Exam #4: Glomerular Filtration Flashcards

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1
Q

What is ultrafiltration at the glomerulus?

A

Bulk flow of fluid from the glomerular capillaries into Bowman’s Capsule

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2
Q

What is tubular reabsorption?

A

Returning filtered substances back to the circulation & ECF

See p. 261

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3
Q

What is tubular secretion?

A

Removal of substances from the peritubular capillary blood & adding them to the urine

See p.261

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4
Q

Explain why large, negatively charged molecules are less permeable to the glomerular capillary than smaller or neutral molecules.

A
  • Endothelial cells of the glomerular capillary are negatively charged with mucopolysaccharides
  • Negative charges are present on the filtration slits of the epithelium in the glomerular capillary

*****Because of these negative charges, large negatively charged proteins are repelled from being filtered. Small molecules & neutral molecules are not influenced.

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5
Q

List the Starling forces and tell whether each would promote filtration or not. Write the equation for GFR.

A

N/A

Filtration coefficient= water permeability of hydraulic conductance of the glomerular capillary wall

Hydrostatic pressure in glomerular capillary= favors filtration

Hydrostatic pressure in bowman’s space= pressure from the fluid in the lumen; opposes filtration

Oncotic pressure in glomerular capillary= opposes filtration; this is determined by the protein concentration in the glomerular capillary, which is higher than bowman’s space

See p. 257

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6
Q

Define term filtration fraction.

A

Filtration Fraction is the percent of renal plasma flow (RPF) that is filtered at the glomerulus or,

GFR/RPF= ~20%

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7
Q

How do changes in the filtration fraction affect the oncotic pressure at the efferent end of the glomerular capillaries?

A

High Filtration Fraction= High Oncotic pressure at the efferent arteriole

Low Filtration Fraction= Low Oncotic pressure at the efferent arteriole

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8
Q

Describe the different transport mechanisms that are used for reabsorption.

A

Mechanisms for reabsorption involve transporters in the membranes of the renal epithelial cells

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9
Q

Describe the different transport mechanisms that are used for secretion.

A

Secretin, like reabsorption, involves transporters in the membranes of epithelial cells lining the nephron

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10
Q

Where is Na+ reabsorbed in the nephron?

A
  • First, note that ~99% of the filtered Na+ is reabsorbed through the nephron i.e. urine contains <1% of the filtered Na+

1) 67% of filtered Na+ is reabsorbed in the proximal tubule–isosmotically
2) 25% of filtered Na+ is reabsorbed in the thick ascending limb, WITHOUT WATER
3) Distal tubule & collecting ducts reabsorb the remaining 8%

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11
Q

How is glucose reabsorbed? Trace the path from tubule lumen to capillary describing the transport process used.

A
  • Remember:
    a) Na+ & glucose are cotransported in the early proximal tubule (reabsorbed together)
    b) 100% of filtered glucose is normally reabsorbed by the end of the early proximal tubule

1) Secondary active transport i.e. cotransport of Na+ & Glucose into the early proximal tubule cell (Na+ downhill & Glucose uphill)
2) Glucose is transported into the peritubular capillary blood via facilitated diffusion i.e. GLUT 1 & GLUT2 transport proteins

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12
Q

How is water reabsorbed? Trace the path from tubule lumen to capillary describing the transport process used.

A
  • Reabsorption of solute into the proximal tubule creates a transtubular osmotic gradient that favors water reabsorption here as well
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13
Q

Describe how proteins and peptides are reabsorbed.

A
  • Proteins are reabsorbed in the proximal tubule
  • Enzymes on the luminal surface (inside) degrade proteins into small peptides & amino acids
  • These peptides & amino acids bind receptors on the liminal surface (inside) & are transported by carrier protein to the basolateral membrane
  • Facilitated diffusion or “uniporters” transport these peptides & amino acids into the peritubular capillary
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14
Q

Define “transport maximum.”

A

Point at which increases in concentration do not result in an increase in movement of a substance across a membrane.

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15
Q

Explain why a person with a very high blood level of glucose will have a high urine volume (high urine excretion rate).

A
  • Filtered load= GFR x plasma concentration of substance, in this case, glucose; Increase in plasma glucose = increase in filtered glucose
  • There comes a point at which Na+/glucose cotransporters can no longer keep up & filtered glucose is excreted
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16
Q

What is osmotic diuresis?

A
  • Plasma concentration of glucose > transport maximum of nephron= filtered glucose will be excreted
  • Increased glucose in the urine decreases water reabsorption, leading to increased water in the urine

*Net result= “osmotic diuresis”

17
Q

What does it mean to say that a substance is “freely filtered?”

A

The substance is in the same concentration in the plasma as it is in the ultrafiltrate
- Includes low molecular weight substances e.g. Na+, K+, Cl-, bicarboante…etc.

18
Q

What are the differences between the Starling forces in the glomerular capillaries & regular capillaries?

A
  • Higher hydrostatic pressure b/c the glomerular capillary is between 2x high pressure circuits: afferent & efferent arterioles
19
Q

List the layers of the glomerular capillary.

A

Endothelium
Basement membrane
Epithelium

20
Q

How do the pores of the glomerular endothelium compare to the normal capillary?

A

Pores are larger, which allows fluid, dissolved solutes, and plasma proteins to the filtered across the membrane

*Note that these pores are NOT large enough to normally let RBCs through

21
Q

What specialized cells are contained within the epithelium of the glomerular capillary?

A
  • Podocytes that are attached to the basement membrane by foot processes
  • The gaps between podocytes are filled with “filtration slits” that is closed by a thin membrane
22
Q

Why is there high oncotic pressure in efferent arterioles & peritubular capillaries?

A
  • As fluid if filtered out of the glomerular capillary, protein is left behind.
  • By the end of the glomerular capillary, this oncotic pressure is so high that net ultrafiltration pressure becomes zero.
  • Thus, the blood entering the peritubular capillary has a high oncotic pressure, which drives reabsorption
23
Q

How are Starling’s Forces altered in the glomerular capillary if there is a renal stone obstructing the kidney?

A

Hydrostatic pressure in Bowman’s Space is dramatically increased

24
Q

How is Na+ reabsorbed in the early proximal tubule?

A
  • Remember a total of 67% of the filtered Na+ is reabsorbed in the proximal tubule–isosmotically
  • Na+ moves into the early proximal tubule cell via contransport i.e. Na+ moves DOWN its electrochemical gradient, coupled with glucose, amino acids, phosphate, lactate, and citrate
  • Once in the cell the concentration gradient & electrical gradient DO NOT favor the movement of Na+ into the interstitial fluid; thus, an Na+/K+ ATPase uses “primary active transport” to extrude Na+ into the interstitial fluid

p. 272

25
Q

How is Na+ reabsorbed in the late proximal tubule

A

*Remember a total of 67% of the filtered Na+ is reabsorbed in the proximal tubule–isosmotically

26
Q

What is the countertransport or exchange mechanism that exists in the luminal side of the early proximal tubule?

A

Na+/ H+ exchanger

  • Na+ comes INTO the cell, DOWN its electrochemical gradient
  • H+ is exchanged & moves out of the early proximal tubule cell, into the tubular lumen

p. 272

27
Q

How and where is NaCl reabsorbed?

A
  • NaCl is reabsorbed in the late proximal tubule
  • There are BOTH transcellular & paracellular mechanisms that exist for the reabsorption of NaCl in the late proximal tubule

p. 273

28
Q

What is splay?

A

Not all tubules have exactly the same transport maximum; thus, there is some “splay” in the actual glucose reabsorption vs. ideal

p. 264