Kidney function tests

Edmund Lamb, Ph.D., David J. Newman, Ph.D., and Christopher P. Price, Ph.D. 

Specific defects in particular functions of the nephrons can also be identified and evaluated. For example, assessment of the maximum concentrating capacity of the kidneys gives an estimate of antidiuretic hormone (ADH)-controUed reabsorption of solute-free water in the distal portion of the tubule. Pinpoint defects, caused by genetically determined deficiencies of specific tubular transport systems or ion channels and giving rise to characteristic biochemical disorders, are considered in Chapter 45. 

Creatinine is the cyclic anhydride of creatine that is produced as the final product of decomposition of phospho- 

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Gross and microscopic examination Hemogram Liver and kidney function tests... 

A number of clinical tests are available to detect kidney damage. The clinician examining a patient or the toxicologist monitoring an animal toxicity stndy collects urine and blood samples. Indications of kidney damage (which, of course, for the human patient could be related to many factors other then chemical toxicity) include urinary excretion of excessive amonnts of proteins and glucose, and excessive levels in the blood of unexcreted waste products such as urea and creatine. A number of additional kidney function tests are available to help pin down the location of kidney dysfunction. 

Monitoring Perform periodic blood counts and liver and kidney function tests. Discontinue use if blood dyscrasias or signs of hepatic or renal disorders occur. Frequently measure arterial blood pressure during IV use. 

Monitoring In prolonged therapy, perform liver/kidney function tests and blood counts. 

No evidence of liver or kidney dysfunction was found in 73 male workers employed for an average of 8.2 years (range, 0.5-23 years) in a plant in the Netherlands producing allyl chloride, 1,3-dichloropropene, epichlorohydrin and hexachlorocyclopentadiene. Mean allyl chloride concentrations ranged from 0.21 to 2.89 mg/mL the values for hexachlorocyclopentadiene ranged from 0.01 to 0.23 mg/mL Exposures to 1,3-dichloropropene and epichlorohydrin were well below the current maximmn allowable concentrations. The results of the liver and kidney function tests were compared with those of 35 men in the same plant who were not occupationally exposed to these chemicals (Boogaard et al., 1993). 

Some studies of renal function in chromate production workers found negative or equivocal results. In a survey of a facility engaged in chromate production in Italy, where exposure concentrations were 0.01 mg chromium(VI)/m3, results of periodic urinalyses of workers who worked in the production of dichromate and chromium trioxide for at least 1 year were generally unremarkable, with the exception of one case of occasional albuminuria and a few cases of slight urobilinuria (Sassi 1956). As part of a mortality and morbidity study of workers engaged in the manufacture of chromium(VI) compounds (84%) and chromium(III) compounds (16%) derived from chromium(VI) in Japan, 94 workers who had been exposed for 1-28 years were given a complete series of kidney function tests (not further characterized) 3 years after exposure ended. All values were within normal limits (Satoh et al. 1981). 

Before initiating treatment, kidney function tests (including creatinine and urine specific gravity) and thyroid function tests electrocardiogram for patients over 50... 

Repeat kidney function tests 1-2 times/year... 

Hotz P, Pllllod J, Bernard A, Berode M, Rey F, Mazzocato C, Guillemin M, Boillat MA. Hydrocarbon exposure, hypertension and kidney function tests. Int Arch Occup Environ Health 1990 62 501-508. 

Supportive care must be instituted for patients accidentally exposed to aerosol contents via topical, inhalation, or oral routes. A number of chemicals produce abnormalities of the hematopoietic system, liver, and kidneys. Monitoring complete blood count, urinalysis, and liver and kidney function tests is suggested for patients with significant exposure. 

Consultant Clinical Scientist Department of Clinical Biochemistry East Kent Hospitals NHS Trust Kent and Canterbury Hospital Canterbury, Kent, United Kingdom Kidney Function Tests Kidney Disease... 

Carshalton, Surrey, United Kingdom Kidney Function Tests Kidney Disease... 

Creatinine has no useful function and is eliminated by renal glomerular filtration and to a small extent by renal tubular secretion. Creatinine clearance approximately parallels the glomerular filtration rate (GFR) and is used as a kidney function test. It is calculated as follows ... 

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