clearance – italijanski" lang="it" hreflang="it" data-title="Clearance" data-language-autonym="Italiano" data-language-local-name="italijanski" class="interlanguage-link-target"><span>Italiano</span></a></li><li class="interlanguage-link interwiki-ja mw-list-item"><a href="https://ja.wikipedia.org/wiki/%E3%82%AF%E3%83%AA%E3%82%A2%E3%83%A9%E3%83%B3%E3%82%B9_(%E8%96%AC%E7%90%86%E5%AD%A6)" title="クリアランス (薬理学) – japanski" lang="ja" hreflang="ja" data-title="クリアランス (薬理学)" data-language-autonym="日本語" data-language-local-name="japanski" class="interlanguage-link-target"><span>日本語</span></a></li><li class="interlanguage-link interwiki-ko mw-list-item"><a href="https://ko.wikipedia.org/wiki/%EC%B2%AD%EC%86%8C%EC%9C%A8_(%EC%95%BD%EB%A6%AC%ED%95%99)" title="청소율 (약리학) – korejski" lang="ko" hreflang="ko" data-title="청소율 (약리학)" data-language-autonym="한국어" data-language-local-name="korejski" class="interlanguage-link-target"><span>한국어</span></a></li><li class="interlanguage-link interwiki-nl mw-list-item"><a href="https://nl.wikipedia.org/wiki/Klaring_(medisch)" title="Klaring (medisch) – nizozemski" lang="nl" hreflang="nl" data-title="Klaring (medisch)" data-language-autonym="Nederlands" data-language-local-name="nizozemski" class="interlanguage-link-target"><span>Nederlands</span></a></li><li class="interlanguage-link interwiki-no mw-list-item"><a href="https://no.wikipedia.org/wiki/Clearance" title="Clearance – norveški (Bokmal)" lang="nb" hreflang="nb" data-title="Clearance" data-language-autonym="Norsk bokmål" data-language-local-name="norveški (Bokmal)" class="interlanguage-link-target"><span>Norsk bokmål</span></a></li><li class="interlanguage-link interwiki-pl mw-list-item"><a href="https://pl.wikipedia.org/wiki/Klirens" title="Klirens – poljski" lang="pl" hreflang="pl" data-title="Klirens" data-language-autonym="Polski" data-language-local-name="poljski" class="interlanguage-link-target"><span>Polski</span></a></li><li class="interlanguage-link interwiki-pt mw-list-item"><a href="https://pt.wikipedia.org/wiki/Depura%C3%A7%C3%A3o_plasm%C3%A1tica" title="Depuração plasmática – portugalski" lang="pt" hreflang="pt" data-title="Depuração plasmática" data-language-autonym="Português" data-language-local-name="portugalski" class="interlanguage-link-target"><span>Português</span></a></li><li class="interlanguage-link interwiki-ro mw-list-item"><a href="https://ro.wikipedia.org/wiki/Clearance_plasmatic" title="Clearance plasmatic – rumunski" lang="ro" hreflang="ro" data-title="Clearance plasmatic" data-language-autonym="Română" data-language-local-name="rumunski" class="interlanguage-link-target"><span>Română</span></a></li><li class="interlanguage-link interwiki-ru mw-list-item"><a href="https://ru.wikipedia.org/wiki/%D0%9A%D0%BB%D0%B8%D1%80%D0%B5%D0%BD%D1%81_(%D0%BC%D0%B5%D0%B4%D0%B8%D1%86%D0%B8%D0%BD%D0%B0)" title="Клиренс (медицина) – ruski" lang="ru" hreflang="ru" data-title="Клиренс (медицина)" data-language-autonym="Русский" data-language-local-name="ruski" class="interlanguage-link-target"><span>Русский</span></a></li><li class="interlanguage-link interwiki-sh mw-list-item"><a href="https://sh.wikipedia.org/wiki/Klirens" title="Klirens – srpskohrvatski" lang="sh" hreflang="sh" data-title="Klirens" data-language-autonym="Srpskohrvatski / српскохрватски" data-language-local-name="srpskohrvatski" class="interlanguage-link-target"><span>Srpskohrvatski / српскохрватски</span></a></li><li class="interlanguage-link interwiki-sl mw-list-item"><a href="https://sl.wikipedia.org/wiki/Iz%C4%8Distek" title="Izčistek – slovenski" lang="sl" hreflang="sl" data-title="Izčistek" data-language-autonym="Slovenščina" data-language-local-name="slovenski" class="interlanguage-link-target"><span>Slovenščina</span></a></li><li class="interlanguage-link interwiki-sr mw-list-item"><a href="https://sr.wikipedia.org/wiki/Klirens" title="Klirens – srpski" lang="sr" hreflang="sr" data-title="Klirens" data-language-autonym="Српски / srpski" data-language-local-name="srpski" class="interlanguage-link-target"><span>Српски / srpski</span></a></li><li class="interlanguage-link interwiki-sv mw-list-item"><a href="https://sv.wikipedia.org/wiki/Clearance" title="Clearance – švedski" lang="sv" hreflang="sv" data-title="Clearance" data-language-autonym="Svenska" data-language-local-name="švedski" class="interlanguage-link-target"><span>Svenska</span></a></li><li class="interlanguage-link interwiki-uk mw-list-item"><a href="https://uk.wikipedia.org/wiki/%D0%9A%D0%BB%D1%96%D1%80%D0%B5%D0%BD%D1%81_(%D0%BC%D0%B5%D0%B4%D0%B8%D1%86%D0%B8%D0%BD%D0%B0)" title="Кліренс (медицина) – ukrajinski" lang="uk" hreflang="uk" data-title="Кліренс (медицина)" data-language-autonym="Українська" data-language-local-name="ukrajinski" class="interlanguage-link-target"><span>Українська</span></a></li> </ul> <div class="after-portlet after-portlet-lang"><span class="wb-langlinks-edit wb-langlinks-link"><a href="https://www.wikidata.org/wiki/Special:EntityPage/Q1163287#sitelinks-wikipedia" title="Uredi međujezičke linkove" class="wbc-editpage">Uredi veze</a></span></div> </div> </div> </div> </header> <div class="vector-page-toolbar"> <div class="vector-page-toolbar-container"> <div id="left-navigation"> <nav aria-label="Imenski prostori"> <div id="p-associated-pages" class="vector-menu vector-menu-tabs mw-portlet mw-portlet-associated-pages" > <div class="vector-menu-content"> <ul class="vector-menu-content-list"> <li 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class="vector-body-before-content"> <div class="mw-indicators"> </div> <div id="siteSub" class="noprint">S Wikipedije, slobodne enciklopedije</div> </div> <div id="contentSub"><div id="mw-content-subtitle"></div></div> <div id="mw-content-text" class="mw-body-content"><div class="mw-content-ltr mw-parser-output" lang="bs" dir="ltr"><p><b>Klirens</b> – u <a href="/wiki/Farmakologija" title="Farmakologija">farmakologiji</a> – je <a href="/w/index.php?title=Farmakokinetika&action=edit&redlink=1" class="new" title="Farmakokinetika (stranica ne postoji)">farmakokinetička</a> mjera zapremine <a href="/wiki/Krvna_plazma" title="Krvna plazma">krvne plazme</a> iz koje se supstanca potpuno uklanja po jedinici vremena. Obično se klirens mjeri u L/h ili mL/min.