By Jeremy Hughes; Ashley Jefferson; John Iredale

ISBN-10: 0443071969

ISBN-13: 9780443071966

ISBN-10: 0443071977

ISBN-13: 9780443071973

ISBN-10: 0702047945

ISBN-13: 9780702047947

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Renal artery stenosis, hypovolaemia, severe heart failure), the reduction in the capacity of the kidney to maintain the GFR puts patients at an increased risk of developing acute renal failure. NSAIDs may also lead to acute renal failure in these settings by inhibiting the autoregulatory dilatation of the afferent arteriole by prostaglandins. Learning point Treatment with ACE inhibitors or NSAIDs reduces the capacity of the kidney to maintain the GFR during episodes of renal hypoperfusion, putting the patient at risk of acute renal failure.

Inulin, iohexol, 51Cr-EDTA or 99Tc-DTPA may be used accurately to measure GFR by this methodology, but this requires the intravenous administration of the chosen filtration marker and is not performed routinely. The clearance of creatinine over a 24-h period may be calculated using a 24-h urine collection (urine volume and creatinine concentration) and a serum creatinine measurement. The 24-h creatinine clearance is used in clinical practice to give a useful, albeit approximate, measure of the GFR.

Aldo-R, aldosterone receptor. Patients receiving drugs that may affect serum potassium level Drugs such as loop diuretics may lower serum potassium levels, whereas drugs such as potassium-sparing diuretics, angiotensin 24 2 When should I check potassium level? converting enzyme (ACE) inhibitors, non-steroidal anti-inflammatory drugs (NSAIDs) may increase serum potassium levels. Patients with diabetes mellitus Patients who present to hospital with acute diabetic ketoacidosis often have normal or slightly raised potassium levels as the systemic acidosis promotes the exit of potassium from cells into the extracellular fluid.

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Clinical chemistry made easy by Jeremy Hughes; Ashley Jefferson; John Iredale

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