Tests For Renal Function And Glomerular | report

Running Head: TESTS FOR RENAL FUNCTION AND GLOMERULAR FILTRATION RATE
TESTS FOR RENAL FUNCTION AND GLOMERULAR FILTRATION RATE
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1TESTS FOR RENAL FUNCTION AND GLOMERULAR FILTRATION RATE
Abstract
The aim of this report is to highlight is to highlight the importance of renal cell function and
glomerular filtration rate. The writing deals with various case studies and elaborates the
consequences of change in creatinine levels. It also highlights the mathematical sections to
calculate various aspects of creatinine and urea. Moreover, the report give as an elaborative
explanation regarding the importance of creatine, Urea and Protein. Finally, the report concludes
with a brief discussion regarding the symptoms of various kidney diseases as well. It is always
necessary to beware of such symptoms, even if minor symptoms can be immediately cured with
utmost importance and care. So, it is always better to consult a general practitioner if a individual
is suffering from such symptoms that might lead him to chronic kidney disease.

2TESTS FOR RENAL FUNCTION AND GLOMERULAR FILTRATION RATE
Table of Contents
Introduction......................................................................................................................................3
Results..............................................................................................................................................4
Discussion......................................................................................................................................11
Conclusion.....................................................................................................................................15
References......................................................................................................................................17

3TESTS FOR RENAL FUNCTION AND GLOMERULAR FILTRATION RATE
Introduction
Renal cell function and Glomerular Filtration rate are two vital process in the body.
These processes determines proper functioning of the body. Renal cell function can be studied
with the powerful tool of cell biology that is cell culture (1). Whereas, Glomerular filtration rate
test can be done to check proper functioning of the kidneys (2). The test determines the amount
of blood passes through glomeruli per minute. However, Glomeruli are the micro filters inside
the kidneys that clean waste from the blood flow (3). Various structural characteristics have been
oriented in the epithelial sheets. Kidney cell cultures are effectively used to study hormonal
derivative of Vitamin D and to understand the mechanism of prostaglandin production (4). Cell
culture tests are often performed to understand the biological development of kidney function.
However, Glomerular Filtration rate is mostly recommended to people suffering from chronic
kidney diseases as well as to people suffering from diabetes, heart disorder, blockage during
urination, high blood pressure and family history of kidney disorders or urinary tract infections
(5). Renal cell function mainly includes mineral composition, electrolytes, proteins, glucose
level, creatinine level in blood and urine, urea level in blood, Blood Urea Nitrogen (BUN),
albumin level and micro-albumin. In addition, creatinine can be directly related to kidney
function, increasing level of creatinine leads to decrease in kidney function(6). Sometimes
estimation of Glomerular Filtration rate from creatinine clearance is often inappropriate.
Additionally, estimated glomerular filtration rate can be less accurate in comparison to normal
glomerular filtration rate. In this report, a spectrophotometric method has been used to analyze
the creatinine and urea concentration in few samples. The method evaluates to form a reaction
with Creatinine and Picric Acid in presence of an alkaline solution to give Janovsky complex
(Chromogen) which is red-orange colour (7).

4TESTS FOR RENAL FUNCTION AND GLOMERULAR FILTRATION RATE
Results
There are several methods to detect the presence creatinine, urea and Urinary protein.
The method involves use of a Libra spectrophotometer, which is a UV visible
spectrophotometer. Often enormous sample constituent and a variety of accessories make this
apparatus much more reliable for measurement purpose (8). Three tests were mainly performed
for the patients; creatinine mainly reveals information about kidneys. Body produces a chemical
waste after the metabolic process. Whereas, urea is a vital component in the human body, it
carries waste nitrogen from the body as well as play a crucial role in the cross-section system of
nephrons, which allows re-absorption of water and vital ions from urine. Lastly, Urinary protein
is a kind of tests that signifies the health of kidneys because healthy kidneys will not allow
maximum quantity of protein to pass through the filters (9).
However, the reports of three unknown patients give significant amount of information
regarding their kidney function. Their estimated glomerular filtration rate gives enormous idea
regarding their kidney health. The first patient who was a 45-year old male has an estimated
glomerular filtration rate of 108 that gives a clear idea of kidney damage with an increased value
of GFR. Moreover, his creatinine clearance was extremely low that gives a clear indication of
Kidney disease. Low creatinine clearance level indicate diseases like muscular dystrophy or
extreme liver disorders. Low level of creatinine clearance clearly indicates that he must be
suffering from chronic kidney disease (10).
The reports of the second patient clearly where estimated glomerular filtration rate was
found to be 63 which is extremely low. However, it indicates that kidney is on the way to
damage if remained untreated (11). His creatinine clearance levels was also very much low as
compared to the normal range. This clearly states that kidney is about to be damaged if not

