Formation of urine 1 Flashcards

(41 cards)

1
Q

Overall function of proximal convoluted tubule

A

Reabsorption:

  • water
  • Ions
  • all organic nutrients
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2
Q

Overall function of Loop of Henle

A

Descending limb- more absorption of water.

Ascending limb-
Absorption of NaCl

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3
Q

Overall function of distal convoluted tubule

A

Secretion:

  • Ions
  • Acids
  • Drugs
  • Toxins

Reabsorption:

  • Water
  • Na+
  • Ca2+
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4
Q

Overall function of the collecting duct

A

Variable absorption of water

Reabsorption of:

  • Na+
  • K+
  • H+
  • HCO3-
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5
Q

Papillary duct

A

Section of the nephron that delivers urine to the minor calyx.

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6
Q

Two forces that drive filtration in the nephrons

A

Blood pressure

Differing diameter of afferent and efferent arterioles/ renal blood flow

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7
Q

GFR

A

Glomerular filtration rate
- The rate at which glomerular filtrate is produced.

  • Normally 125mL/min
  • Used as an indicator of renal function.
  • Stays constant even when systemic BP changes due to autoregulation of renal blood flow
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8
Q

Ultrafiltration

  • Definition
  • Molecules filtered
  • Things that stay in the blood
A

The filtration of the blood at a molecular scale.

Small molecules filtered:

  • Electrolytes
  • Amino acids
  • Glucose
  • Metabolic waste
  • Some drugs and metabolites.

Cells and larger molecules stay in the blood.

  • RBCs
  • Lipids
  • Large proteins
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9
Q

Sequence the filtrate passes through during filtration.

A
  1. Pores in glomerular capillary
  2. Basement membrane of Bowman’s capsule.
  3. Filtration slits in podocytes into the capsular space
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10
Q

Two forces that filter fluid out of the blood.

A

This is the Glomerular capillary hydrostatic pressure
- Filtrate leaving glomerulus into capsular space.

It is also the oncotic pressure of the Bowman’s space but this is almost 0.

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11
Q

Two forces that oppose ultrafiltration

A

Glomerular capillary oncotic pressure

Bowman’s capsule hydrostatic pressure.

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12
Q

Overall equation of net filtration pressure

A

[Glomerular capillary hydrostatic pressure]- [Bowman’s capsule hydrostatic pressure + Glomerular capillary oncotic pressure]

This decreases significantly at the end of glomerular capillary.

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13
Q

Autoregulation of renal blood flow

- hypotheses

A

In the kidneys, renal blood flow and GFR stay the same when blood pressure is 90-200 mmHg.

Not due to neuronal or hormonal response.

Two hypotheses for this mechanism:
- Myogenic: arterioles respond to stretch..

  • Metabolic: renal metabolites modulate vasodilation
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14
Q

Change in GFR according to afferent and efferent arterioles

A

Afferent arteriole is usually wider than efferent.

To increase GFR:

  • Afferent dilates and efferent constricts
  • GFR returns to normal

To decrease GFR due to high BP:
- Afferent constrict and efferent dilates

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15
Q

Substances that dilate the afferent artery

A

Prostaglandins

ANP (atrial natriuretic peptide)

Dopamine

NO

Kinins

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16
Q

Factor that constricts the efferent arteriole

A

Angiotensin II

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17
Q

Decrease in GFR according to afferent and efferent arterioles
- Include what causes dilation and constriction

A

The afferent arterioles constricts and efferent arterioles dilates.

Constriction of afferent:

  • Adrenaline
  • Endothelin
  • Adenosine
  • ADH

Dilation of efferent:
- Adenosine

18
Q

Explain how changes in GFR can alter system blood pressure

A

When blood pressure drops, filtration pressure drops:

  • Decreases GFR
  • Less Na+ is filtered

Less Na+ in proximal tubule is sensed by macula densa:
- Stimulates juxtaglomerular cells to release renin into the blood.

Renin release leads to Ang II release:
- Increases BP via vasoconstriction until it returns back to normal

19
Q

Effects of angiotensin II in the RAAS

  • Ions
  • Water
  • Blood pressure
  • Hormone secretion
A

Increases sympathetic activity

Increases reabsorption of:
Na+
Cl-

Increase secretion of K+

Increases H2O retention.