<sup id="cite_ref-:0_1-0" class="reference"><a href="#cite_note-:0-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup> Količina odražava brzinu eliminacije lijeka podijeljenu s koncentracijom u plazmi. <a href="/wiki/Izlu%C4%8Divanje" title="Izlučivanje">Izlučivanje</a> je, s druge strane, mjera količine supstance uklonjene iz tijela u jedinici vremena (npr. mg/min, μg / min itd.). Iako su klirens i izlučivanje supstance povezani, to nije isto. Koncept klirensa opisao je <a href="/w/index.php?title=Thomas_Addis&action=edit&redlink=1" class="new" title="Thomas Addis (stranica ne postoji)">Thomas Addis</a>, diplomac Medicinskog fakulteta Univerziteta u Edinburgu (<i>University of Edinburgh Medical School</i>). </p><p>Supstance u tijelu mogu se očistiti od različitih organa, uključujući <a href="/wiki/Bubreg" title="Bubreg">bubrege</a>, <a href="/wiki/Jetra" title="Jetra">jetru</a>, <a href="/wiki/Plu%C4%87a" title="Pluća">pluća</a> itd. Dakle, ukupni tjelesni klirens jednak je zbroju klirensa supstance svakog organa (npr. bubrežni klirens + jetrin klirens + plućni klirens = ukupni tjelesni klirens). Međutim, za mnoge lijekove klirens je isključivo funkcija bubrežnog izlučivanja. U tim slučajevima ro je gotovo sinonim za <i>bubrežni klirens</i> ili <i>renalnii klirens</i>. Svaka supstanca ima specifičan klirens koji ovisi o načinu na koji <a href="/wiki/Nefron" title="Nefron">nefron</a> „rukuje“ supstancom. Klirens je funkcija: </p> <ol><li><a href="/w/index.php?title=Glomerulska_filtracija&action=edit&redlink=1" class="new" title="Glomerulska filtracija (stranica ne postoji)">glomerulske filtracije</a>,</li> <li>sekrecije iz <a href="/w/index.php?title=Peritubulski_kapilar&action=edit&redlink=1" class="new" title="Peritubulski kapilar (stranica ne postoji)">peritubulskih kapilara</a> u <a href="/wiki/Nefron" title="Nefron">nefronu</a> i</li> <li>reapsorpcije iz <a href="/wiki/Nefron" title="Nefron">nefrona</a> natrag u peritubulske kapilare. <br />Klirens je varijabilan u kinetici nultog reda, jer se konstantna količina lijeka eliminira u jedinici vremena, ali je konstantna u <a href="/w/index.php?title=Kinetika_prvorg_reda&action=edit&redlink=1" class="new" title="Kinetika prvorg reda (stranica ne postoji)">kinetici prvog reda</a>, jer se količina eliminiranog lijeka u jedinici vremena mijenja s koncentracijom lijeka u krvi.<sup id="cite_ref-2" class="reference"><a href="#cite_note-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup><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></li></ol> <p>Klirens se može odnositi na volumen plazme iz koje se tvar uklanja (tj. „očisti“) u jedinici vremena ili, u nekim slučajevima, može se raspravljati o međusobnim razmacima kada se govori o preraspodjeli između dijelova tijela kao što su plazma, mišići i masti.<sup id="cite_ref-:0_1-1" class="reference"><a href="#cite_note-:0-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup> </p> <meta property="mw:PageProp/toc" /> <div class="mw-heading mw-heading2"><h2 id="Definicija">Definicija</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Klirens_(farmakologija)&veaction=edit&section=1" title="Uredi odlomak "Definicija"" class="mw-editsection-visualeditor"><span>uredi</span></a><span class="mw-editsection-divider"> | </span><a href="/w/index.php?title=Klirens_(farmakologija)&action=edit&section=1" title="Edit section's source code: Definicija"><span>uredi izvor</span></a><span class="mw-editsection-bracket">]</span></span></div> <figure class="mw-halign-right" typeof="mw:File/Thumb"><a href="/wiki/Datoteka:Physiology_of_Nephron.png" class="mw-file-description"><img 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>Dijagram osnovnih fizioloških mehanizme bubrega</figcaption></figure> <p>Kada se govori o funkciji <a href="/wiki/Bubreg" title="Bubreg">bubrega</a>, klirensom se smatra <i>količina tečnosti filtrirana iz krvi koja se preradi od <a href="/wiki/Bubreg" title="Bubreg">bubrezima</a></i> ili <i>količina prčišćene krvi po jedinici vremena</i>, jer ima jedinice <a href="/wiki/Zapreminski_protok" title="Zapreminski protok">protoka zapremine</a> <a href="/wiki/Zapremina" title="Zapremina">zapremina</a>/<a href="/wiki/Vrijeme" class="mw-disambig" title="Vrijeme">vrijeme</a>. Međutim, ne odnosi se na stvarnu vrijednost; <i>bubreg ne uklanja potpuno supstancu iz ukupnog protoka bubrežne plazme.</i><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> Iz perspktive <a href="/w/index.php?title=Transfer_mase&action=edit&redlink=1" class="new" title="Transfer mase (stranica ne postoji)">transfera mase</a><sup id="cite_ref-5" class="reference"><a href="#cite_note-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup> i <a href="/wiki/Fiziologija" title="Fiziologija">fiziološki</a>, volumetrijski protok krvi (do aparata za dijalizu i / ili bubrega) samo je jedan od nekoliko faktora koji određuju koncentraciju krvi i uklanjanje supstance iz tijela. Ostali faktori uključuju <a href="/w/index.php?title=Koeficijent_prenosa_mase&action=edit&redlink=1" class="new" title="Koeficijent prenosa mase (stranica ne postoji)">koeficijent prenosa mase</a>, protok dijalizata i protok recirkulacije dijalizata za hemodijalizu, te <a href="/wiki/Brzina_glomerulske_filtracije" title="Brzina glomerulske filtracije">brzinu glomerulske filtracije</a> i <a href="/wiki/Nefron" title="Nefron">tubulske</a> reapsorpciju bubrega. Fiziološka interpretacija klirensa (u stabilnom stanju) je da je to <i> omjer stvaranja mase i koncentracije krvi (ili <a href="/wiki/Krvna_plazma" title="Krvna plazma">plazme</a>)</i>. Njegova definicija slijedi iz <a href="/wiki/Diferencijalna_jednad%C5%BEba" class="mw-redirect" title="Diferencijalna jednadžba">diferencijalne jednadžbe</a> koja opisuje <a href="/w/index.php?title=Eksponencijalni_raspad&action=edit&redlink=1" class="new" title="Eksponencijalni raspad (stranica ne postoji)">eksponencijalni raspad</a> i koristi se za modeliranje funkcije bubrega i funkcije aparata za <a href="/wiki/Hemodijaliza" title="Hemodijaliza">hemodijalizu</a>: </p><p><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 V{\frac {dC}{dt}}=-K\cdot C+{\dot {m}}\qquad (1)}"> <semantics> <mrow class="MJX-TeXAtom-ORD"> <mstyle displaystyle="true" scriptlevel="0"> <mi>V</mi> <mrow class="MJX-TeXAtom-ORD"> <mfrac> <mrow> <mi>d</mi> <mi>C</mi> </mrow> <mrow> <mi>d</mi> <mi>t</mi> </mrow> </mfrac> </mrow> <mo>=</mo> <mo>−</mo> <mi>K</mi> <mo>⋅</mo> <mi>C</mi> <mo>+</mo> <mrow class="MJX-TeXAtom-ORD"> <mrow class="MJX-TeXAtom-ORD"> <mover> <mi>m</mi> <mo>˙</mo> </mover> </mrow> </mrow> <mspace width="2em" /> <mo stretchy="false">(</mo> <mn>1</mn> <mo stretchy="false">)</mo> </mstyle> </mrow> <annotation encoding="application/x-tex">{\displaystyle V{\frac {dC}{dt}}=-K\cdot C+{\dot {m}}\qquad (1)}</annotation> </semantics> </math></span><img src="https://wikimedia.org/api/rest_v1/media/math/render/svg/36709c5f33108d8531ea19d6bc69d20f408de505" class="mwe-math-fallback-image-inline mw-invert skin-invert" aria-hidden="true" style="vertical-align: -2.005ex; width:28.521ex; height:5.509ex;" alt="{\displaystyle V{\frac {dC}{dt}}=-K\cdot C+{\dot {m}}\qquad (1)}"></span> </p><p>gdje: </p> <ul><li><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 {\dot {m}}}"> <semantics> <mrow class="MJX-TeXAtom-ORD"> <mstyle displaystyle="true" scriptlevel="0"> <mrow class="MJX-TeXAtom-ORD"> <mrow class="MJX-TeXAtom-ORD"> <mover> <mi>m</mi> <mo>˙</mo> </mover> </mrow> </mrow> </mstyle> </mrow> <annotation encoding="application/x-tex">{\displaystyle {\dot {m}}}</annotation> </semantics> </math></span><img src="https://wikimedia.org/api/rest_v1/media/math/render/svg/ad59b9876301e8fb75b9ddbf08de594b87251d3b" class="mwe-math-fallback-image-inline mw-invert skin-invert" aria-hidden="true" style="vertical-align: -0.338ex; width:2.04ex; height:2.176ex;" alt="{\displaystyle {\dot {m}}}"></span> = brzina stvaranja mase supstance – pretpostavlja se da je konstanta, tj. da nije funkcija vremena (jednaka nuli za strane supstance / lijekove) [mmol/min] ili [mol/s]</li> <li>t = vrijeme dijalize ili vrijeme od injekcije supstance / lijeka [min] ili [s]</li> <li>V = <a href="/w/index.php?title=Volumen_raspodjele&action=edit&redlink=1" class="new" title="Volumen raspodjele (stranica ne postoji)">volumen raspodjele</a> ili ukupna <a href="/w/index.php?title=Tjelesna_voda&action=edit&redlink=1" class="new" title="Tjelesna voda (stranica ne postoji)">tjelesna voda</a> [L] ili [m³]</li> <li>K = razmak [ml / min] ili [m³ / s]</li> <li>C = koncentracija [mmol / L] ili [mol / m³] (u Sjedinjenim Državama često [mg/ml])</li></ul> <p>Iz gornjih definicija proizlazi <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 {\frac {dC}{dt}}}"> <semantics> <mrow class="MJX-TeXAtom-ORD"> <mstyle displaystyle="true" scriptlevel="0"> <mrow class="MJX-TeXAtom-ORD"> <mfrac> <mrow> <mi>d</mi> <mi>C</mi> </mrow> <mrow> <mi>d</mi> <mi>t</mi> </mrow> </mfrac> </mrow> </mstyle> </mrow> <annotation encoding="application/x-tex">{\displaystyle {\frac {dC}{dt}}}</annotation> </semantics> </math></span><img src="https://wikimedia.org/api/rest_v1/media/math/render/svg/f2fa41912219f104c9541dce3706e52c089a016c" class="mwe-math-fallback-image-inline mw-invert skin-invert" aria-hidden="true" style="vertical-align: -2.005ex; width:3.818ex; height:5.509ex;" alt="{\displaystyle {\frac {dC}{dt}}}"></span> je prvi <a href="/w/index.php?title=Derivat&action=edit&redlink=1" class="new" title="Derivat (stranica ne postoji)">derivat</a> koncentracije s obzirom na vrijeme, tj. promjena koncentracije s vremenom. </p><p>Izvodi se iz bilansa mase. </p><p>Klirens supstance ponekad se izražava kao inverzna vrijednost <a href="/w/index.php?title=Vremenska_konstanta&action=edit&redlink=1" class="new" title="Vremenska konstanta (stranica ne postoji)">vremenske konstante</a> koja opisuje brzinu njegovog uklanjanja iz tijela, podijeljenu s <a href="/w/index.php?title=Volumen_distribucije&action=edit&redlink=1" class="new" title="Volumen distribucije (stranica ne postoji)">volumenom distribucije</a> (ili ukupnom <a href="/w/index.php?title=Tjelesna_voda&action=edit&redlink=1" class="new" title="Tjelesna voda (stranica ne postoji)">tjelesnom vodom</a>). </p><p>U ravnotežnom stanju, definira se kao stopa stvaranja mase supstance (koja je jednaka brzini uklanjanja mase) podeljena sa njenom koncentracijom u <a href="/wiki/Krv" title="Krv">krvi</a>. </p><p>Potrošnja, poluvrijeme i volumen distribucije </p><p>Postoji važna veza između klirensa, poluvijeka eliminacije i volumena distribucije. Konstanta brzine eliminacije drugel lijeka ekvivalentna je ukupnom klirensu podijeljenom s volumenom distribucije (Κel=Cltot/Vd) (treba znati da se upotrebljava simbol Cl, a ne Κ, zato da se ne pobrka sa Κel). Ali Κel je također ekvivalentan ln2 podijeljen s poluvrijemeom eliminacije t1/2 (Κel = ln2t1 / 2). Dakle, Cltot = ln2 Vd / t1 / 2. To znači, naprimjer, da povećanje ukupnog klirensa rezultira smanjenjem poluživota brzine eliminacije, pod uvjetom da je volumen distribucije konstantan.<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> </p> <div class="mw-heading mw-heading2"><h2 id="Učinak_vezanja_proteina_u_plazmi"><span id="U.C4.8Dinak_vezanja_proteina_u_plazmi"></span>Učinak vezanja proteina u plazmi</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Klirens_(farmakologija)&veaction=edit&section=2" title="Uredi odlomak "Učinak vezanja proteina u plazmi"" class="mw-editsection-visualeditor"><span>uredi</span></a><span class="mw-editsection-divider"> | </span><a href="/w/index.php?title=Klirens_(farmakologija)&action=edit&section=2" title="Edit section's source code: Učinak vezanja proteina u plazmi"><span>uredi izvor</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Za supstance koje pokazuju značajno <a href="/w/index.php?title=Vezanje_za_proteine_u_plazmi&action=edit&redlink=1" class="new" title="Vezanje za proteine u plazmi (stranica ne postoji)">vezanje za proteine u plazmi</a>, klirens uglavnom ovisi o ukupnoj koncentraciji (slobodna + vezana za proteine), a ne o slobodnoj koncentraciji.<sup id="cite_ref-Winter_7-0" class="reference"><a href="#cite_note-Winter-7"><span class="cite-bracket">[</span>7<span class="cite-bracket">]</span></a></sup> </p><p>Za većinu supstanci u plazmi, koncentracije se prvenstveno reguliraju na bazi slobodnih koncentracija, koje stoga ostaju iste, pa opsežno vezanje za proteine povećava ukupnu koncentraciju u plazmi (slobodno + vezano za proteine). To smanjuje klirens u odnosu na ono što bi bio slučaj da se supstanca nije vezala za protein.<sup id="cite_ref-Winter_7-1" class="reference"><a href="#cite_note-Winter-7"><span class="cite-bracket">[</span>7<span class="cite-bracket">]</span></a></sup> Međutim, stopa uklanjanja mase je ista,<sup id="cite_ref-Winter_7-2" class="reference"><a href="#cite_note-Winter-7"><span class="cite-bracket">[</span>7<span class="cite-bracket">]</span></a></sup>, jer ovisi samo o koncentraciji slobodne supstance i neovisan je o vezivanju za proteine u plazmi, čak i uz činjenicu da proteini u plazmi povećavaju koncentraciju u distalnom <a href="/wiki/Glomerul" title="Glomerul">glomerulu</a>, dok se plazma filtrira u <a href="/wiki/Bowmanova_%C4%8Dahura" title="Bowmanova čahura">Bowmanovu čahuru</a>, jer se relativno povećava koncentracija supstanca-protein i neokupirani protein su jednaki i stoga ne daju neto vezanje ili disocijaciju supstanci iz proteina plazme. To daje konstantnu koncentraciju slobodne supstance u plazmi u cijelom glomerulu, što bi također bio slučaj bez vezanja proteina u plazmi. Međutim, na drugim mjestima, osim u bubrezima, gdje se klirens vrši pomoću <a href="/wiki/Membranski_transportni_protein" title="Membranski transportni protein">membranskog transportnog proteina</a>, a ne filtracijom, ekstenzivno vezanje za proteine u plazmi može povećati klirens, održavanjem koncentracije slobodne supstance prilično konstantnom kroz kapilarni sloj, inhibirajući smanjenje klirensa uzrokovano smanjenom koncentracijom slobodne supstance kroz kapilar. </p> <div class="mw-heading mw-heading2"><h2 id="Izvođenje_jednadžbe"><span id="Izvo.C4.91enje_jednad.C5.BEbe"></span>Izvođenje jednadžbe</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Klirens_(farmakologija)&veaction=edit&section=3" title="Uredi odlomak "Izvođenje jednadžbe"" class="mw-editsection-visualeditor"><span>uredi</span></a><span class="mw-editsection-divider"> | </span><a href="/w/index.php?title=Klirens_(farmakologija)&action=edit&section=3" title="Edit section's source code: Izvođenje jednadžbe"><span>uredi izvor</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Jednadžba <i>1</i> izvedena je iz <a href="/w/index.php?title=Bilans_mase&action=edit&redlink=1" class="new" title="Bilans mase (stranica ne postoji)">balansa mase</a>: </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 \Delta m_{body}=(-{\dot {m}}_{out}+{\dot {m}}_{in}+{\dot {m}}_{gen.})\Delta t\qquad (2)}"> <semantics> <mrow class="MJX-TeXAtom-ORD"> <mstyle displaystyle="true" scriptlevel="0"> <mi mathvariant="normal">Δ</mi> <msub> <mi>m</mi> <mrow class="MJX-TeXAtom-ORD"> <mi>b</mi> <mi>o</mi> <mi>d</mi> <mi>y</mi> </mrow> </msub> <mo>=</mo> <mo stretchy="false">(</mo> <mo>−</mo> <msub> <mrow class="MJX-TeXAtom-ORD"> <mrow class="MJX-TeXAtom-ORD"> <mover> <mi>m</mi> <mo>˙</mo> </mover> </mrow> </mrow> <mrow class="MJX-TeXAtom-ORD"> <mi>o</mi> <mi>u</mi> <mi>t</mi> </mrow> </msub> <mo>+</mo> <msub> <mrow class="MJX-TeXAtom-ORD"> <mrow class="MJX-TeXAtom-ORD"> <mover> <mi>m</mi> <mo>˙</mo> </mover> </mrow> </mrow> <mrow class="MJX-TeXAtom-ORD"> <mi>i</mi> <mi>n</mi> </mrow> </msub> <mo>+</mo> <msub> <mrow class="MJX-TeXAtom-ORD"> <mrow class="MJX-TeXAtom-ORD"> <mover> <mi>m</mi> <mo>˙</mo> </mover> </mrow> </mrow> <mrow class="MJX-TeXAtom-ORD"> <mi>g</mi> <mi>e</mi> <mi>n</mi> <mo>.