5TESTS FOR RENAL FUNCTION AND GLOMERULAR FILTRATION RATE
treated with appropriate care. Moreover, his urinary creatinine was extremely low that signifies
he is about to suffer from a chronic kidney disease (12). It is necessary for him to be take an
immediate action against his disturbed levels of creatinine and estimated glomerular filtration
rate. In further his health condition can lead to some life-threatening diseases like cancer, flow of
blood from the urine, urinary tract infections and urinary tract blockage.
Lastly, in case of a 35-year old male whose estimated glomerular filtration rate was
extremely low and he has serious case of kidney damage. Even if treated with proper medicines,
it can continue for life-long. Such cases can clearly state that he is going to have a kidney failure
and his urinary creatinine was below than the normal range, which is 8.7. A clear sign of kidney
damage is highlighted over the case.
Kidney is one of the vital organ in the body and the most important factor that manages
the level is creatinine. With a slight change of creatinine can lead to severe damage of the entire
system. As kidney filters the blood, kidney damage will results in formation of impure blood in
the body, which will affect the other organs as well. However, certain limitations of glomerular
filtration rate can be found out as it often predicts the less value than the mentioned range.
Estimated glomerular filtration rate can sometimes be incorrect because sample collected
from a person suffering from a liver disease can give inappropriate values. In case of person
following a strict diet routine eGFR values can be different.
There following results are obtained by using the given formula and samples:
Creatinine ( μmol / L )= [ Sample absorbance ( Ac )
Average standard absorbance ]× standard concentration ( μmol/ L )
Urea ( mmol/ L )= [ Sample absorbance
Average standard absorbance ]× standard concentration ( mmol /L )

6TESTS FOR RENAL FUNCTION AND GLOMERULAR FILTRATION RATE
Sample ID Creatinine
Initial
Absorbance
(A1) @ 30
seconds &
505nm
Creatinine
Final
Absorbance
(A2) @ 150
seconds &
505nm
Corrected
Absorbanc
e (Ac)
[Creatinine]
(g/L)
Urea
Absorbance
@ 340nm
[Urea]
Standard 1 0.037 0.202 0.165 440 0.560 14.3
Standard 2 0.046 0.209 0.163 440 0.532 14.3
Control 1 0.113 0.173 0.06 161 0.229 6.0
Control 2 0.239 0.464 0.225 604 0.561 14.7
Peter Toth 0.033 0.129 0.096 258 0.435 11.4
Mickey
Dolenz
0.036 0.079 0.053 142 0.332 8.7
Dianne
Beattie
0.050 0.181 0.131 352 0.355 9.3
David
Jones
0.022 0.129 0.107 294 0.462 12.1
Michael
Nesmith
0.056 0.227 0.171 459 0.103 2.7
Jennifer
Glomerulus
0.009 0.029 0.020 54 0.508 13.3

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Table 1: Creatinine and Urea Results
Sample
ID
[Serum
creatinine]
(mol/L)
[Urinary
creatinine]
(mol/L)
24 Hour
Volume
(mL/min)
Creatinine
Excretion
Rate
(mmol/L)
Creatinine
Clearance
(mL/min)
eGFR
(mL/min/1.73m2)
U102145 71 18.3 0.44 11.7 0.11 108
U547845 107 25.4 0.76 27.9 0.18 63
U458752 204 8.7 2.46 30.8 0.11 27
Table 2: Estimated Glomerular Filtration rate of unknown samples
From the above reports it can be predicted that some patients are suffering from severe chronic
kidney diseases and need get to get an immediate treatment.

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Sample ID Absorbance
1 @ 650nm
Absorbance
2 @ 650nm
[Protein]
(g/L)
24 hour
volume (mL)
Protein
Excretion
(g/24hr)
Standard
0.0g/L
0.00 0.00
Avg value=
0.00
0.0 NA NA
Standard
0.2g/L
0.104 0.120
Avg value=
0.112
0.104 NA NA
Standard
0.4g/L
0.219 0.221
Avg value=
022
0.219 NA NA
Standard
0.6g/L
0.328 0.333
Avg value=
0.33
0.328 NA NA
Standard
0.8g/L
0.458 0.451
Avg value=
0.45
0.458 NA NA
Standard
1.0g/L
0.565 0.595 0.565 NA NA

