CSI 9 main tasks flashcards
What 2 parameters can be used to assess kidney function?
protein in urine
serum creatinine
What 4 processes occur in the kidney?
filtration
reabsorption
secretion
excretion
What is the functional unit of the kidney?
the nephron
What is filtration at the glomerulus mainly based on?
size and charge
What cells perform reabsorption in the kidney?
epithelial cells of renal tubules
What is reabsorbed in the proximal convoluted tubule?
large amounts of electrolytes, glucose and filtered proteins are reabsorbed by active transport and passive diffusion
What cells can secrete substances into the urine?
tubular cells in the kidney
What happens to anything that is filtered and no reabsorbed in the kidney?
it is secreted as waste in urine
What is creatinine?
a non protein molecule generally filtered very easily by glomerulus in healthy individuals, freely filtered, not reabsorbed (very slightly secreted)
What do high creatinine levels in serum suggest?
kidneys aren’t filtering properly
What is protein in urine abnormal?
Because most proteins in filtrate should be reabsorbed and large proteins should never cross filtration barrier
What is the most abundant protein in normal urine?
Tam-Horsfall protein/uromodulin (all comes from secretion)
What are the 3 types of proteinuria?
overflow
glomerular
tubular
What is overflow proteinuria?
excess of small low molecular weight proteins in circulation means that more crosses filtration barrier - epithelial cells of tubules get saturated trying to reabsorb all of it, some protein ends up being excreted
What is difference between haemoglobinuria and haematuria?
haemoglobinuria = excess free Hb in urine from overflow haematuria = bleeding from urinary tract itself, so Hb may be present in urine but alongside intact RBCs
What is glomerular proteinuria?
damage to glomerular filtration barrier means more proteins of large sizes than usual are let through, excess saturates reabsorption in tubules resulting in urinary protein loss
What protein is primarily lost in glomerular proteinuria.?
albumin (flexible, ellipsoid shape - similar size to pores)
What is it called when albumin is found in the urine?
albuminuria
What is tubular proteinuria?
tubules are damage and not able to reabsorb filtered proteins as well
What are all types of proteinuria associated with?
potential saturation of tubular cells in reabsorption
What drugs are the most common causes of acute kidney injury in hospitalised patients?
NSAIDs, ACE-inhibitors, Aminoglycoside inhibitors, contrast agents
What mechanism of protein loss is capable of producing the biggest protein loss?
glomerular proteinuria