</mo> </mrow> </msub> <mo stretchy="false">)</mo> <mi mathvariant="normal">Δ</mi> <mi>t</mi> <mspace width="2em" /> <mo stretchy="false">(</mo> <mn>2</mn> <mo stretchy="false">)</mo> </mstyle> </mrow> <annotation encoding="application/x-tex">{\displaystyle \Delta m_{body}=(-{\dot {m}}_{out}+{\dot {m}}_{in}+{\dot {m}}_{gen.})\Delta t\qquad (2)}</annotation> </semantics> </math></span><img src="https://wikimedia.org/api/rest_v1/media/math/render/svg/903cdae409779258fb2018e135b95ca5d19fe91b" class="mwe-math-fallback-image-inline mw-invert skin-invert" aria-hidden="true" style="vertical-align: -1.005ex; width:43.879ex; height:3.009ex;" alt="{\displaystyle \Delta m_{body}=(-{\dot {m}}_{out}+{\dot {m}}_{in}+{\dot {m}}_{gen.})\Delta t\qquad (2)}"></span></dd></dl> <p>gdje: </p> <ul><li><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 \Delta t}"> <semantics> <mrow class="MJX-TeXAtom-ORD"> <mstyle displaystyle="true" scriptlevel="0"> <mi mathvariant="normal">Δ</mi> <mi>t</mi> </mstyle> </mrow> <annotation encoding="application/x-tex">{\displaystyle \Delta t}</annotation> </semantics> </math></span><img src="https://wikimedia.org/api/rest_v1/media/math/render/svg/8c28867ecd34e2caed12cf38feadf6a81a7ee542" class="mwe-math-fallback-image-inline mw-invert skin-invert" aria-hidden="true" style="vertical-align: -0.338ex; width:2.775ex; height:2.176ex;" alt="{\displaystyle \Delta t}"></span> = vremenski period;</li> <li><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 \Delta m_{body}}"> <semantics> <mrow class="MJX-TeXAtom-ORD"> <mstyle displaystyle="true" scriptlevel="0"> <mi mathvariant="normal">Δ</mi> <msub> <mi>m</mi> <mrow class="MJX-TeXAtom-ORD"> <mi>b</mi> <mi>o</mi> <mi>d</mi> <mi>y</mi> </mrow> </msub> </mstyle> </mrow> <annotation encoding="application/x-tex">{\displaystyle \Delta m_{body}}</annotation> </semantics> </math></span><img src="https://wikimedia.org/api/rest_v1/media/math/render/svg/5a32d65d93a7e0415ac8d24c91b9f4022aaac84e" class="mwe-math-fallback-image-inline mw-invert skin-invert" aria-hidden="true" style="vertical-align: -1.005ex; width:7.388ex; height:2.843ex;" alt="{\displaystyle \Delta m_{body}}"></span> = promjena mase toksina u tijelu tokom <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 \Delta t}"> <semantics> <mrow class="MJX-TeXAtom-ORD"> <mstyle displaystyle="true" scriptlevel="0"> <mi mathvariant="normal">Δ</mi> <mi>t</mi> </mstyle> </mrow> <annotation encoding="application/x-tex">{\displaystyle \Delta t}</annotation> </semantics> </math></span><img src="https://wikimedia.org/api/rest_v1/media/math/render/svg/8c28867ecd34e2caed12cf38feadf6a81a7ee542" class="mwe-math-fallback-image-inline mw-invert skin-invert" aria-hidden="true" style="vertical-align: -0.338ex; width:2.775ex; height:2.176ex;" alt="{\displaystyle \Delta t}"></span></li> <li><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 {\dot {m}}_{in}}"> <semantics> <mrow class="MJX-TeXAtom-ORD"> <mstyle displaystyle="true" scriptlevel="0"> <msub> <mrow class="MJX-TeXAtom-ORD"> <mrow class="MJX-TeXAtom-ORD"> <mover> <mi>m</mi> <mo>˙</mo> </mover> </mrow> </mrow> <mrow class="MJX-TeXAtom-ORD"> <mi>i</mi> <mi>n</mi> </mrow> </msub> </mstyle> </mrow> <annotation encoding="application/x-tex">{\displaystyle {\dot {m}}_{in}}</annotation> </semantics> </math></span><img src="https://wikimedia.org/api/rest_v1/media/math/render/svg/f91309bc742c20e3eed14ca8e7fb8dda7ab301e3" class="mwe-math-fallback-image-inline mw-invert skin-invert" aria-hidden="true" style="vertical-align: -0.671ex; width:3.826ex; height:2.509ex;" alt="{\displaystyle {\dot {m}}_{in}}"></span> = brzina unosa toksina</li> <li><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 {\dot {m}}_{out}}"> <semantics> <mrow class="MJX-TeXAtom-ORD"> <mstyle displaystyle="true" scriptlevel="0"> <msub> <mrow class="MJX-TeXAtom-ORD"> <mrow class="MJX-TeXAtom-ORD"> <mover> <mi>m</mi> <mo>˙</mo> </mover> </mrow> </mrow> <mrow class="MJX-TeXAtom-ORD"> <mi>o</mi> <mi>u</mi> <mi>t</mi> </mrow> </msub> </mstyle> </mrow> <annotation encoding="application/x-tex">{\displaystyle {\dot {m}}_{out}}</annotation> </semantics> </math></span><img src="https://wikimedia.org/api/rest_v1/media/math/render/svg/49bdd80a4f1fb821b360a6204ee12497129c3d01" class="mwe-math-fallback-image-inline mw-invert skin-invert" aria-hidden="true" style="vertical-align: -0.671ex; width:4.604ex; height:2.509ex;" alt="{\displaystyle {\dot {m}}_{out}}"></span> = stopa uklanjanja toksina</li> <li><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 {\dot {m}}_{gen.}}"> <semantics> <mrow class="MJX-TeXAtom-ORD"> <mstyle displaystyle="true" scriptlevel="0"> <msub> <mrow class="MJX-TeXAtom-ORD"> <mrow class="MJX-TeXAtom-ORD"> <mover> <mi>m</mi> <mo>˙</mo> </mover> </mrow> </mrow> <mrow class="MJX-TeXAtom-ORD"> <mi>g</mi> <mi>e</mi> <mi>n</mi> <mo>.</mo> </mrow> </msub> </mstyle> </mrow> <annotation encoding="application/x-tex">{\displaystyle {\dot {m}}_{gen.}}</annotation> </semantics> </math></span><img src="https://wikimedia.org/api/rest_v1/media/math/render/svg/fb1eb0c95626cf1080ccc80ce68571ad9406944d" class="mwe-math-fallback-image-inline mw-invert skin-invert" aria-hidden="true" style="vertical-align: -1.005ex; width:5.272ex; height:2.843ex;" alt="{\displaystyle {\dot {m}}_{gen.}}"></span> = brzina stvaranja toksina</li></ul> <p>Riječima, gornja jednadžba kaže: </p> <dl><dd><i>Promjena mase toksina u tijelu (<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 \Delta m}"> <semantics> <mrow class="MJX-TeXAtom-ORD"> <mstyle displaystyle="true" scriptlevel="0"> <mi mathvariant="normal">Δ</mi> <mi>m</mi> </mstyle> </mrow> <annotation encoding="application/x-tex">{\displaystyle \Delta m}</annotation> </semantics> </math></span><img src="https://wikimedia.org/api/rest_v1/media/math/render/svg/8a2559989a97e4068e9e5fb20f24f0249b79e85d" class="mwe-math-fallback-image-inline mw-invert skin-invert" aria-hidden="true" style="vertical-align: -0.338ex; width:3.976ex; height:2.176ex;" alt="{\displaystyle \Delta m}"></span>) tokom nekog vremena <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 \Delta t}"> <semantics> <mrow class="MJX-TeXAtom-ORD"> <mstyle displaystyle="true" scriptlevel="0"> <mi mathvariant="normal">Δ</mi> <mi>t</mi> </mstyle> </mrow> <annotation encoding="application/x-tex">{\displaystyle \Delta t}</annotation> </semantics> </math></span><img src="https://wikimedia.org/api/rest_v1/media/math/render/svg/8c28867ecd34e2caed12cf38feadf6a81a7ee542" class="mwe-math-fallback-image-inline mw-invert skin-invert" aria-hidden="true" style="vertical-align: -0.338ex; width:2.775ex; height:2.176ex;" alt="{\displaystyle \Delta t}"></span> jednaka je unosu toksina plus stvaranje toksina minus uklanjanje toksina</i>.