9TESTS FOR RENAL FUNCTION AND GLOMERULAR FILTRATION RATE
Avg value=
0.58
Control 1 0.016 NA 0.00 NA NA
Control 2 0.054 NA 0.00 NA NA
Peter Toth 0.025 NA 0.04 Spot urine
(637)
25.48
Mickey
Dolenz
0.015 NA 0.02 Spot urine
(1092)
21.84
Dianne
Beattie
0.142 NA 0.25 Spot urine
(3542)
885.5
David Jones 0.316 NA 0.56 1950 1092
Michael
Nesmith
0.11 NA 0.18 Spot urine
(637)
114.66
Jennifer
Glomerulus
0.230 NA 0.39 1350 526.5
Table 3: Protein concentrations

10TESTS FOR RENAL FUNCTION AND GLOMERULAR FILTRATION RATE
Fig 1: Curve for patient protein estimation
The curve stated in figure 1 has the following keynotes:
X axis= Concentration of the protein content in urine
Y axis= Absorbance at 650 nm
Patient protein concentrations found by interpolation are plotted in the curve. The values are
stated in the table (Table 3).

11TESTS FOR RENAL FUNCTION AND GLOMERULAR FILTRATION RATE
Discussion
Case Study: Peter Toth
Peter Toth a 40 Year old Male, who went to a general practitioner regarding an
abdominal pain. His medical history suggest that he was allergic to penicillin and was
undergoing a course of cefotaxime for his pulmonary infection. Penicillin can be either natural or
semisynthetic. Structures similar to penicillin such as cephalosporins and carbapenems, can lead
to allergic infections. These drugs contain one of the most essential component, a beta-lactam
ring, which can either cause immediate or non-immediate reactions. However, his case study
suggest that his abdominal pain could be an early sign of some kidney disorders because as per
the report, he has absorbance value of 440 g/L, Urea absorbance of 0.560 at 340nm and Urea of
14.3. The report gives a clear indication that he might be suffering from some sort of kidney
disorders. There could be a possibility that his penicillin allergies might have led to such
conditions. Suffering from pulmonary infections could transfer the infection to kidney via blood
flow and might have affected the kidney. Moreover, his urea level is quite high that gives a clear
indication that he would be suffering from kidney disorders in the future and that might cause a
huge problem. Being in the early stage it is important for him get treated as early as possible.
Case Study: Mickey Dolenz

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Mickey Dolenz, a 75-year old male who was admitted to a nursing home because of
excessive dehydration and severely confused. However, his reports were not much familiar
because he has creatinine absorbance of 0.053, Creatinine value of 142 g/L, Urea absorbance of
0.332 at 340 nm and urea of 8.7. His reports were not normal and it is a clear sign a Diabetes 1.
Since, he was losing excessive water and this can be termed as Diabetic ketoacidosis. In such a
condition, people usually suffer from Hypernatremia, which is a common problem of electrolyte
that leads to increase in serum sodium level that decreases that total body water with respect to
the electrolyte content. Type 1 Diabetes is an early symptom of Kidney disease because as soon
as the production of insulin becomes less, people need to inject to insulin to maintain the
balance. Sometimes, excessive increase of Glucose in the body can lead to kidney disease
because in such case the body water decreases with a rapid rate and level of serum sodium
increases with an enormous rate. However, proper injection of insulin can decrease the
symptoms but it will be a lifelong treatment.
Case Study: Dianne Beattie
Dianne Beattie, a 30-year old female who has been suffering from Insulin Dependent
Diabetes Mellitus. She had a very poor control over her Diabetic control in last five years. She
was also admitted to the casualty department when he was in a diabetic coma with a glucose
level of 52 mmol/L. Moreover, her doctor noticed a strong smell of ketone from her breath. Her
lab records seemed to be pretty messed up because he has a Creatinine absorbance of 0.131,
Creatinine value of 352, which was quite high, Urea absorbance of 0.355 at 340 nm and had a
urea value of 9.3, which is more than the standard range. Her reports indicate clearly that she had
been suffering from Diabetic Ketoacidosis, which is type 1 diabetes that might affect the kidney
in a long run. Type 1 diabetes is mainly associated with the water and electrolyte disorder. In a

