What is the role of glomerular filtration rate (GFR) in the pathogenesis of azotemia?

Updated: Apr 24, 2020
  • Author: Moro O Salifu, MD, MPH, FACP; Chief Editor: Vecihi Batuman, MD, FASN  more...
  • Print

In addition to accumulation of urea creatinine and other waste products, a substantial reduction in GFR in CKD results in the following:

  • Decreased production of erythropoietin (causing anemia) and vitamin D-3 (causing hypocalcemia, secondary hyperparathyroidism, hyperphosphatemia, and renal osteodystrophy)

  • Reduction in acid, potassium, salt, and water excretion (causing acidosis, hyperkalemia, hypertension, and edema)

  • Platelet dysfunction (leading to increased bleeding tendencies)

The syndrome associated with the signs and symptoms of accumulation of toxic waste products (uremic toxins) is termed uremia and often occurs at a GFR of about 10 mL/min. Some of the uremic toxins (eg, urea, creatinine, phenols, and guanidines) have been identified, but none have been found responsible for all the manifestations of uremia.

Did this answer your question?
Additional feedback? (Optional)
Thank you for your feedback!