Glomerular filtration and its regulation: Starling forces, autoregulation and tubuloglomerular feedback
The filtration barrier, the Starling forces that set GFR, how afferent and efferent arteriolar tone change GFR and filtration fraction, and how myogenic autoregulation and tubuloglomerular feedback explain the effects of ACE inhibitors, SGLT2 inhibitors and NSAIDs on kidney function.
Tier 1Medical sciences concept
Written with AI assistance and fact-checked against the sources below. For exam study, not clinical decisions. How notes are made
At a glance
- GFR is about 125 mL/min (180 L/day). Filtration fraction is about 20% of renal plasma flow.
- GFR depends on the Starling forces across the glomerular capillary and the filtration coefficient (Kf), which is large because the capillary surface is large and permeable.
- Afferent tone sets inflow; efferent tone sets glomerular pressure. The ratio between them is how the kidney protects GFR when perfusion falls.
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Sources
- Brenner and Rector's The Kidney (11th ed.)Elsevier (Yu et al., 2020), 2020
- Guyton and Hall Textbook of Medical Physiology (14th ed.)Elsevier (Hall and Hall, 2021), 2021
- KDIGO 2024 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney DiseaseKidney Disease Improving Global Outcomes (Kidney Int 2024;105(4S):S117-S314), 2024
- Sodium glucose cotransporter 2 inhibitors in the treatment of diabetes mellitus: cardiovascular and kidney effects, potential mechanisms, and clinical applicationsCirculation (Heerspink, Perkins, Fitchett, Husain and Cherney, 2016;134:752-772), 2016
- Renal hemodynamic effect of sodium-glucose cotransporter 2 inhibition in patients with type 1 diabetes mellitusCirculation (Cherney et al., 2014;129(5):587-597), 2014
- The renal hemodynamic effects of the SGLT2 inhibitor dapagliflozin are caused by post-glomerular vasodilatation rather than pre-glomerular vasoconstriction in metformin-treated patients with type 2 diabetes in the randomized, double-blind RED trialKidney International (van Bommel et al., 2020;97(1):202-212), 2020
- Last updated
- 14 November 2026
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