Clinical assessment of renal function

Abstract 

The kidney carries out many key functions in the body, including the maintenance of fluid, acid–base and electrolyte homeostasis, the removal of nitrogenous waste, the production of erythropoietin, the hydroxylation of vitamin D and an important influence on regulation of blood pressure. This perhaps explains the increased risk of morbidity and mortality postoperatively in patients with acute or chronic renal impairment. Identification of these patients preoperatively allows the assessment of risk to both the kidneys and other organs. Protective measures can then be used in these patients with close monitoring to minimize poor outcomes. Clinical assessment of kidney function involves a thorough history and physical examination, with supplementary blood and radiological investigations.

Keywords: creatinine, estimated glomerular filtration rate, protein–creatinine ratio, ultrasound, urine dipstick