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Related Concept Videos

Renal Drug Excretion: Glomerular Filtration01:02

Renal Drug Excretion: Glomerular Filtration

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The kidney serves as the primary organ responsible for eliminating drugs and their metabolites from the body. This process, known as renal elimination, starts with glomerular filtration and results in urine formation. Each kidney houses millions of functional units called nephrons, where urine production occurs. A nephron has two main components: a renal corpuscle and a renal tubule.
Drugs gain access to the kidney via the renal artery, which progressively branches off into afferent arterioles....
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Glomerular Filtration Rate and its Regulation01:28

Glomerular Filtration Rate and its Regulation

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The Glomerular Filtration Rate (GFR) is a measure of kidney function, reflecting the volume of filtrate formed per minute in the kidneys. On average, GFR is approximately 125 mL/min in males and 105 mL/min in females. Maintaining a relatively constant GFR is essential for the kidneys to effectively regulate body fluid homeostasis and maintain extracellular stability.
GFR regulation involves two primary intrinsic controls: the myogenic and tubuloglomerular feedback mechanisms.
The myogenic...
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Renal Clearance01:23

Renal Clearance

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The glomerular filtration rate (GFR) is a critical marker of kidney function, reflecting the efficiency of filtration by the glomeruli. Renal clearance of specific substances, such as inulin or creatinine, is commonly used to measure GFR.
Renal clearance refers to the volume of plasma cleared of a specific substance, such as creatinine, per unit of time. To measure clearance, urine samples are collected over a 24-hour period during each bladder voiding, followed by a single blood sample at the...
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Factors Affecting Renal Clearance: Renal Impairment01:17

Factors Affecting Renal Clearance: Renal Impairment

99
Renal dysfunction significantly impairs the renal clearance of drugs, leading to potential complications in drug therapy. Renal failure, which can be caused by various factors, poses a significant challenge in the elimination of drugs from the body.
One condition associated with renal failure is uremia. Uremia is characterized by impaired glomerular filtration and fluid accumulation in the body. This condition hinders the renal clearance of drugs, resulting in drug accumulation and potential...
99
Glomerular Filtration: Net Filtration Pressure01:26

Glomerular Filtration: Net Filtration Pressure

2.5K
Glomerular filtration, a key process in the kidneys, is regulated by three main pressures: Glomerular blood hydrostatic pressure (GBHP), Capsular hydrostatic pressure (CHP), and Blood colloid osmotic pressure (BCOP).
GBHP, with an average value of 55 mmHg, promotes filtration by pushing water and solutes through the filtration membrane. This is balanced by two opposing forces: CHP, a "back pressure" exerted against the filtration membrane by fluid already in the capsular space and renal...
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Renal Corpuscle01:20

Renal Corpuscle

2.3K
The glomerulus and Bowman's capsule are two essential components of the nephron, which is the functional unit of the kidney. These microscopic structures play a critical role in the process of blood filtration to produce urine.
Glomerulus: Structure and Function
The glomerulus is a tiny, intricate network of capillaries located at the beginning of the nephron. It's enveloped by the Bowman's capsule and receives its blood supply from an afferent arteriole, which divides into numerous...
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Updated: Jul 9, 2025

Assessment of Kidney Function in Mouse Models of Glomerular Disease
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Assessing GFR With Proenkephalin.

Remi Beunders1,2, Leslie J Donato3, Roger van Groenendael1,2,4

  • 1Department of Intensive Care Medicine, Radboud University Medical Center, Nijmegen, The Netherlands.

Kidney International Reports
|November 29, 2023
PubMed
Summary
This summary is machine-generated.

A new proenkephalin (PENK) based equation for estimating glomerular filtration rate (eGFR) shows improved accuracy over traditional creatinine-based methods. This novel biomarker offers a more sensitive approach to monitoring kidney function in diverse patient populations.

Keywords:
acute kidney injurycreatinineestimated glomerular filtration rategold standardkidney functionproenkephalin

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Area of Science:

  • Nephrology
  • Biomarker Discovery
  • Clinical Chemistry

Background:

  • Current estimations of glomerular filtration rate (eGFR) rely on creatinine, a biomarker known for its insensitivity and late detection of kidney dysfunction.
  • Novel biomarkers are needed to overcome the limitations of creatinine-based eGFR calculations.

Purpose of the Study:

  • To develop and validate a novel proenkephalin (PENK)-based equation for estimating glomerular filtration rate (eGFR).
  • To compare the performance of the PENK-based eGFR equation against established creatinine-based equations (MDRD and CKD-EPI).

Main Methods:

  • An international multicenter study involving 1354 patients (stable and critically ill) with measured GFR (mGFR) using iohexol or iothalamate clearance.
  • Equation development utilized a generalized linear model with a sigmoidal nonlinear transfer function, with covariates selected in a data-driven manner.
  • Performance was assessed for bias, precision, and accuracy (P30) in a validation set and compared to MDRD and CKD-EPI equations.

Main Results:

  • The PENK-based equation incorporated PENK, creatinine, and age, demonstrating superior performance without the use of sex or race.
  • The PENK-based equation exhibited significantly lower bias compared to MDRD and 2009 CKD-EPI, and comparable bias to 2021 CKD-EPI.
  • Accuracy (P30) for the PENK-based equation was 83%, significantly higher than MDRD (68%) and 2009 CKD-EPI (76%), and similar to 2021 CKD-EPI (80%).

Conclusions:

  • The proenkephalin (PENK)-based equation for eGFR demonstrates enhanced performance compared to most creatinine-based equations.
  • This novel equation offers a more accurate and potentially earlier assessment of kidney function, independent of sex or race.