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Pharmacology & Medical Chemistry II > Exam 1: Lecture 1: Renal Physiology > Flashcards

Exam 1: Lecture 1: Renal Physiology Flashcards

1
Q

Nephron

A

Basic unit of the Kidney

Each kidney has about 1 million Nephrons

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2
Q

Efferent arteriole

A

Moving away

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3
Q

Afferent arteriole

A

Moving towards

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4
Q

Different cell types in Nephron

A

Polarized cells (1 side different than other)

Ciliated Cells in PCT = Good SA for absorption

Collecting Duct = Bigger cells, less exchange occurs here

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5
Q

Glomerular Mesangial Cells

A

Supportive cell of Glomerulus (Immune cells)

Act as phagocytes and remove trapped material from basement membrane of capillaries, make sure not blocked.

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6
Q

Podocytes

A

Supportive cell of Glomerulus

Structural cells that help maintain structural capillaries

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7
Q

Juxtaglomerular apparatus (JGA)

A

“Sensor”

Important for regulating blood pressure and flow

Contact point, Made up of two cells

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8
Q

JGA is made up of 2 cell types

A

Granular cells/Juxtaglomerular cells

Macula Densa Cells

Point of contact

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9
Q

Macula Densa Cells

A

Portion of Thick Ascending Limb that between afferent and efferent arterioles.

“Detector cells” of flow rate and composition of fluid within Nephron

control GFR and secretion of renin from Granular cells

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10
Q

Granular cells

A

Secretory cells that secrete Renin

within afferent arterial

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11
Q

What is Renin

A

Hormone

Controls renal function and sodium balance

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12
Q

Additional Kidney Regulation

A

Renal circulation

Lymphatics within Kidney

Capsule (Role is to limit swelling)

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13
Q

Renal plasma clearance

A

Volume of plasma from which a substance is removed from the kidney during a given amount of time

ml/min

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14
Q

Stages of Chronic Kidney Disease

A

Stages 1-5

GFR and % of Kidney Function decreases as go towards stage 5

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15
Q

4 Main Functions of the Kidney

A

Filtration
Reabsorption
Secretion
Endocrine (RAAS)

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16
Q

Excretion =

A

Filtration - Reabsorption + Secretion

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17
Q

Filtration occurs at the level of…..

A

the Glomerulus and Bowmans Capsule

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18
Q

Proximal Convoluted Tubule water permeability

A

High

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19
Q

Loop of Henle ( Thin Descending Limb) water permeability

A

Permeable to water

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20
Q

Loop of Henle ( Thick Ascending Limb) water permeability

A

nearly impermeable to water

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21
Q

Where does concentration of urine occur?

A

Loop of Henle

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22
Q

Distal Convoluted Tubule + Collecting Duct water permeability

A

Variable permeability

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23
Q

“Vital” Reabsorption and Secretion occurs at the….