13TESTS FOR RENAL FUNCTION AND GLOMERULAR FILTRATION RATE
long run, it could be such that she could be suffering from hyperkalemia and that could lead to
hemodialysis. However, in such cases insulin pump is must, although we need to check whether
insulin is blocked or not. The strong smell of ketone could lead to Ketoacidosis and diabetic-
ketoacidosis. However, increase in her creatinine value suggest she was suffering from Chronic
kidney diseases and that might lead to kidney failure as well.
Case Study: Mike Nesmith
Mike Nesmith, a 46-year old male who was admitted to hospital after he suffered from a
motor vehicle accident and lost an enormous amount of blood along with some head injuries. He
had also undergone a laparotomy to remove his injured spleen. However, after 12-hours of post-
operation he had only passed 180 mL of Urine. His reports were like 0.171 of Creatinine
Absorbance, a creatinine value of 459, Urea absorbance of 0.103 and Urea level of 2.3, which is
quite low in comparison to the standard range. A rupture spleen is one of the most complicated
surgery but quite often in case of laparoscopic surgery. Moreover, his reports suggest that he
might be suffering from some sort if kidney disorders because of Spleen ruptures. Although,
spleen ruptures is one the serious complications. However, Ultrasound and Computed
Tomography scan could be helpful during the process of diagnosis. His reports were complicated
in case of Creatinine and Urea which were very much different from the standard range. These
are the clear signs of Chronic Kidney Diseases. Moreover, his ruptured spleen could lead him to
permanent damage for the lifetime. Complications can be cured within a particular period but
medications will be lifelong.
Case Study: Jennifer Glomerulus

14TESTS FOR RENAL FUNCTION AND GLOMERULAR FILTRATION RATE
Jennifer Glomerulus, a 19-year old female, who was suffering from psychiatric
disturbances and admitted to hospital. She was also found that her renal function was reduced.
Her reports suggest that she has a creatinine value of 54, which is extremely low, Urea
absorbance of 0.508 at 304 nm and Urea level of 13.3. Her reports clearly suggest that she has a
low kidney function and that could cost him permanent damage. Low kidney function could be
arise from numerous factors. May be kidney is unable to filter the blood. This could arise from
Cardiovascular disease, gastrointestinal disease, cancer, obesity, osteoporosis or neurological
disorders. However, low creatinine values can be upgraded with proper diet and medications but
that could be life-long.
Case Study: David Jones
David Jones, who visited a general practitioner because of his breathing difficulties. He
often used to be Hypertensive that led him to rise in blood pressure up to 180/110 mmHg. His
reports seemed to be messed up as creatinine absorbance was found to be 0.107, creatinine levels
were found to be 294, Urea absorbance was found to be 0.462 and his urea level was found to be
12.1. Although his reports were not normal but he was also suffering from high blood pressure.
This put an extra effort to the kidney to filter the blood as early as possible. However, incorrect
levels might cause him to some form of chronic kidney diseases. That could also lead David to
suffer from obesity, cardiovascular disease, gastrointestinal disease or neurological disorders.
Things can be cured with utmost treatment and care but it could be remain life long.
Case Study: U102145
The reports of this unknown sample can be depicted as estimated glomerular filtration
rate is 108 mL/min/1.73m2. This clearly indicates that the patient could be suffering from kidney

15TESTS FOR RENAL FUNCTION AND GLOMERULAR FILTRATION RATE
damage with an increasing value of Glomerular Filtration rate. However, this can be cured with
medication or dialysis but the process will continue as long the patient is alive. Moreover, his
serum creatinine is also quite high as it shows 71 mol/L, Urinary Creatinine value with 18.3
mol/L and Creatinine clearance was pretty low with 0.11 mL/min. The above data clearly
signifies that he is patient with chronic kidney disease.
Case Study: U547845
The reports of this unknown sample can be depicted as estimated glomerular filtration
rate is 63 mL/min/1.73m2. This clearly indicates that the patient could be suffering from kidney
damage with an increasing value of Glomerular Filtration rate. Moreover, his serum creatinine is
also quite high as it shows 107 mol/L, Urinary Creatinine value with 25.4 mol/L and
Creatinine clearance was pretty low with 0.18 mL/min. The above data clearly signifies that he is
patient with kidney damage with short decrease in estimated glomerular filtration rate value.
Case Study: U458752
The reports of this unknown sample can be depicted as estimated glomerular filtration
rate is 27 mL/min/1.73m2. This clearly indicates that the patient could be suffering from kidney
damage with an increasing value of Glomerular Filtration rate. Moreover, his serum creatinine is
also quite high as it shows 204 mol/L, Urinary Creatinine value with 8.7 mol/L and Creatinine
clearance was pretty low with 0.18 mL/min. The above is a clear sign of kidney failure that
would lead to dialysis.
Conclusion
Creatinine and Urea being the two vital components of the body that determines the
overall kidney function. Renal cell function and Glomerular Filtration rate are two vibrant

