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Evaluation of Kidney Function Evaluation of Kidney Function
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Serum Creatinine Serum Creatinine
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Urinalysis Urinalysis
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Renal Clearance Renal Clearance
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Renal Imaging Renal Imaging
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Glomerular Disease Glomerular Disease
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Clinical Manifestations of Glomerular Disease Clinical Manifestations of Glomerular Disease
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Nephrotic Syndrome Nephrotic Syndrome
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Nephritic Syndrome Nephritic Syndrome
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Glomerular Disease in Patients Who Present With Nephritic Syndrome Glomerular Disease in Patients Who Present With Nephritic Syndrome
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Poststreptococcal Glomerulonephritis Poststreptococcal Glomerulonephritis
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IgA Nephropathy IgA Nephropathy
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Henoch-Schönlein Purpura Henoch-Schönlein Purpura
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Membranoproliferative Glomerulonephritis Membranoproliferative Glomerulonephritis
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Rapidly Progressive Glomerulonephritis— Crescentic Glomerulonephritis Rapidly Progressive Glomerulonephritis— Crescentic Glomerulonephritis
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ANCA Vasculitides ANCA Vasculitides
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Microscopic Polyangiitis Microscopic Polyangiitis
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Wegener Granulomatosis Wegener Granulomatosis
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Churg-Strauss Syndrome Churg-Strauss Syndrome
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Polyarteritis Nodosa Polyarteritis Nodosa
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Goodpasture Disease: Anti-GBM Antibody–Mediated Glomerulonephritis Goodpasture Disease: Anti-GBM Antibody–Mediated Glomerulonephritis
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Glomerular Disease That Usually Manifests as Nephrotic Syndrome Glomerular Disease That Usually Manifests as Nephrotic Syndrome
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Minimal Change Nephropathy Minimal Change Nephropathy
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Focal Segmental Glomerulosclerosis Focal Segmental Glomerulosclerosis
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HIV-Associated Nephropathy HIV-Associated Nephropathy
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Membranous Nephropathy Membranous Nephropathy
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Other Glomerular Disorders Other Glomerular Disorders
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Diabetic Nephropathy Diabetic Nephropathy
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Systemic Lupus Erythematosus Nephritis Systemic Lupus Erythematosus Nephritis
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Cryoglobulinemic Glomerulonephritis Associated With Hepatitis Infection Cryoglobulinemic Glomerulonephritis Associated With Hepatitis Infection
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Hemolytic Uremic Syndrome and Thrombocytopenic Purpura Hemolytic Uremic Syndrome and Thrombocytopenic Purpura
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Diseases With GBM Abnormalities: Alport Syndrome and Thin GBM Disease Diseases With GBM Abnormalities: Alport Syndrome and Thin GBM Disease
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Alport Syndrome Alport Syndrome
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Thin GBM Disease Thin GBM Disease
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Monoclonal Gammopathies Monoclonal Gammopathies
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Multiple Myeloma Multiple Myeloma
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Amyloidosis Amyloidosis
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Light Chain Deposition Disease Light Chain Deposition Disease
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Congenital Nephrotic Syndrome Congenital Nephrotic Syndrome
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Tubulointerstitial Disease Tubulointerstitial Disease
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Clinical Manifestations of Tubulointerstitial Renal Disease Clinical Manifestations of Tubulointerstitial Renal Disease
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Acute Interstitial Nephritis Acute Interstitial Nephritis
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Analgesic Chronic Interstitial Nephritis Analgesic Chronic Interstitial Nephritis
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Cystic Renal Disease Cystic Renal Disease
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Autosomal Dominant Polycystic Kidney Disease Autosomal Dominant Polycystic Kidney Disease
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Medullary Sponge Kidney and Acquired Renal Cystic Disease Medullary Sponge Kidney and Acquired Renal Cystic Disease
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Part I Evaluation of Kidney Function, Glomerular Disease, and Tubulointerstitial Disease
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Published:August 2010
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Abstract
Several measures are used to evaluate kidney function: serum creatinine, urinalysis, renal clearance, and renal imaging. Creatinine is an end product of muscle catabolism and is commonly used as a filtration marker. Dysmorphic erythrocytes in the urinary sediment indicate bleeding in the upper urinary tract. A urine pH less than 5.5 excludes type 1 renal tubular acidosis. A pH greater than 7 suggests infection. Acidic urine is indicative of a high-protein diet, acidosis, and potassium depletion. Alkaline urine is associated with a vegetarian diet, alkalosis and urease-producing bacteria. Clearance of p-aminohippurate is a measure of renal blood flow. Kidney function is evaluated to determine disease states such as glomeruluar disease or tubulointerstitial disease. Clinical manifestations of glomerular injury can vary from the finding of isolated hematuria or proteinuria, or both. In addition, some patients who present with advanced renal insufficiency, hypertension, and shrunken, smooth kidneys are presumed to have chronic glomerulonephritis. Acute and chronic interstitial disease preferentially involves renal tubules.
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