A

PCT

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24
Q

“Optional” Reabsorption and Secretion occurs at the…

A

DCT and Collecting Duct

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25
water goes where....
Na and Cl go
26
Apical Membrane is the....
Lumenal side
27
Basal Membrane is the....
Side facing interstitial fluid, capillary space
28
3 Hormones kidney synthesize and secrete....
Activated Vitamin D3 made in kidney Erythropoietin Renin
29
Activated Vitamin D3 role
promote calcium conservation and increase calcium absorption + reducing calcium loss
30
Erythropoietin
activates synthesis of red blood cells, increasing blood oxygen capacity. Negative feedback loop Kidney release EPO if low O2 in blood.
31
Renin
enzyme released by JGA in response to a decrease in effective circulating blood volume
32
Renin-angiotensin system
1. Drop in blood pressure or fluid volume (Macula dense cells sense it) 2. Renin released from kidney and acts on angiotensinogen (released from kidney) to form angiotensin I 3. ACE is released from lungs, and acts on angiotensin I to form angiotensin II 4. Angiotensin II acts on adrenal gland to stimulate release of aldosterone. 5a. Aldosterone acts on the kidneys to stimulate reabsorption of salt and water, increasing fluid volume 5b. Angiotensin II also acts directly on blood vessels, stimulating vasoconstriction
33
Covid-19 and ACE2
Target for the virus is ACE2, where the spike protein binds ACE2 expressed mostly in the epithelial cells if lungs. certain drugs or pathologies can increase your expression of ACE2 (ie type I/II diabetes or those taking ACE inhibitors or ARBS, angiotensin II type-1 receptor blockers)
34
Drugs that can increase ACE2 expression....
Thiazolidindiones and ibuprofen ARBs
35
Order of collecting system duct
Glomerulus -> PCT -> Loop of Henle -> DCT -> Collecting tubule -> Collecting duct
36
Proximal Tubule
** Reabsorption and secretion ** Any damage here will cause alteration in glucose, potassium and other ion levels Has very high water permeability
37
Two most important compounds for diuretic action?
Sodium bicarbonate and sodium chloride. Will have affect on blood volume and water reabsorption
38
Most important process occurring at PCT is?
Reabsorption ``` 66% of sodium ions 85% of NaHCO3 65% of K+ 60% of water Virtually all glucose and amino acids ```
39
Four main transporters of PCT
NHE3 Na/K ATPase Carbonic anhydrase Sodium-glucose cotransporter
40
NHE3
Sodium Hydrogen Exchanger on the Lumen side Key to how sodium bicarbonate is absorbed H+ binds to HCO3 to make carbonic acid, and gets converted to H20 and CO2. CO2 will passively diffuse into nephron and turned into carbonic acid via carbonic anhydrase. Dissociation of carbonic acid, the sodium bicarbonate now gets transported via transporter into interstitial space and towards capillaries.
41
Na/K ATPase
requires energy and control level of reabsorbed sodium and returning it into interstitial space
42
Carbonic anhydrase
Bicarbonate reabsorption is dependent on this enzyme
43
Sodium glucose cotransporter
Responsible for reabsorbing much of glucose that is filtered by the glomeruli
44
NBCe1-A
transporter that allows HCO3 to exit PCT on basolateral side
45
Loop of Henle has divided into two parts....
Thick Ascending limb and Thin Descending limb
46
Thick ascending limb
about 25% of NaCL reabsorbed thought of as diluting segment, not losing water
47
NKCC2
Transporter for Na/Cl/K in the Thick ascending limb
48
ROMK
drives diffusion of K from NKCC2 back into the tubular lumen this drives transport of Mg and Ca back into blood paracellularly
49
3 Transporters in Loop of Henle
NKCC2 ROMK Na/K ATPase
50
What drives Mg and Ca reabsorption in Loop of Henle?
ROMK channel
51
Distal convoluted tubule
only about 10% NaCl reabsorbed via NCC (sensitive to thiazide diuretics) Generally impermeable to water, also diluting function, Calcium reabsorption under control of parathyroid hormone control.
52
5 Transporters in DCT
NCC PTH-Receptor Na/K-ATPase Na/Ca exchanger Ca/H ATPase
53
NCC transporter
Move sodium and chloride into nephron
54
Na/K-ATPase
moves sodium back into capillaries
55
PTH-Receptor
Drive calcium reuptake in DCT Hormones = transcription factors = slower response by causing up regulation in transporters to bring Ca into cell
56
Na/Ca exchanger and Ca/H ATPase
Move Ca from Nephron back out into the blood towards capillaries
57
Collecting Tubule System
Final chance to get back sodium, only about 2-5% This is the most important site of K+ secretion Aquaporins being inserted from RAAS occur here
58
3 important cell types of collecting Tubule system
Principle cells Alpha/beta intercalated cells
59
EnaC (Collecting Tubule System, Principle cells)
Brings sodium into cell and makes an electrical potential , not a cotransporter, and drives paracellular transport of Cl into blood towards capillaries. This also drives secretion of K
60
Aldosterone (Collecting Tubule System, Principle cells)
Causes increase in ENaC, increasing Na uptake and also increase Na/K ATPase. This is how it drives Na reuptake and regulate water balance
61
Intercalated Alpha cells primary secretion of....
proton secretion H ATPase secrete into Lumen
62
Intercalated Beta cells primary secretion of....
bicarbonate secretion H ATPase balances secretion basolateral side Cl/HCO3 secrete bicarbonate into lumen
63
Aquaporins of the Collecting Tubule System
Aquaporins are not inserted into the membrane Vasopression/ADH binds to receptor, causes cAMP mediated insertion of Aquaporins into luminal side of membrane and this promotes the uptake of water. Then Aquaporins on the basolateral side move water into blood.

Pharmacology & Medical Chemistry II (43 decks)

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