Dr. ATUL TIWARI (M.D.) INTERNATIONAL UMPIRE - (Table Tennis) Sr. VICE PRESIDENT- MP Table Tennis...
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Transcript of Dr. ATUL TIWARI (M.D.) INTERNATIONAL UMPIRE - (Table Tennis) Sr. VICE PRESIDENT- MP Table Tennis...
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• Dr. ATUL TIWARI (M.D.)
INTERNATIONAL UMPIRE - (Table Tennis)Sr. VICE PRESIDENT- MP Table Tennis Asso.
NATIONAL AWARDEE- S. Radhakrishnan Award (For- Teaching Excellence)
PROFESSOR- Physiology-JMC- Jhalawar (RAJ)PRESIDENT- Medical Teacher Asso (JMCTA) - JMCPRESIDENT-Student Welfare Society (SWS) -JMCCHIEF NODAL OFFICER- Medical Education Unit (MEU) - JMC CONVENER- Anti-Ragging Committee (ARC) - JMCCHIEF NODAL OFFICER- College Website Committee (CWC) - JMCCHIEF ORGANIZER- Cultural, Literary. Fine Arts & Sports- JMC
Secretary- Gwalior Dist. TT AssociationEx- Secretary- IMA- Gwalior (4 Yrs)Ex- National Office Secretary- NMO (6Yrs)Ex- Radio Singer (BL- Akashwani)Ex- Radio Announcer (Casual- Akashwani)- Poet &, Prose & Script writer - Stage Anchor- Music Composer.
Contact- 9602691106. 9414226811. 9826224474 (Gwl)
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INULINE CLEARANCE
NOTHING OF THIS SHOULD BE OMMITED
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BY- DR. ATUL TIWARI 3
Plasma Clearances• Renal clearance of a substance is the volume of plasma that is completely cleared of the that substance by the kidneys per unit Time.
• However this definition is quite abstract because there is no volume of plasma that is cleared COMPLETELY!
• (Basic formula is C=U X V/P (Put “s” with all except “V”)
Cs = Us X V/ PsCs X Ps = Us X V
Cs = Rate at which Plasma that is cleared of a substance each min (ml / Min)Us = Conc. of Substance In Urine (mg / ml)Ps = Plasma Conc. Of substance (mg / ml)V = Urine Flow Rate (ml / Min)
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4
Inulin Clearance
If a substance is freely filtered (filtered as freely as water or Glucose) but is not reabsorbed or secreted by the renal tubules, Than its clearance rate would be equal to GFR-As per formula(I) Ci = Ui X V = GFR OR Ci X Pi = Ui X V = GFR X Pi (Filtered Load) Pi OR (II) Clearance rate will be equal to GFR & Its rate of excretion in Urine
Ci X Pi = GFR X Pi = Ci = GFR = Ui X V OR(III) Clearance value will be equal to filtered Load
Ci X Pi = GFR X Pi (Filtered Load)
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BY- DR. ATUL TIWARI 5
Inulin Clearance & GFR
Inulin is the substance that is filtered completely in Glomerulus & it is neither secreted nor reabsorbed in tubules.
Other substances that have been used clinically to estimate GFR include radioactive iothalamate and Creatinin.
Please remember that Ci is Clearance Rate & is = Ui X V / Pi
While Ci X Pi is Clearance Value & is = Ui X V
Value & importance of both are same in normal conditions.
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BY- DR. ATUL TIWARI 6
Calculation for InulinSince Pi is 1 & V is 1 under normal conditions so GFR = Ui = Ci
Please note that-if Inulin was 1mg / ml in Plasma & was Completely filtered than its Conc. in Urine would be 125mg /ml because GFR is125/
ml/Min. It was not re-absorbed at all. At this GFR Urine flow is 1 ml / Minute
So Here- Ci = GFR & Since Ci = Ui X V / Pi so
GFR would also Be the same I.E. GFR = Ui X V / Pi OR GFR X Pi (FL) = Ci X Pi = Ui X V / Pi (I.E. FL = Clearance value)
I.E. -GFR X Pi (125 X 1) = Cinulin X Pi (125 X 1) = Ui X V (125 X 1)
Or GFR = Ci = 125ml (Ui) X 1ml / Min (V) / 1mg / ml (Pi) = 125ml / Min
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BY- DR. ATUL TIWARI 7
Estimation of GFR BY Inulin clearance
Please note that same is the formula for Cs so Ci = Ui X V/Pi= GFR
OR
Cin = 125 X1 / 1 = 125ml / Min = GFR