</dd></dl> <p>Pošto: </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 m_{body}=C\cdot V\qquad (3)}"> <semantics> <mrow class="MJX-TeXAtom-ORD"> <mstyle displaystyle="true" scriptlevel="0"> <msub> <mi>m</mi> <mrow class="MJX-TeXAtom-ORD"> <mi>b</mi> <mi>o</mi> <mi>d</mi> <mi>y</mi> </mrow> </msub> <mo>=</mo> <mi>C</mi> <mo>⋅</mo> <mi>V</mi> <mspace width="2em" /> <mo stretchy="false">(</mo> <mn>3</mn> <mo stretchy="false">)</mo> </mstyle> </mrow> <annotation encoding="application/x-tex">{\displaystyle m_{body}=C\cdot V\qquad (3)}</annotation> </semantics> </math></span><img src="https://wikimedia.org/api/rest_v1/media/math/render/svg/479128fa73fe5336f87552a2b2dd99f4384d3293" class="mwe-math-fallback-image-inline mw-invert skin-invert" aria-hidden="true" style="vertical-align: -1.005ex; width:21.4ex; height:3.009ex;" alt="{\displaystyle m_{body}=C\cdot V\qquad (3)}"></span></dd></dl> <p>i </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 {\dot {m}}_{out}=K\cdot C\qquad (4)}"> <semantics> <mrow class="MJX-TeXAtom-ORD"> <mstyle displaystyle="true" scriptlevel="0"> <msub> <mrow class="MJX-TeXAtom-ORD"> <mrow class="MJX-TeXAtom-ORD"> <mover> <mi>m</mi> <mo>˙</mo> </mover> </mrow> </mrow> <mrow class="MJX-TeXAtom-ORD"> <mi>o</mi> <mi>u</mi> <mi>t</mi> </mrow> </msub> <mo>=</mo> <mi>K</mi> <mo>⋅</mo> <mi>C</mi> <mspace width="2em" /> <mo stretchy="false">(</mo> <mn>4</mn> <mo stretchy="false">)</mo> </mstyle> </mrow> <annotation encoding="application/x-tex">{\displaystyle {\dot {m}}_{out}=K\cdot C\qquad (4)}</annotation> </semantics> </math></span><img src="https://wikimedia.org/api/rest_v1/media/math/render/svg/683077c4f805499f19f2fd6eb9b573c04fd9050e" class="mwe-math-fallback-image-inline mw-invert skin-invert" aria-hidden="true" style="vertical-align: -0.838ex; width:20.831ex; height:2.843ex;" alt="{\displaystyle {\dot {m}}_{out}=K\cdot C\qquad (4)}"></span></dd></dl> <p>jednadžba A1 može se preraditi kao: </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 \Delta (C\cdot V)=(-K\cdot C+{\dot {m}}_{in}+{\dot {m}}_{gen.})\Delta t\qquad (5)}"> <semantics> <mrow class="MJX-TeXAtom-ORD"> <mstyle displaystyle="true" scriptlevel="0"> <mi mathvariant="normal">Δ</mi> <mo stretchy="false">(</mo> <mi>C</mi> <mo>⋅</mo> <mi>V</mi> <mo stretchy="false">)</mo> <mo>=</mo> <mo stretchy="false">(</mo> <mo>−</mo> <mi>K</mi> <mo>⋅</mo> <mi>C</mi> <mo>+</mo> <msub> <mrow class="MJX-TeXAtom-ORD"> <mrow class="MJX-TeXAtom-ORD"> <mover> <mi>m</mi> <mo>˙</mo> </mover> </mrow> </mrow> <mrow class="MJX-TeXAtom-ORD"> <mi>i</mi> <mi>n</mi> </mrow> </msub> <mo>+</mo> <msub> <mrow class="MJX-TeXAtom-ORD"> <mrow class="MJX-TeXAtom-ORD"> <mover> <mi>m</mi> <mo>˙</mo> </mover> </mrow> </mrow> <mrow class="MJX-TeXAtom-ORD"> <mi>g</mi> <mi>e</mi> <mi>n</mi> <mo>.</mo> </mrow> </msub> <mo stretchy="false">)</mo> <mi mathvariant="normal">Δ</mi> <mi>t</mi> <mspace width="2em" /> <mo stretchy="false">(</mo> <mn>5</mn> <mo stretchy="false">)</mo> </mstyle> </mrow> <annotation encoding="application/x-tex">{\displaystyle \Delta (C\cdot V)=(-K\cdot C+{\dot {m}}_{in}+{\dot {m}}_{gen.})\Delta t\qquad (5)}</annotation> </semantics> </math></span><img src="https://wikimedia.org/api/rest_v1/media/math/render/svg/85ba6cd09f9ea1c8380a0d0bfeca0fc9207ffbf7" class="mwe-math-fallback-image-inline mw-invert skin-invert" aria-hidden="true" style="vertical-align: -1.005ex; width:46.376ex; height:3.009ex;" alt="{\displaystyle \Delta (C\cdot V)=(-K\cdot C+{\dot {m}}_{in}+{\dot {m}}_{gen.})\Delta t\qquad (5)}"></span></dd></dl> <p>Ako se spoje pojmove <i>u</i> i <i>gen.</i>, tj. <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 {\dot {m}}={\dot {m}}_{in}+{\dot {m}}_{gen.}}"> <semantics> <mrow class="MJX-TeXAtom-ORD"> <mstyle displaystyle="true" scriptlevel="0"> <mrow class="MJX-TeXAtom-ORD"> <mrow class="MJX-TeXAtom-ORD"> <mover> <mi>m</mi> <mo>˙</mo> </mover> </mrow> </mrow> <mo>=</mo> <msub> <mrow class="MJX-TeXAtom-ORD"> <mrow class="MJX-TeXAtom-ORD"> <mover> <mi>m</mi> <mo>˙</mo> </mover> </mrow> </mrow> <mrow class="MJX-TeXAtom-ORD"> <mi>i</mi> <mi>n</mi> </mrow> </msub> <mo>+</mo> <msub> <mrow class="MJX-TeXAtom-ORD"> <mrow class="MJX-TeXAtom-ORD"> <mover> <mi>m</mi> <mo>˙</mo> </mover> </mrow> </mrow> <mrow class="MJX-TeXAtom-ORD"> <mi>g</mi> <mi>e</mi> <mi>n</mi> <mo>.</mo> </mrow> </msub> </mstyle> </mrow> <annotation encoding="application/x-tex">{\displaystyle {\dot {m}}={\dot {m}}_{in}+{\dot {m}}_{gen.}}</annotation> </semantics> </math></span><img src="https://wikimedia.org/api/rest_v1/media/math/render/svg/84ad9bb1a8cb42d044728fbc86dd348319982a57" class="mwe-math-fallback-image-inline mw-invert skin-invert" aria-hidden="true" style="vertical-align: -1.005ex; width:17.077ex; height:2.843ex;" alt="{\displaystyle {\dot {m}}={\dot {m}}_{in}+{\dot {m}}_{gen.}}"></span> i podijeli sa <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 \Delta t}"> <semantics> <mrow class="MJX-TeXAtom-ORD"> <mstyle displaystyle="true" scriptlevel="0"> <mi mathvariant="normal">Δ</mi> <mi>t</mi> </mstyle> </mrow> <annotation encoding="application/x-tex">{\displaystyle \Delta t}</annotation> </semantics> </math></span><img src="https://wikimedia.org/api/rest_v1/media/math/render/svg/8c28867ecd34e2caed12cf38feadf6a81a7ee542" class="mwe-math-fallback-image-inline mw-invert skin-invert" aria-hidden="true" style="vertical-align: -0.338ex; width:2.775ex; height:2.176ex;" alt="{\displaystyle \Delta t}"></span> the result is a <a href="/w/index.php?title=Difference_equation&action=edit&redlink=1" class="new" title="Difference equation (stranica ne postoji)">difference equation</a>: </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 {\frac {\Delta (C\cdot V)}{\Delta t}}=-K\cdot C+{\dot {m}}\qquad (6)}"> <semantics> <mrow class="MJX-TeXAtom-ORD"> <mstyle displaystyle="true" scriptlevel="0"> <mrow class="MJX-TeXAtom-ORD"> <mfrac> <mrow> <mi mathvariant="normal">Δ</mi> <mo stretchy="false">(</mo> <mi>C</mi> <mo>⋅</mo> <mi>V</mi> <mo stretchy="false">)</mo> </mrow> <mrow> <mi mathvariant="normal">Δ</mi> <mi>t</mi> </mrow> </mfrac> </mrow> <mo>=</mo> <mo>−</mo> <mi>K</mi> <mo>⋅</mo> <mi>C</mi> <mo>+</mo> <mrow class="MJX-TeXAtom-ORD"> <mrow class="MJX-TeXAtom-ORD"> <mover> <mi>m</mi> <mo>˙</mo> </mover> </mrow> </mrow> <mspace width="2em" /> <mo stretchy="false">(</mo> <mn>6</mn> <mo stretchy="false">)</mo> </mstyle> </mrow> <annotation encoding="application/x-tex">{\displaystyle {\frac {\Delta (C\cdot V)}{\Delta t}}=-K\cdot C+{\dot {m}}\qquad (6)}</annotation> </semantics> </math></span><img src="https://wikimedia.org/api/rest_v1/media/math/render/svg/9d8eade062b8eb69f9873ae19925571aa922ab4f" class="mwe-math-fallback-image-inline mw-invert skin-invert" aria-hidden="true" style="vertical-align: -2.005ex; width:32.73ex; height:5.843ex;" alt="{\displaystyle {\frac {\Delta (C\cdot V)}{\Delta t}}=-K\cdot C+{\dot {m}}\qquad (6)}"></span></dd></dl> <p>Ako se primijeni <a href="/w/index.php?title=Limit_(matematika)&action=edit&redlink=1" class="new" title="Limit (matematika) (stranica ne postoji)">limitf</a> one applies the <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 \Delta t\rightarrow 0}"> <semantics> <mrow class="MJX-TeXAtom-ORD"> <mstyle displaystyle="true" scriptlevel="0"> <mi mathvariant="normal">Δ</mi> <mi>t</mi> <mo stretchy="false">→</mo> <mn>0</mn> </mstyle> </mrow> <annotation encoding="application/x-tex">{\displaystyle \Delta t\rightarrow 