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400 mL/min
19%
39/207
600 mL/min
8%
17/207
800 mL/min
9%
18/207
1.0 L/min
51%
106/207
1.2 L/min
7%
14/207
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This patient’s renal blood flow (RBF) is calculated to be 1.0 L/min using the values provided in the question stem and the equations detailed in the explanation below. Creatinine clearance can be used as the best available estimate of glomerular filtration rate (GFR).The serum creatinine value provided in the question stem is extraneous information and is not necessary in the calculation of the patient's renal blood flow. Calculation: RBF = RPF / (1 - HCT) RPF = GFR / FF RBF = (GFR/ FF) / (1-HCT) RBF = (100/0.25) / (1-0.6) = 400/0.4 = 4000/4 = 1,000mL = 1L Where RBF = renal blood flow, RPF = renal plasma flow, HCT = hematocrit, and FF = filtration fraction. Epstein summarizes changes in renal function that occur with aging. The report states that beyond 30 years, kidney size begins to decrease as does total renal blood flow, outer cortical flow, glomerular filtration rate and the ability both to conserve and to excrete sodium. The kidney also begins to experience a decline in concentrating ability. Ferguson et al. explore renal function markers, including emerging methods for clinical estimation of GFR. They note that plasma creatinine concentration is the most widely used estimation of GFR. Currently, plasma cystatin C and ß-trace protein are being investigated as potential replacements but of yet, have not replaced creatinine. The calculation can be seen in Illustration A below. Incorrect Answers: Answers 1-3, 5: These values are not correct calculations of GFR.
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