Tests for Renal Function and Glomerular Filtration Rate Analysis

This report delves into the critical aspects of renal function and glomerular filtration rate (GFR), essential for assessing kidney health. It explores various tests, including creatinine and urea analysis, and their significance in diagnosing kidney-related disorders. The report presents case studies that highlight the impact of altered creatinine levels and estimated GFR (eGFR) on patient health, including discussions on the Jaffe reaction for creatinine measurement and the implications of different GFR stages. The report also covers the importance of urinary protein and its relation to kidney function. Furthermore, the report includes a discussion on the symptoms of various kidney diseases, emphasizing the need for early detection and intervention to prevent chronic kidney disease and potential complications. The report utilizes spectrophotometric methods for creatinine and urea analysis, providing a comprehensive overview of renal function assessment. The report is contributed by a student to be published on the website Desklib.

Running Head: TESTS FOR RENAL FUNCTION AND GLOMERULAR FILTRATION RATE
TESTS FOR RENAL FUNCTION AND GLOMERULAR FILTRATION RATE
Name of the Student:
Name of the University:
Author’s Note:

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

7TESTS FOR RENAL FUNCTION AND GLOMERULAR FILTRATION RATE
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.

8TESTS FOR RENAL FUNCTION AND GLOMERULAR FILTRATION RATE
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