0}</annotation> </semantics> </math></span><img src="https://wikimedia.org/api/rest_v1/media/math/render/svg/a6653c7dd9b507bcbd475cbfc8fa331280a2a1b6" class="mwe-math-fallback-image-inline mw-invert skin-invert" aria-hidden="true" style="vertical-align: -0.338ex; width:7.552ex; height:2.176ex;" alt="{\displaystyle \Delta t\rightarrow 0}"></span> dobije se diferencijalna jednadžba: </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 {\frac {d(C\cdot V)}{dt}}=-K\cdot C+{\dot {m}}\qquad (7)}"> <semantics> <mrow class="MJX-TeXAtom-ORD"> <mstyle displaystyle="true" scriptlevel="0"> <mrow class="MJX-TeXAtom-ORD"> <mfrac> <mrow> <mi>d</mi> <mo stretchy="false">(</mo> <mi>C</mi> <mo>⋅</mo> <mi>V</mi> <mo stretchy="false">)</mo> </mrow> <mrow> <mi>d</mi> <mi>t</mi> </mrow> </mfrac> </mrow> <mo>=</mo> <mo>−</mo> <mi>K</mi> <mo>⋅</mo> <mi>C</mi> <mo>+</mo> <mrow class="MJX-TeXAtom-ORD"> <mrow class="MJX-TeXAtom-ORD"> <mover> <mi>m</mi> <mo>˙</mo> </mover> </mrow> </mrow> <mspace width="2em" /> <mo stretchy="false">(</mo> <mn>7</mn> <mo stretchy="false">)</mo> </mstyle> </mrow> <annotation encoding="application/x-tex">{\displaystyle {\frac {d(C\cdot V)}{dt}}=-K\cdot C+{\dot {m}}\qquad (7)}</annotation> </semantics> </math></span><img src="https://wikimedia.org/api/rest_v1/media/math/render/svg/e5bb9cd0edaa7fb88297b86ff1b952f7c731428d" class="mwe-math-fallback-image-inline mw-invert skin-invert" aria-hidden="true" style="vertical-align: -2.005ex; width:32.01ex; height:5.843ex;" alt="{\displaystyle {\frac {d(C\cdot V)}{dt}}=-K\cdot C+{\dot {m}}\qquad (7)}"></span></dd></dl> <p>Koristeći <a href="/w/index.php?title=Pravilo_proizvoda&action=edit&redlink=1" class="new" title="Pravilo proizvoda (stranica ne postoji)">pravilo proizvoda</a>, ovo se može prepisati kao: </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 C{\frac {dV}{dt}}+V{\frac {dC}{dt}}=-K\cdot C+{\dot {m}}\qquad (8)}"> <semantics> <mrow class="MJX-TeXAtom-ORD"> <mstyle displaystyle="true" scriptlevel="0"> <mi>C</mi> <mrow class="MJX-TeXAtom-ORD"> <mfrac> <mrow> <mi>d</mi> <mi>V</mi> </mrow> <mrow> <mi>d</mi> <mi>t</mi> </mrow> </mfrac> </mrow> <mo>+</mo> <mi>V</mi> <mrow class="MJX-TeXAtom-ORD"> <mfrac> <mrow> <mi>d</mi> <mi>C</mi> </mrow> <mrow> <mi>d</mi> <mi>t</mi> </mrow> </mfrac> </mrow> <mo>=</mo> <mo>−</mo> <mi>K</mi> <mo>⋅</mo> <mi>C</mi> <mo>+</mo> <mrow class="MJX-TeXAtom-ORD"> <mrow class="MJX-TeXAtom-ORD"> <mover> <mi>m</mi> <mo>˙</mo> </mover> </mrow> </mrow> <mspace width="2em" /> <mo stretchy="false">(</mo> <mn>8</mn> <mo stretchy="false">)</mo> </mstyle> </mrow> <annotation encoding="application/x-tex">{\displaystyle C{\frac {dV}{dt}}+V{\frac {dC}{dt}}=-K\cdot C+{\dot {m}}\qquad (8)}</annotation> </semantics> </math></span><img src="https://wikimedia.org/api/rest_v1/media/math/render/svg/9643c214b9ad6be67af2bf9d299ee50b12b52fe2" class="mwe-math-fallback-image-inline mw-invert skin-invert" aria-hidden="true" style="vertical-align: -2.005ex; width:36.967ex; height:5.509ex;" alt="{\displaystyle C{\frac {dV}{dt}}+V{\frac {dC}{dt}}=-K\cdot C+{\dot {m}}\qquad (8)}"></span></dd></dl> <p>Ako se pretpostavi da promjena zapremine nije značajna, tj. <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 C\ frac{dV}{dt}=0}"> <semantics> <mrow class="MJX-TeXAtom-ORD"> <mstyle displaystyle="true" scriptlevel="0"> <mi>C</mi> <mtext> </mtext> <mi>f</mi> <mi>r</mi> <mi>a</mi> <mi>c</mi> <mrow class="MJX-TeXAtom-ORD"> <mi>d</mi> <mi>V</mi> </mrow> <mrow class="MJX-TeXAtom-ORD"> <mi>d</mi> <mi>t</mi> </mrow> <mo>=</mo> <mn>0</mn> </mstyle> </mrow> <annotation encoding="application/x-tex">{\displaystyle C\ frac{dV}{dt}=0}</annotation> </semantics> </math></span><img src="https://wikimedia.org/api/rest_v1/media/math/render/svg/cd586ca829aca30efbde30a762f45ffe2ad71a14" class="mwe-math-fallback-image-inline mw-invert skin-invert" aria-hidden="true" style="vertical-align: -0.671ex; width:16.23ex; height:2.509ex;" alt="{\displaystyle C\ frac{dV}{dt}=0}"></span>, rezultat je jednadžba <i> 1 </i>: </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 V{\frac {dC}{dt}}=-K\cdot C+{\dot {m}}\qquad (1)}"> <semantics> <mrow class="MJX-TeXAtom-ORD"> <mstyle displaystyle="true" scriptlevel="0"> <mi>V</mi> <mrow class="MJX-TeXAtom-ORD"> <mfrac> <mrow> <mi>d</mi> <mi>C</mi> </mrow> <mrow> <mi>d</mi> <mi>t</mi> </mrow> </mfrac> </mrow> <mo>=</mo> <mo>−</mo> <mi>K</mi> <mo>⋅</mo> <mi>C</mi> <mo>+</mo> <mrow class="MJX-TeXAtom-ORD"> <mrow class="MJX-TeXAtom-ORD"> <mover> <mi>m</mi> <mo>˙</mo> </mover> </mrow> </mrow> <mspace width="2em" /> <mo stretchy="false">(</mo> <mn>1</mn> <mo stretchy="false">)</mo> </mstyle> </mrow> <annotation encoding="application/x-tex">{\displaystyle V{\frac {dC}{dt}}=-K\cdot C+{\dot {m}}\qquad (1)}</annotation> </semantics> </math></span><img src="https://wikimedia.org/api/rest_v1/media/math/render/svg/36709c5f33108d8531ea19d6bc69d20f408de505" class="mwe-math-fallback-image-inline mw-invert skin-invert" aria-hidden="true" style="vertical-align: -2.005ex; width:28.521ex; height:5.509ex;" alt="{\displaystyle V{\frac {dC}{dt}}=-K\cdot C+{\dot {m}}\qquad (1)}"></span></dd></dl> <div class="mw-heading mw-heading2"><h2 id="Rješenje_diferencijalne_jednadžbe"><span id="Rje.C5.A1enje_diferencijalne_jednad.C5.BEbe"></span>Rješenje diferencijalne jednadžbe</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Klirens_(farmakologija)&veaction=edit&section=4" title="Uredi odlomak "Rješenje diferencijalne jednadžbe"" class="mw-editsection-visualeditor"><span>uredi</span></a><span class="mw-editsection-divider"> | </span><a href="/w/index.php?title=Klirens_(farmakologija)&action=edit&section=4" title="Edit section's source code: Rješenje diferencijalne jednadžbe"><span>uredi izvor</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Opće rješenje gornje diferencijalne jednadžbe (<i> 1 </i>) je: </p><p><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 C={\frac {\dot {m}}{K}}+\left(C_{o}-{\frac {\dot {m}}{K}}\right)e^{-{\frac {K\cdot t}{V}}}\qquad (9)}"> <semantics> <mrow class="MJX-TeXAtom-ORD"> <mstyle displaystyle="true" scriptlevel="0"> <mi>C</mi> <mo>=</mo> <mrow class="MJX-TeXAtom-ORD"> <mfrac> <mrow class="MJX-TeXAtom-ORD"> <mover> <mi>m</mi> <mo>˙</mo> </mover> </mrow> <mi>K</mi> </mfrac> </mrow> <mo>+</mo> <mrow> <mo>(</mo> <mrow> <msub> <mi>C</mi> <mrow class="MJX-TeXAtom-ORD"> <mi>o</mi> </mrow> </msub> <mo>−</mo> <mrow class="MJX-TeXAtom-ORD"> <mfrac> <mrow class="MJX-TeXAtom-ORD"> <mover> <mi>m</mi> <mo>˙</mo> </mover> </mrow> <mi>K</mi> </mfrac> </mrow> </mrow> <mo>)</mo> </mrow> <msup> <mi>e</mi> <mrow class="MJX-TeXAtom-ORD"> <mo>−</mo> <mrow class="MJX-TeXAtom-ORD"> <mfrac> <mrow> <mi>K</mi> <mo>⋅</mo> <mi>t</mi> </mrow> <mi>V</mi> </mfrac> </mrow> </mrow> </msup> <mspace width="2em" /> <mo stretchy="false">(</mo> <mn>9</mn> <mo stretchy="false">)</mo> </mstyle> </mrow> <annotation encoding="application/x-tex">{\displaystyle C={\frac {\dot {m}}{K}}+\left(C_{o}-{\frac {\dot {m}}{K}}\right)e^{-{\frac {K\cdot t}{V}}}\qquad (9)}</annotation> </semantics> </math></span><img src="https://wikimedia.org/api/rest_v1/media/math/render/svg/63f47303ced650f95ba81c41fee9f897110b56f5" class="mwe-math-fallback-image-inline mw-invert skin-invert" aria-hidden="true" style="vertical-align: -2.505ex; width:35.936ex; height:6.176ex;" alt="{\displaystyle C={\frac {\dot {m}}{K}}+\left(C_{o}-{\frac {\dot {m}}{K}}\right)e^{-{\frac {K\cdot t}{V}}}\qquad (9)}"></span><sup id="cite_ref-gotch1998_8-0" class="reference"><a href="#cite_note-gotch1998-8"><span class="cite-bracket">[</span>8<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-gotch2000_9-0" class="reference"><a href="#cite_note-gotch2000-9"><span class="cite-bracket">[</span>9<span class="cite-bracket">]</span></a></sup> </p><p>gdje: </p> <ul><li>C<sub>o</sub> je koncentracija na početku dijalize ili početna koncentracija supstance/lijeka (nakon što se raspodijeli) [mmol/L] or [mol/m³]</li> <li><a href="/w/index.php?title=E_(matemati%C4%87ka_konstanta)&action=edit&redlink=1" class="new" title="E (matematićka konstanta) (stranica ne postoji)">e</a> je baza <a href="/wiki/Prirodni_logaritam" title="Prirodni logaritam">prirodnog logaritma</a>.