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GLOMERULAR FILTRATION: CLINICAL DEFINITION & LAB DIAGNOSIS

1. DEFINITION

Glomerular filtration is the passive, pressure-driven process in the renal corpuscle where water and low-molecular-weight solutes in plasma cross a semipermeable, three-layered barrier into Bowman's capsule, yielding an ultrafiltrate virtually free of cells and large plasma proteins.


2. LABORATORY DIAGNOSTIC MARKERS

A. Serum / Plasma Biomarkers

• Serum Creatinine: Inverse relationship with GFR. Levels rise primarily after $≈ 50\%$ of nephron function is lost.

• Serum Cystatin C: Low-molecular-weight protein produced at a constant rate by nucleated cells; independent of muscle mass, age, and diet.

• Estimated GFR (eGFR): Calculated via CKD-EPI equation using serum creatinine and/or cystatin C.

• Normal: ≥ 90 mL/min/1.73 m^2

• Renal Impairment: < 60 mL/min/1.73 m^2 for ≥ 3 months confirms Chronic Kidney Disease (CKD).

B. Clearance Testing

• Creatinine Clearance (C_Cr): Gold-standard timed collection (24 hours):

  C_Cr = U_Cr × V/P_Cr × 1440

(Where U_Cr = urine creatinine, $V$ = total volume in mL, P_Cr = serum creatinine).

C. Urinalysis & Glomerular Damage Flags

• Proteinuria / Albuminuria: Loss of barrier negative charge or podocyte slit integrity.

Urine Albumin-to-Creatinine Ratio (UACR):

• Normal: < 30 mg/g

• Microalbuminuria: 30 - 300 mg/g (early diabetic nephropathy marker)

• Macroalbuminuria: > 300 mg/g (overt glomerular disease)


Urine Sediment Microscopy:

• Dysmorphic RBCs & RBC Casts: Pathognomonic for active glomerulonephritis.

• Broad / Waxy Casts: Marker of end-stage tubular atrophy and severe nephron hypofiltration.



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📚1. Van den Bergh Reaction is use to detect ?
Ans👉 Serum Bilirubin

📚2. Tuberculous Meningitis which test indicates ?
Ans👉 cob-web- Appearance of clot.

📚3. Who is bad Cholestrol.?
Ans👉 LDL

📚4. Which is add mac conkeys agar to inhibit the growth of gram positive bacteria?
Ans👉 Bile Salt

📚5. Confirmatory Test for Aids?
Ans👉 western Blot test.

📚6. The Fixative use for blood containing specimen is ?
Ans👉 Cornoy's Fluid

📚7. Mycology Means Study of -?
Ans- Fungus

📚8. The basic component of Leishman's Stain is -
Ans👉 methelene Blue.

📚9. The Anticoagulant use in OFT is?
Ans👉 Heparin

📚10. To remove blood clots from blood pipetts it is immersed in 🤔
Ans👉 KOH

📚11. In complete Antibody are detected using. ?
Ans👉 Coombs Test.

📚12. Mycobacterium tuberculosis is also known as-
Ans- Koch's Bacillus

 📚13. mycobacterium Leprae is is also known as -
Ans- hensen's bacillus




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