Notes on Renal Clearance

    Rahul's Noteblog     Notes on Nephrology     Notes on Renal Clearance

Clearance = volume of plasma that is completely cleared of the substance by kidneys per unit time.
Clearance is determined by plasma concentration and excretion rate.

Clearance of some substances:
Glucose: normally 0; clearance rises as plasma concentration rises; as plasma concentration continues to rise, clearance increases approaching that of insulin but never being equal to that of insulin.

Insulin: always excreted; not metabolized, not reabsorbed, and not secreted. 100% insulin is freely excreted. The greater the water reabsorption, the greater the increase in insulin concentration in urine; meaning, greater water reabsorption decreases water excretion, which causes concentrated urine.

Creatinine: completely filtered and some is secreted; used to measure GFR in clinical settings.

PAH: clearance = renal plasma flow (RPF); as plasma concentration rises, carriers in nephrons reach saturation. As plasma concentration rises further, clearance = GFR. Some PAH is always secreted.

Additional Reading:

Basic Nephrology

1. Renal Control in Acid-Base Balance
2. Renal Processes
3. Renal Clearance
4. Regional Transport

Related Topics

1. Kidney Disorders
2. Histology of the Urinary System

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