Free water clearance by the kidney is increased by which of the following
Correct Answer: Diabetes insipidus
Description: Free-water clearance (CH2O) is calculated as the difference between water excretion (urine flow rate) and osmolar clearance.Thus, the rate of free-water clearance represents the rate at which solute-free water is excreted by the kidneys. When free-water clearance is positive, excess water is being excreted by the kidneys; when free-water clearance is negative, excess solutes are being removed from the blood by the kidneys and water is being conserved.Inappropriate secretion of ADH: Either too much or too little ADH secretion results in abnormal water excretion by the kidneys.In Diabetes insipidus: Because the distal tubular segments cannot reabsorb water in the absence of ADH, It results in the formation of a large volume of dilute urine with urine volumes that can exceed 15 L/day.Ref: Guyton; 13th edition; Chapter 29 Urine Concentration and Dilution
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