Increases aldosterone secretion

Arteriolar vasoconstriction- increases BP

Stimulates ADH secretion

Increase H20 absorption in collecting duct.

20
Q

Reabsorption at proximal tubule

A

The following are almost completely reabsorbed:

  • Glucose
  • Amino acids
  • Filtered proteins
60-70% of the following:
Water
Na+ Cl-
HCO3-
K+
Urea
21
Q

What protein drives reabsorption at the proximal tubule?

A

Na+/K+- ATPase

  • 3 Na+ out of cells into blood
  • 2+ K+ into cells
22
Q

Na+ reabsorption at PT

A

Gradient for Na+ absorption is driven by Na+/K+ pump at basolateral membrane of tubular cells.

Na+ enter the cells via Na+/H+ pump.
- Also co-transported with Phosphate and sulfate ions.

Cl- follows reabsorption of Na+ through facilitated diffusion

23
Q

Water reabsorption at PT

A

Movement of solutes out of the tubular lumen (Na+, Cl- and HCO3-) increases osmolarity of interstitial fluid.

This drives water out of tubular fluid into interstitial spaces via paracellular and transcellular (aquaporins) routes
- Aquaporins are on the basolateral and apical membranes

24
Q

Aquaporin-1

A

Widely distributed aquaporin.

Abundantly found in the PCT.

25
Aquaporin-2
Aquaporin found on the apical surface of the collecting duct. Controlled by ADH
26
Aquaporin-3 and Aquaporin-4
Aquaporin found on the basolateral surface of the collecting duct
27
Glucose reabsorption at the PT
Co-transported with Na+ into the tubular cell- apical membrane - At PCT the co-transporter has high capacity and low affinity for glucose. - At PST the co-transporter has low capacity and high affinity. Moves down a concentration gradient. Exits cell via basolateral membrane: - GLUT-2 at PCT - GLUT-1 at PST This mechanism ensures very little glucose is excreted.
28
Transport maxima
Maximum transport capacity of glucose. Maximum amount of glucose that can be reabsorbed at the PT. The rest is excreted. Excess urinary excretion of glucose= diabetes
29
SGLT2
Na+/ Glucose co-transporter in the PCT. - Low affinity - High capacity SGLT2 inhibitors
30
K+ reabsorption in the PT
70% absorbed- mainly down concentration gradient through tight gap junctions
31
Urea reabsorption in the PT
40-50% reabsorbed down conc gradient
32
Amino acid reabsorption in the PT
7 different transport processes, depending on amino acids. High transport maxina
33
Protein reabsorption in the PT
Small amount of proteins reabsorbed enter the cell via pinocytosis. They are enclosed in vesicles and degraded by lysosomes to release amino acid into the blood. This method has a very limited transport maxima.
34
Secretion into the PT
Some drugs/ substances are to large or bound to proteins. OAT and URAT pumps compounds from plasma to nephron.
35
OAT
Organic anion transporter. Pump that moves substances from the blood into the lumen. Located on both apical and basolateral membranes.
36
PAH
Para-amino hippourate. Secreted into the PT with alpha-ketoglutarate or di/tricarboxylates- from the blood. Transported out of PT cells in exchange with another anion into lumen. Used to measure tubular secretion as it is not endogenous.
37
Endogenous acids secreted into the urine by PT (6)
cAMP Bile salts Hippurates Urate Oxalate Prostaglandins
38
Endogenous bases secreted into the urine by PT (8)
Creatinine Dopamine Adrenaline + Noradrenaline Histamine Choline Thiamine, Guadine
39
Acidic drugs secreted into the urine by the PT (7)
Acetozolamide Chlorothiazide Furosemide Pencillin Salicylate Hydrochlorothiazide Bumetanide
40
Organic basic drugs secreted into urine by the PT
Atropine Isoproterenol Cimetidine Morphine Quinine
41
SGLT2 inhibitors
'Flozins'- Used to treat diabetes by increasing excretion of glucose Dapagliflozin Canagliflozin Empagliflozin