1.3.1 Glomerular Filtration Function and Renal Blood Flow II Flashcards

1
Q

How does dilation of efferent arterioles affect blood flow resistance, RBF, and glomular capillary pressure? What is the net effect on GFR?

A

Decrease blood flow resistance

Increase RBF (tends to increase GFR)

Drop in glomerular capillary pressure (tends to decrease GFR)

Net effect: Small drop in GFR

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2
Q

Between which arterial pressures does RBF and GFR remain fairly constant?

A

90 and 180 mm Hg

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3
Q

What are some of the extrinsic regulators of RBF and GFR?

A

Sympathetic nerves

Humoral factors (ANG II, prostaglandins, NO, bradykinin, endothelin, adenosine)

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4
Q

What are the two mechanisms through which renal blood flow is autoregulated?

A
  1. The myogenic response
  2. The tubuloglomerular feedback
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5
Q

Describe the cellular mechanism of ANG II action on the adrenal glands.

A

ANG II binds AT1 on the surface of the adrenal cell. This activates PLC which produces IP3 and DAG. These two cellular factors work to increase Ca and PKC. The net effect in the activation of txn factors and aldosterone synthesis.

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6
Q

Describe the cellular mechanism of ANG II on SM cells of vessels.

A

ANG II binds AT1 on the surface of SM cells. This stimulates PLC to produce IP3 and DAG. These two pathways act to increase the Ca++ within the SM cell resulting vasoconstriction

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7
Q

The myogenic response mainly involves which type of arteriole?

A

Afferent

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8
Q

How does dilation of afferent arterioles affect blood flow resistance, RBF, and glomular capillary pressure? What is the net effect on GFR?

A

Drop in blood flow resistance

Rise in RBF

Rise in glomerular capillary pressure

Net effect: Increase in GFR

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9
Q

What are some of the other substances produced by the kidney that have an endocrine function?

A

Prostaglandins: vasodilation, reduce Na+ reabsorption

Kinins: vasodilation

Endothelin: vasoconstriction

Urodilatin: Na+ secretion in collecting ducts

Dopamine: Vasodilation, reduced Na+ reabsorption

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10
Q

What is the normal value for glomerular filtration rate (GFR)?

A

125 mL/min, 180 L/day

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11
Q

Describe the pathway through which renin leads to vasconstriction, Na+ retention, and Na+ reabsorption in proximal tubules.

A
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12
Q

How does constriction of efferent arterioles affect blood flow resistance, RBF, and glomular capillary pressure? What is the net effect on GFR?

A

Increase blood flow resistance

Slows RBF (tends to reduce GFR)

Rise in glomerular capillary pressure (tends to increase GFR)

Net effect: Small rise in GFR

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13
Q

ANG II stimulates the adrenal gland to release what? What effects does this hormone have on Na+ and K+?

A

The release of aldosterone.

Aldosterone incites Na+ and water absorption while promoting K+ secretion

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14
Q

Describe the cellular mechanisms leading to renin release

A

Decreased delivery of Na to the macula densa has two effects: inhibits the production/release of adenosine and increases its production of PGE2. The PGE2 passes through the mesangial cells and binds to a receptor on the granular cell of the afferent arteriole. As a result of the decreased adenosine signals and increased PGE2 signals, the granular has reduced calcium leading to the release of renin.

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15
Q
A
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16
Q

Describe the tone of the artery (dilated, normal, or constricted) at the following pressures: 200, 125, 60?

A

60: dilated
125: normal
200: constricted

17
Q

What are some of the stimuli for increased renin release?

A

Increased sympathetic nerve activity

Decreased renal blood perfusion

Decreased Na delivery to macula densa

18
Q

Describe the TGF mechanism at the cellular level.

A

Increased Na and Cl delivery to the macula densa leads to the release of adenosine from the macula densa. The adenosine binds to the A1 receptor on SM cells of the afferent arteriole resulting in an increased in Ca levels. The increased calcium leads to vasoconstriction of the afferent arteriole

19
Q

When thinking of the kidney as a sprinkler how does constriction of the afferent/efferent arterioles effect the spray?

A
20
Q

Draw of the juxtaglomerular apparatus (include renal tubule, macula densa, proximal tubule, glomerular capillaries, afferent arteriole, efferent arteriole, mesangial cells)

A
21
Q

What is the equation for GFR?

A

GFR = KUF * PUF

KUF (includes surface area and permeability)

PUF (net filtration pressure)

22
Q

What is the mechanistic pathway of the myogenic mechanism?

A

Increase BP -> Ateriolar SM stretch -> Arteriolar contraction -> Increase resistance -> little change in RBF

23
Q

Describe the angiotensin effects on renal glomerular arterioles.

A
24
Q

What are the systemic effects of the three endocrine substances produced by the kidney (renin, calcitriol, erythropoietin)?

A

Renin: Vasoconstriction, Na+ retention

Calcitriol: Regulation of Ca and PO4 metabolism

Erythropoietin: RBC production

25
Q

What is the normal value for renal plasma flow (RPF)?

A

660 mL/min, 950 L/day

26
Q

Describe the mechanistic flow of tubuloglomerular feedback.

A

Increased GFR -> increased tubular fluid flow rate -> increased Na and Cl delivery to macula densa -> increased vasoconstrictor signals (adenosine) -> Increase afferent arteriolar constriciton -> decrease RBF

27
Q

What is calcitriol?

A

Active Vit D

28
Q

What three factors influence ultrafiltration and ultimately the GFR?

A

Net filtration pressure, surface area, and permeability

29
Q

What cells release renin?

A

Granular cells of the afferent arteriole

30
Q

How does constriction of afferent arterioles affect blood flow resistance, RBF, and glomular capillary pressure? What is the net effect on GFR?

A

Increases blood flow resistance

Fall in RBF

Fall in glomerular capillary pressure

Net effect: Decrease in GFR

31
Q

What are the four functions of the mesangial cells?

A
  1. Structural support for the glomerular capillaries
  2. Regulate glomerular filtration via their contractile capacity
  3. Function as phagocytes
  4. Secrete paracrine substances
32
Q

Describe the PGC, GFR, RBF changes in the following circumstances: Afferent constriction, efferent constriction, afferent and efferent constriction, no constriction.

A