常用肾脏功能实验室检测—诊断学科.ppt

诊断学

肾功能检查

ASSESSMENTOFRENALFUNCTION

提要UrineTests:Cheapandconvenient;ForscreeningandfollowingRenalFunctionsImmunologicalTestImagingExaminationRenalBiopsy3

WhenorforWhatKidneydiseasesorinjuriesOtherdiseasesinducedkidneyfunctioninjuriesDiabetesmellitusHypertensionShockorextensiveburnAuto-immunologicaldiseasesDrugtoxicity4

StructureofKidney5肾单位集合管肾小体肾小管肾小球肾小囊近曲小管远曲小管髓袢

肾小球功能检查Glomerularfunctionassessment6

StructureandFunctionGFR:thevolumeoffluidfilteredfromtheglomerularcapillariesintotheBowmanscapsuleperunittime120-160ml/min

ContentsSerumCreatinine(sCr)Serumurea(SU)CreatinineClearanceRate,CcrCystatinCMicroalbumin(MA)、Transferrinuria(TRU)、uricacid、urineIg……

SerumCreatinine(sCr)EndogenousawasteproductproducedbymusclemetabolismCreatinineExogenousComefromfoods,suchasmeat,fish,coffee,tea,etc.9

SerumCreatinine(sCr)Asmallmolecule,filtratedbyglomerularcompletely,andnotreabsorbedbytubulesCr:riseifthefilteringofthekidneyisdeficient,NormalValue:SerumCr:male:44-132μmol/Lfemale:70-106μmol/L10

Stageofrenalfailure(male)11445μmol/L178μmol/L177μmol/L44-132μmol/LStage4(Failurestage)Stage3(De-compensatorystage)Stage2(Compensatorystage)Stage1(Normalfunction)707μmol/LStage5(Uremia)Scr

ClinicalSignificanceofsCrincrease12riseonlywithmarkeddamagetonephronsfiltration

Serumurea(SU)alsonamedasBUNInfluencefactorsProteinintakeProteindegradationLiverfunctionGlomerularfiltrationNormalvalue:Adults:1.8-7.1mmol/LChildrenorinfants:1.8-6.5mmol/L13Ureaorornithinecycleinliver

ClinicalSignificanceofSURenaldamage:ChronicrenalfailureCompensatorystage:SU9mmol/LDecompensatorystage:SU9mmol/LFailurestage:SU20mmol/LUremia:SU28.6mmol/LAcuterenaldisease14

ClinicalSignificancePhysical:↑：highproteindiet↓：pregnancyPre-renal:Highfever,Shock,Uppergastrointestinalhemorrhage,extensiveburn，sever