</li></ul> <div class="mw-heading mw-heading3"><h3 id="Stabilni_rastvor">Stabilni rastvor</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Klirens_(farmakologija)&veaction=edit&section=5" title="Uredi odlomak "Stabilni rastvor"" class="mw-editsection-visualeditor"><span>uredi</span></a><span class="mw-editsection-divider"> | </span><a href="/w/index.php?title=Klirens_(farmakologija)&action=edit&section=5" title="Edit section's source code: Stabilni rastvor"><span>uredi izvor</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Rješenje gornje diferencijalne jednadžbe (<i>9</i>) u vremenskoj beskonačnosti (stabilno stanje) je: </p><p><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 C_{\infty }={\frac {\dot {m}}{K}}\qquad (10a)}"> <semantics> <mrow class="MJX-TeXAtom-ORD"> <mstyle displaystyle="true" scriptlevel="0"> <msub> <mi>C</mi> <mrow class="MJX-TeXAtom-ORD"> <mi mathvariant="normal">∞</mi> </mrow> </msub> <mo>=</mo> <mrow class="MJX-TeXAtom-ORD"> <mfrac> <mrow class="MJX-TeXAtom-ORD"> <mover> <mi>m</mi> <mo>˙</mo> </mover> </mrow> <mi>K</mi> </mfrac> </mrow> <mspace width="2em" /> <mo stretchy="false">(</mo> <mn>10</mn> <mi>a</mi> <mo stretchy="false">)</mo> </mstyle> </mrow> <annotation encoding="application/x-tex">{\displaystyle C_{\infty }={\frac {\dot {m}}{K}}\qquad (10a)}</annotation> </semantics> </math></span><img src="https://wikimedia.org/api/rest_v1/media/math/render/svg/72a370a8525e662c39c34768f3c4b4333c757d3e" class="mwe-math-fallback-image-inline mw-invert skin-invert" aria-hidden="true" style="vertical-align: -1.838ex; width:19.547ex; height:5.176ex;" alt="{\displaystyle C_{\infty }={\frac {\dot {m}}{K}}\qquad (10a)}"></span> </p><p>Gornja jednadžba (<i>10a</i>) može se prepisati kao: </p><p><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 K={\frac {\dot {m}}{C_{\infty }}}\qquad (10b)}"> <semantics> <mrow class="MJX-TeXAtom-ORD"> <mstyle displaystyle="true" scriptlevel="0"> <mi>K</mi> <mo>=</mo> <mrow class="MJX-TeXAtom-ORD"> <mfrac> <mrow class="MJX-TeXAtom-ORD"> <mover> <mi>m</mi> <mo>˙</mo> </mover> </mrow> <msub> <mi>C</mi> <mrow class="MJX-TeXAtom-ORD"> <mi mathvariant="normal">∞</mi> </mrow> </msub> </mfrac> </mrow> <mspace width="2em" /> <mo stretchy="false">(</mo> <mn>10</mn> <mi>b</mi> <mo stretchy="false">)</mo> </mstyle> </mrow> <annotation encoding="application/x-tex">{\displaystyle K={\frac {\dot {m}}{C_{\infty }}}\qquad (10b)}</annotation> </semantics> </math></span><img src="https://wikimedia.org/api/rest_v1/media/math/render/svg/46f2363e9124d456a9c782182255be4e570bdbb0" class="mwe-math-fallback-image-inline mw-invert skin-invert" aria-hidden="true" style="vertical-align: -2.338ex; width:19.315ex; height:5.676ex;" alt="{\displaystyle K={\frac {\dot {m}}{C_{\infty }}}\qquad (10b)}"></span> </p><p>Gornja jednadžba (<i>10b</i>) jasno pokazuje vezu između uklanjanja mase i <i>klirensa</i>. U njoj se navodi da (uz konstantno stvaranje mase) koncentracija i klirens variraju <a href="/w/index.php?title=Obrnuto_proporcionalno&action=edit&redlink=1" class="new" title="Obrnuto proporcionalno (stranica ne postoji)">obrnutok</a>. Ako se primjenjuje na kreatinin (tj. <a href="/w/index.php?title=Klirens_kreatinina&action=edit&redlink=1" class="new" title="Klirens kreatinina (stranica ne postoji)">klirens kreatinina</a>, iz jednadžbe proizlazi da ako <a href="/w/index.php?title=Serumski_kreatinin&action=edit&redlink=1" class="new" title="Serumski kreatinin (stranica ne postoji)">serumski kreatinin</a> udvostruči klirens se prepolovi i da ako se kreatinin u serumu učetverostruči, klirens je raščetvoren. </p> <div class="mw-heading mw-heading2"><h2 id="Mjerenje_bubrežnog_klirensa"><span id="Mjerenje_bubre.C5.BEnog_klirensa"></span>Mjerenje bubrežnog klirensa</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Klirens_(farmakologija)&veaction=edit&section=6" title="Uredi odlomak "Mjerenje bubrežnog klirensa"" class="mw-editsection-visualeditor"><span>uredi</span></a><span class="mw-editsection-divider"> | </span><a href="/w/index.php?title=Klirens_(farmakologija)&action=edit&section=6" title="Edit section's source code: Mjerenje bubrežnog klirensa"><span>uredi izvor</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Bubrežni klirens može se izmjeriti vremenskim prikupljanjem <a href="/wiki/Mokra%C4%87a" title="Mokraća">urina</a> i analizom njegovog sastava, uz pomoć sljedeće jednačine (koja izravno proizlazi iz izvedenice (<i>10b</i>): </p><p><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 K={\frac {C_{U}\cdot Q}{C_{B}}}\qquad (11)}"> <semantics> <mrow class="MJX-TeXAtom-ORD"> <mstyle displaystyle="true" scriptlevel="0"> <mi>K</mi> <mo>=</mo> <mrow class="MJX-TeXAtom-ORD"> <mfrac> <mrow> <msub> <mi>C</mi> <mrow class="MJX-TeXAtom-ORD"> <mi>U</mi> </mrow> </msub> <mo>⋅</mo> <mi>Q</mi> </mrow> <msub> <mi>C</mi> <mrow class="MJX-TeXAtom-ORD"> <mi>B</mi> </mrow> </msub> </mfrac> </mrow> <mspace width="2em" /> <mo stretchy="false">(</mo> <mn>11</mn> <mo stretchy="false">)</mo> </mstyle> </mrow> <annotation encoding="application/x-tex">{\displaystyle K={\frac {C_{U}\cdot Q}{C_{B}}}\qquad (11)}</annotation> </semantics> </math></span><img src="https://wikimedia.org/api/rest_v1/media/math/render/svg/4103962433e0eaa7b5c4128d89df02363c48fa58" class="mwe-math-fallback-image-inline mw-invert skin-invert" aria-hidden="true" style="vertical-align: -2.338ex; width:21.452ex; height:5.843ex;" alt="{\displaystyle K={\frac {C_{U}\cdot Q}{C_{B}}}\qquad (11)}"></span> </p><p>gdje: </p> <ul><li>K = klirens [mL/min]</li> <li>C<sub>U</sub> = koncentracija mokraće [mmol/L] (u SAD, često [mg/mL])</li> <li>Q = protok urina (zapremina/vrijeme) [mL/min] (često [mL/24 h])</li> <li>C<sub>B</sub> = konentracija plazme [mmol/L] (u SAD često [mg/mL])</li></ul> <p>Kada je supstanca "C" kreatinin, endogena hemikalija koja se izlučuje samo filtracijom, klirens je približna vrijednosti <a href="/wiki/Brzina_glomerulske_filtracije" title="Brzina glomerulske filtracije">brzini glomerulske filtracije</a>. Za precizno određivanje brzine glomerulske filtracije, rjeđe se koristi klirens <a href="/wiki/Inulin" title="Inulin">inulina</a>. </p><p><b>Napomena</b> – gornja jednadžba (<i>11</i>) vrijedi <i>samo</i> za stabilno stanje. Ako je supstanca koja se čisti nije "pri konstantnoj koncentraciji u plazmi (tj."nije" u stanju