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Old 01-29-2012
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Kidney Donor Kidney Changes after transplant!

A 28-year-old man decides to donate a kidney to his brother, who is in chronic renal failure, after HLA typing suggests that he would be a suitable donor. He is admitted to the hospital, and his right kidney is removed and transplanted into his brother. Which of the following indices would be expected to be decreased in the donor after full recovery from the operation?

(A) Creatinine clearance

(B) Creatinine production

(C) Daily excretion of sodium

(D) Plasma creatinine concentration

(E) Renal excretion of creatinine
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Old 01-29-2012
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Ans ........ D ............
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plasma level of creatinine
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(A) Creatinine clearance-- would increase as kidney function increases

(B) Creatinine production-- depends on the bodies metabolism.. e

(C) Daily excretion of sodium -- will increase due to increase in GFR

(D) Plasma creatinine concentration--- will go down as excess will be excreted


(E) Renal excretion of creatinine-- will increase.. due to increase in GFR.
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Old 01-29-2012
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Quote:
Originally Posted by mbbs2010 View Post
(A) Creatinine clearance-- would increase as kidney function increases

(B) Creatinine production-- depends on the bodies metabolism.. e

(C) Daily excretion of sodium -- will increase due to increase in GFR

(D) Plasma creatinine concentration--- will go down as excess will be excreted


(E) Renal excretion of creatinine-- will increase.. due to increase in GFR.
plasma creatinine conc decrease--bcoz excess will be excreted(option D)= increase renal excretion(option E) acc to ur explanation.please make it clear...
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Old 01-29-2012
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Originally Posted by doctordexter View Post
plasma creatinine conc decrease--bcoz excess will be excreted(option D)= increase renal excretion(option E) acc to ur explanation.please make it clear...
Plasma volume will go down because more is being excreted by the kidney.
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Originally Posted by doctordexter View Post
plasma creatinine conc decrease--bcoz excess will be excreted(option D)= increase renal excretion(option E) acc to ur explanation.please make it clear...

GFR will increase.. hence creatinine CLEARANCE .. will increase.. which will inturn increase the creat EXCRETION


the question asks which one will DECREASE
so thats plasma creat conc.
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Old 01-31-2012
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The correct answer is A. Because creatinine is freely filtered by the glomerulus, but not secreted or reabsorbed to a significant extent, the renal clearance of creatinine is approximately equal to the glomerular filtration rate (GFR). In fact, creatinine clearance is commonly used to assess renal function in the clinical setting. When a kidney is removed, the total glomerular filtration rate decreases because 50% of the nephrons have been removed, which causes the creatinine clearance to decrease. In turn, the plasma creatinine concentration (choice D) increases until the rate of creatinine excretion by the kidneys (choice E) is equal to the rate of creatinine production by the body. Recall that creatinine excretion = GFR x plasma creatinine concentration. Therefore, creatinine excretion is normal when GFR is decreased following removal of a kidney because the plasma concentration of creatinine is elevated.

Creatinine is a waste product of metabolism. Creatinine production (choice B) is directly related to the muscle mass of an individual, but is independent of renal function.

The daily excretion of sodium (choice C) is unaffected by the removal of a kidney. The amount of sodium excreted each day by the remaining kidney exactly matches the amount of sodium entering the body in the diet.
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Quote:
Originally Posted by Hope2Pass View Post
The correct answer is A. Because creatinine is freely filtered by the glomerulus, but not secreted or reabsorbed to a significant extent, the renal clearance of creatinine is approximately equal to the glomerular filtration rate (GFR). In fact, creatinine clearance is commonly used to assess renal function in the clinical setting. When a kidney is removed, the total glomerular filtration rate decreases because 50% of the nephrons have been removed, which causes the creatinine clearance to decrease. In turn, the plasma creatinine concentration (choice D) increases until the rate of creatinine excretion by the kidneys (choice E) is equal to the rate of creatinine production by the body. Recall that creatinine excretion = GFR x plasma creatinine concentration. Therefore, creatinine excretion is normal when GFR is decreased following removal of a kidney because the plasma concentration of creatinine is elevated.

Creatinine is a waste product of metabolism. Creatinine production (choice B) is directly related to the muscle mass of an individual, but is independent of renal function.

The daily excretion of sodium (choice C) is unaffected by the removal of a kidney. The amount of sodium excreted each day by the remaining kidney exactly matches the amount of sodium entering the body in the diet.


ugghhhh misread the question to which of the following would change in the recipient !!!

DAMN IT!
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Old 01-31-2012
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it's not B,C, or D.

can somebody explain to me why its A over D?

surely if you remove a kidney, you are decreasing the amount of creatine that is excreted by the body, no?
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Quote:
Originally Posted by khushi.chahal View Post
it's not B,C, or D.

can somebody explain to me why its A over D?

surely if you remove a kidney, you are decreasing the amount of creatine that is excreted by the body, no?
I think its because the amount of creatinine excreted decreases because GFR decreases. Therefore the amount of plasma level goes up equally.

The CLEARANCE doesn't change .. because you balance out the the increase in plasma levels by the decrease in urine clearance.

And you have to keep in mind that since we removed one kidney, the other kidney will try to compensate but the GFR would never come back to its original levels.

I think thats right ? I am not too sure.. just trying to work it out conceptually lol
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Old 11-23-2013
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In the donor, plasma creatinine is expected to be decreased after full recovery from the surgery. However, if you want to know the detailed information about it, you can seek an opinion of transplant center professionals at Justsavelives.com or you can read some helpful blogs at kidneycare.com. I hope you will get some information on it.
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