CSI 9 Pre-reading flashcards
What is diabetic nephropathy?
name given to kidney damage caused by diabetes - develops slowly over many years and is also referred to as kidney disease
Symptoms of kidney disease?
may not have visible symptoms in early stages. If it progresses, could notice: - swollen ankles, feet and hands - blood in urine - feeling really tired - being short of breath - feeling sick
How to reduce risk of kidney disease?
- keep blood sugar levels within target range
- keep blood pressure down
- get support to stop smoking
- eat healthily and keep active
- go to all medical appointments
Tests for kidney disease?
(1) urine test (ACR) –> albumin:creatinine ratio looks for signs that protein is leaking into urine
(2) blood test (eGFR) –> tests for waste product called creatinine, this and other info used to measure how well kidneys are working
How is kidney disease treated?
type depends on stage of disease.
May be given ACE inhibitors or ARBs to help keep BP low
may also get advice to avoid certain foods
if kidneys fail then options include dialysis or transplant
What is the glomerulus?
ball of capillaries surrounded by Bowman’s capsule into which urine is filtered
What 3 components make up the filtration barrier?
- endothelial cells of glomerular capillaries
- glomerular BM
- epithelial cells of Bowman’s capsule (podocytes)
Describe the endothelial cells of the glomerular capillaries?
- pores called fenestrae limit filtration of cellular components like RBCs
- luminal surface is glycocalyx consisting of -vely charged GAGs to hinder diffusion of -vely charged molecules
Describe glomerular BM?
- found surrounding endothelium
- mostly made of type IV collagen, heparan sulfate proteoglycans (repel -vely charged molecules) and lamina
- 3 layers that help limit filtration of intermediate to large sized solutes
What are the 3 layers of the glomerular BM?
inner thin layer (lamina rara interna)
a thick layer (lamina densa)
outer dense layer (lamina rara externa)
Describe the epithelial cells of the filtration barrier?
- podocytes specialised cells
- form visceral layer of capsule
- foot like projections interdigiate to form filtration slits
- filtration slits bridged by thin diaphragm (slit diaphragm) which has very small pores to prevent large molecules crossing
- covered by -vely charged glycoproteins resrtict filtration of large anions
What is the filtration rate of molecules of the same charge across the filtration barrier inversely related to?
their molecular weight
What is nephrotic syndrome triad of symptoms?
proteinuria, hypoalbuminaemia, oedema
What are the 3 main hormones of the RAAS?
renin, angiotensin II, aldosterone
What is the RAAS primarily regulated by?
rate of renal blood flow
