5 GFR and Filtration Flashcards

1
Q

What are the functions of the kidney? (4)

A
  • Regulation
    • Conc of ECF
  • Excretion
    • eg urea
  • Endocrine
    • Renin, EPO, prostaglandins
  • Metabolism
    • active form of Vitamin D, insulin catabolism, calcitonin
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2
Q

Describe the path taken by blood from the renal artery to the afferent arterioles.

A

Renal artery

5 Segmental arteries

Interlobar arteries

Arcuate arteries

Interlobular arteries

Afferent arterioles

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3
Q

What causes the (relatively) higher hydrostatic pressure of blood in the glomerulus?

A

Diameter of afferent arteriole is slightly greater than diameter of efferent arteriole

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4
Q

The increased hydrostatic pressure in the blood in the glomerulus helps to force what components out of the blood?

A

Water, salts, glucose, urea

(NOT blood cells and plasma proteins as larger)

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5
Q

What is ultrafiltrate and how much of it does the body produce in a day?

A

Ultrafiltrate: (of plasma) plasma without cells and large organic molecules

180L per day

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6
Q

What is a normal GFR?

A

125 mL/min

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7
Q

Describe the glomerular capillaries.What is their function?

A

Small tuft of inter-connecting capillaries with fenestrated endothelium and specialised basement membrane

Function:

Selective filtration of blood

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8
Q

What is a podocyte and what is its function?

A

Specialised epithelial cell

Have ‘foot processes’ (pedicels)–> connect to basement membrane

Gaps between pedicels= filtration slits

Filtration slits= critical for selective permeability

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9
Q

Describe bowman’s capsule.

A

Layer of epithelial cells- surround glomerular capillaries- continuous with epithelium of proximal tubule so fluid directed into proximal tubule

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10
Q

What is the name for the cells that maintain the basement membrane in which the glomerular capillaries are embedded (providing them with structural support). What is the basement membrane made up of?

A

Mesangial cells (connected together by gap junctions)

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11
Q

What makes up the juxtaglomerular apparatus?

A
  • Macula densa cells (salt sensors)
  • Mesangial cells
  • Afferent and efferent glomerular arterioles
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12
Q

What do the macula densa cells do?

A

Sensitive to changes in NaCl conc

–> affects renin release by juxtaglomerular cells

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13
Q

What % of blood arriving at the glomerulus exits via the efferent arteriole unfiltered?

A

80%

(Only 20% filtered)

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14
Q

Name some solutes which may be symported (active transport) back from the tubules with sodium.

A

Lactate

Acetate

Ketones

Glucose

Amino acids

Vitamin C

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15
Q

What is ‘tubular secretion’?

A

Substances- added to glomerular filtrate in nephron tubule- from epithelial cells lining renal tubules and collecting ducts - to remove excessive quatities from body eg:

  • H+
  • K+
  • NH4+
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16
Q

Name the 2 mechanisms used to autoregulate renal blood flow to the glomerulus (and therefore GFR).

(Protects glomerular capillaries against increased perfusion pressure that could cause structural damage)

A

Myogenic (faster) (smooth muscle)

Tubuloglomerular (TG-F) (slower)

17
Q

Describe how the myogenic response works. (will reference to glomerulus)

A

Opening of stretch activated cation channels in vascualr smooth muscle

Depolarisation: influx of Ca2+ stimulates contraction

18
Q

Describe how the tubuloglomerular feedback works.

A

Macula densa cells- sense increase in glomerula filtration rate

BECAUSE increase in NaCl concentration increases NaCl

Causes vasoconstriction

More detail:

NaCl delivered to distal convoluted

Causes more Na and Cl ions to move into Macula densa

Increase intracellular conc of NaCl in macula densa–> triggers release of ATP

ATP exits macula densa

ATP converted to AMP

Adenosine binds to mesangial cells

Activation of GPCRs

Rise in intracellular calcium- vasoconstriction of afferent arteriole

19
Q

Differentiate between osmolarity and osmolality.

A

Osmolality= solute per kg of solvent

Osmolarity= number of osmoles of solute per litre

20
Q

What is the filtration fraction?

A

% volume of fluid reaching kidneys that passes into renal tubules (= about 20%)

21
Q

In which type of nephron (cortical or juxtamedullary) does autoregulation take place?

A

Cortical

22
Q

Fill in the missing labels:

A
23
Q

What is highlighted in pink on this image?

A
24
Q

The selectivity of the barrier in the glomerulus means that inulin is the largest molecule that can pass through. Why is it that smaller, negative molecules may not be able to pass through the barrier?

A

Basement membrane contains glycoproteins

Glycoproteins= negative

25
Q

What is PGC?

A

Hydrostatic pressure in glomerular capillary

26
Q

What forces oppose the PGC?

A
27
Q

What is the immediate response in the glomerulus if the GFR drops?

A

Prostaglandin release

-strong vasodilators- to increase GFR

28
Q

Why is it very important to ask a patient about their kidneys before prescribing NSAIDs?

A

NSAIDs inhibit prostaglandins

So patient won’t be able to recover from sudden drop in GFR

29
Q

Explain how blocking the effect of angiotensin II (eg ACE inhibitors) cause acute renal failure in elderly patients.

A

Angiotensin II helps to maintain GFR when renal perfusion low

Major determinant of efferent vasoconstriction

30
Q

Neural regulation of the GFR occurs in situations such as:

Fight of flight

Ischaemia

Haemorrhage

Describe the neural regulation of GFR.

A

Sympathetic nerve fibres- innervate Afferent and Efferent arterioles

Vasoconstriction occurs