ravnoteže) "K" se mora dobiti iz (punog) rješenja diferencijalne jednadžbe (<i>9</i>). </p> <div class="mw-heading mw-heading2"><h2 id="Također_pogledajte"><span id="Tako.C4.91er_pogledajte"></span>Također pogledajte</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Klirens_(farmakologija)&veaction=edit&section=7" title="Uredi odlomak "Također pogledajte"" class="mw-editsection-visualeditor"><span>uredi</span></a><span class="mw-editsection-divider"> | </span><a href="/w/index.php?title=Klirens_(farmakologija)&action=edit&section=7" title="Edit section's source code: Također pogledajte"><span>uredi izvor</span></a><span class="mw-editsection-bracket">]</span></span></div> <ul><li><a href="/wiki/Glomerul" title="Glomerul">Glomerul</a></li> <li><a href="/wiki/Bowmanova_%C4%8Dahura" title="Bowmanova čahura">Bowmanova čahura</a></li> <li><a href="/w/index.php?title=Farmakokinetika&action=edit&redlink=1" class="new" title="Farmakokinetika (stranica ne postoji)">Farmakokinetika</a></li> <li><a href="/wiki/Mokra%C4%87ni_sistem" title="Mokraćni sistem">Mokraćni sistem</a></li></ul> <div class="mw-heading mw-heading2"><h2 id="Reference">Reference</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Klirens_(farmakologija)&veaction=edit&section=8" title="Uredi odlomak "Reference"" class="mw-editsection-visualeditor"><span>uredi</span></a><span class="mw-editsection-divider"> | </span><a href="/w/index.php?title=Klirens_(farmakologija)&action=edit&section=8" title="Edit section's source code: Reference"><span>uredi izvor</span></a><span class="mw-editsection-bracket">]</span></span></div> <style data-mw-deduplicate="TemplateStyles:r3312388">.mw-parser-output .reflist{font-size:90%;margin-bottom:0.5em;list-style-type:decimal}.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"> <div class="mw-references-wrap"><ol class="references"> <li id="cite_note-:0-1"><span class="mw-cite-backlink">^ <a href="#cite_ref-:0_1-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-:0_1-1"><sup><i><b>b</b></i></sup></a></span> <span 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no-repeat}.mw-parser-output .cs1-subscription,.mw-parser-output .cs1-registration{color:#555}.mw-parser-output .cs1-subscription span,.mw-parser-output .cs1-registration span{border-bottom:1px dotted;cursor:help}.mw-parser-output .cs1-ws-icon a{background:linear-gradient(transparent,transparent),url("//upload.wikimedia.org/wikipedia/commons/4/4c/Wikisource-logo.svg")right 0.1em center/12px no-repeat}.mw-parser-output code.cs1-code{color:inherit;background:inherit;border:none;padding:inherit}.mw-parser-output .cs1-hidden-error{display:none;font-size:100%}.mw-parser-output .cs1-visible-error{font-size:100%}.mw-parser-output .cs1-maint{display:none;color:#33aa33;margin-left:0.3em}.mw-parser-output .cs1-format{font-size:95%}.mw-parser-output .cs1-kern-left,.mw-parser-output .cs1-kern-wl-left{padding-left:0.2em}.mw-parser-output .cs1-kern-right,.mw-parser-output .cs1-kern-wl-right{padding-right:0.2em}.mw-parser-output .citation .mw-selflink{font-weight:inherit}</style><cite 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Transplant</i>. 13 Suppl 6 (90006): 10–4. <a href="/wiki/Doi_(identifikator)" class="mw-redirect" title="Doi (identifikator)">doi</a>:<span class="cs1-lock-free" title="Slobodno dostupno"><a rel="nofollow" class="external text" href="https://doi.org/10.1093%2Fndt%2F13.suppl_6.10">10.1093/ndt/13.suppl_6.10</a></span>. <a href="/wiki/PMID_(identifikator)" class="mw-redirect" title="PMID (identifikator)">PMID</a> <a rel="nofollow" class="external text" href="//pubmed.ncbi.nlm.nih.gov/9719197">9719197</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Nephrol.+Dial.+Transplant.&rft.atitle=The+current+place+of+urea+kinetic+modelling+with+respect+to+different+dialysis+modalities&rft.volume=13+Suppl+6&rft.issue=90006&rft.pages=10-4&rft.date=1998&rft_id=info%3Adoi%2F10.1093%2Fndt%2F13.suppl_6.10&rft_id=info%3Apmid%2F9719197&rft.au=Gotch+FA&rft_id=%2F%2Fdoi.org%2F10.1093%252Fndt%252F13.suppl_6.10&rfr_id=info%3Asid%2Fbs.wikipedia.org%3AKlirens+%28farmakologija%29" class="Z3988"></span> <a rel="nofollow" class="external text" href="http://ndt.oxfordjournals.org/cgi/reprint/13/suppl_6/10">Full Text</a></span> </li> <li id="cite_note-gotch2000-9"><span class="mw-cite-backlink"><b><a href="#cite_ref-gotch2000_9-0">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r3303350"><cite id="CITEREFGotchSargentKeen2000" class="citation journal cs1">Gotch FA, Sargent JA, Keen ML (2000). "Whither goest Kt/V?". <i>Kidney Int. Suppl</i>. <b>76</b>: S3–18. <a href="/wiki/Doi_(identifikator)" class="mw-redirect" title="Doi (identifikator)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1046%2Fj.1523-1755.2000.07602.x">10.1046/j.1523-1755.2000.07602.x</a>. <a href="/wiki/PMID_(identifikator)" class="mw-redirect" title="PMID (identifikator)">PMID</a> <a rel="nofollow" class="external text" href="//pubmed.ncbi.nlm.nih.gov/10936795">10936795</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Kidney+Int.+Suppl.&rft.atitle=Whither+goest+Kt%2FV%3F&rft.volume=76&rft.pages=S3-18&rft.date=2000&rft_id=info%3Adoi%2F10.1046%2Fj.1523-1755.2000.07602.x&rft_id=info%3Apmid%2F10936795&rft.aulast=Gotch&rft.aufirst=FA&rft.au=Sargent%2C+JA&rft.au=Keen%2C+ML&rfr_id=info%3Asid%2Fbs.wikipedia.org%3AKlirens+%28farmakologija%29" class="Z3988"></span></span> </li> </ol></div></div></div><noscript><img src="https://login.wikimedia.org/wiki/Special:CentralAutoLogin/start?type=1x1&useformat=desktop" alt="" width="1" height="1" style="border: none; position: absolute;"></noscript> <div class="printfooter" data-nosnippet="">Preuzeto iz "<a dir="ltr" href="https://bs.wikipedia.org/w/index.php?title=Klirens_(farmakologija)&oldid=3508808">https://bs.wikipedia.org/w/index.php?title=Klirens_(farmakologija)&oldid=3508808</a>"</div></div> <div id="catlinks" class="catlinks" data-mw="interface"><div id="mw-normal-catlinks" class="mw-normal-catlinks"><a href="/wiki/Posebno:Kategorije" title="Posebno:Kategorije">Kategorije</a>: <ul><li><a href="/wiki/Kategorija:Nefrologija" title="Kategorija:Nefrologija">Nefrologija</a></li><li><a href="/wiki/Kategorija:Farmakologija" title="Kategorija:Farmakologija">Farmakologija</a></li><li><a href="/w/index.php?title=Kategorija:Privremene_stope&action=edit&redlink=1" class="new" title="Kategorija:Privremene stope (stranica ne postoji)">Privremene stope</a></li></ul></div><div id="mw-hidden-catlinks" class="mw-hidden-catlinks mw-hidden-cats-hidden">Sakrivena kategorija: <ul><li><a href="/wiki/Kategorija:CS1:_duga_vrijednost_parametra_volume" title="Kategorija:CS1: duga vrijednost parametra volume">CS1: duga vrijednost parametra volume</a></li></ul></div></div> </div> </main> </div> <div class="mw-footer-container"> <footer id="footer" class="mw-footer" > <ul id="footer-info"> <li id="footer-info-lastmod"> Ova stranica je posljednji put izmijenjena na datum 15 april 2023 u 17:49.</li> <li id="footer-info-copyright">Tekst je dostupan pod <a rel="nofollow" class="external text" href="https://creativecommons.org/licenses/by-sa/4.0/">slobodnom licencom Autorstvo-Dijeliti pod istim uvjetima</a>; mogu se primijeniti i dodatni uvjeti. 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