1 1.

2.

3.1 Na+ K+ Cl- HCO3-

2 3 H+K+4

1.

2.

3.1 I

2

3VitD3 125-OH2-VitD3Ca2+P3- 4 5

4.1 : pH

2 180-200L/ 0.5-1.5L/

3a. K+ H+

b.

c.

2 1 2

1glomerular filtration rate ,GFR)

2.1 ml/min2 U VC= PC(ml/min) V(ml/min)U: mmol/L)P: mmol/L

UV 1.73C= x P A

A

3inulin1

2

Cin= x x

+ =

3 2.0-2.3ml/s

4

4.1 100g(98%)

(endogenous creatinine clearance rate,Ccr)

2 (mol/L)(ml/min)Ccr = (mol/L) Ucr V = Pcr Ucr V 1.73 Ccr= Pcr A[] 80-120ml/min

(3) Ccr 80% 70-51ml/min 50-31ml/min < 30ml/min

5Urea []

[] 3.56-14.28mmol/L: 1.78-7.14mmol/L

6creatinine,Cr)

/ = 10-201 2 3

72 2 -microglobulin, 2 MG 11.8kD

2 MG

8uric acid,UA) 20% 80%

12

9Ccystain C 13kD cystainC

cystainC

1

:

113h[] 8 3h18 8

[]2/3--3/4 1.025 1.003

2[] 600ml810122468 81

[] 24h1000-2000ml 341 12h750ml 1.020 ,0.009

+ 1.010:

2urine osmolUosm1 2 8h

3 800mOsm/kgH2O 300mOsm/kgH2O

(4) Uosm >Posm Uosm

1 NAG2

3TMG[] (TMG)

42-2-MG)

51- 1-MG 26kD

1-MG11-MG 21-MG 1-MG

renal plasma flow,RPF) [] PAH 20% 80% PAH UPAH CPAH= V PPAH

I II III IV

1 NH4Cl H+NH3NH4+ Cl-NH4Cl pH pHpH

2 NaHCO3 90% HCO3-10%II HCO3- HCO3-

3

1

2-MG

2-MG1-MG

2 PAH

T H A N K