16TESTS FOR RENAL FUNCTION AND GLOMERULAR FILTRATION RATE
method in the physique. These procedures regulates appropriate operational of the body. Renal
cell function can be calculated with the influential means of cell biology that is cell culture.
Whereas, Glomerular filtration rate test can be completed to check appropriate effective of the
kidneys. The test controls the amount of blood permits over glomeruli per minute. However,
Glomeruli are the micro filters privileged the kidneys that clean waste from the blood flow.
Numerous mechanical features have been concerned with in the epithelial sheets. Kidney cell
cultures are successfully used to optimize hormonal derivative of Vitamin D and to comprehend
the mechanism of prostaglandin construction. Cell culture tests are often achieved to
comprehend the organic expansion of kidney function. However, Glomerular Filtration rate is
mostly suggested to individuals suffering from chronic kidney diseases as well as to individuals
suffering from diabetes, heart complaint, blockage during urination, high blood pressure and
family history of kidney disorders or urinary tract infections. Renal cell function mainly includes
mineral composition, electrolytes, proteins, glucose level, creatinine level in blood and urine,
urea level in blood, Blood Urea Nitrogen (BUN), albumin level and micro-albumin.

17TESTS FOR RENAL FUNCTION AND GLOMERULAR FILTRATION RATE
References
1. Ochoa AC, Zea AH, Hernandez C, Rodriguez PC. Arginase, prostaglandins, and
myeloid-derived suppressor cells in renal cell carcinoma. Clinical Cancer Research. 2007
Jan 15;13(2):721s-6s.
2. Stevens LA, Coresh J, Greene T, Levey AS. Assessing kidney function—measured and
estimated glomerular filtration rate. New England Journal of Medicine. 2006 Jun
8;354(23):2473-83.
3. Lee RH, Seo MJ, Reger RL, Spees JL, Pulin AA, Olson SD, Prockop DJ. Multipotent
stromal cells from human marrow home to and promote repair of pancreatic islets and
renal glomeruli in diabetic NOD/scid mice. Proceedings of the National Academy of
Sciences. 2006 Nov 14;103(46):17438-43.
4. Sugimoto Y, Narumiya S. Prostaglandin E receptors. Journal of Biological Chemistry.
2007 Apr 20;282(16):11613-7.
5. Yeomans ER, Gilstrap LC. Physiologic changes in pregnancy and their impact on critical
care. Critical care medicine. 2005 Oct 1;33(10):S256-8.
6. Levey AS, Coresh J, Greene T, Marsh J, Stevens LA, Kusek JW, Van Lente F.
Expressing the Modification of Diet in Renal Disease Study equation for estimating
glomerular filtration rate with standardized serum creatinine values. Clinical chemistry.
2007 Apr 1;53(4):766-72.
7. Hill FC, Sviatenko LK, Gorb L, Okovytyy SI, Blaustein GS, Leszczynski J. DFT M06-
2X investigation of alkaline hydrolysis of nitroaromatic compounds. Chemosphere. 2012
Jul 1;88(5):635-43.

18TESTS FOR RENAL FUNCTION AND GLOMERULAR FILTRATION RATE
8. Mueller LN, Brusniak MY, Mani DR, Aebersold R. An assessment of software solutions
for the analysis of mass spectrometry based quantitative proteomics data. Journal of
proteome research. 2008 Jan 4;7(01):51-61.
9. Nakamura T, Sugaya T, Kawagoe Y, Ueda Y, Osada S, Koide H. Effect of pitavastatin
on urinary liver-type fatty acid–binding protein levels in patients with early diabetic
nephropathy. Diabetes care. 2005 Nov 1;28(11):2728-32.
10. Premanode B, Toumazou C. A novel, low power biosensor for real time monitoring of
creatinine and urea in peritoneal dialysis. Sensors and Actuators B: Chemical. 2007 Jan
10;120(2):732-5.
11. Ma YC, Zuo L, Chen JH, Luo Q, Yu XQ, Li Y, Xu JS, Huang SM, Wang LN, Huang W,
Wang M. Modified glomerular filtration rate estimating equation for Chinese patients
with chronic kidney disease. Journal of the American Society of Nephrology. 2006 Oct
1;17(10):2937-44.
12. Jha V, Garcia-Garcia G, Iseki K, Li Z, Naicker S, Plattner B, Saran R, Wang AY, Yang
CW. Chronic kidney disease: global dimension and perspectives. The Lancet. 2013 Jul
20;382(9888):260-72.