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GERR Physiology > Glomerular Filtration Rate > Flashcards

Glomerular Filtration Rate Flashcards

1
Q

What are the 3 barriers to filtration

A

1- capillary endothelium
2- fused basement membrane
3- podocyte foot processes

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2
Q

List Filtrate composition

A 
1- Plasma protein ( small ones )
2- H20 
3- Glucose 
4- Electrolytes 
5- amino acids 
6- fatty acids 
7- Nitrogenous wastes
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3
Q

Do RBC pass the filtration barrier

A

no

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4
Q

What is Proteinuria

A

protein in the urine

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5
Q

What is Hematuria

A

Blood in urine

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6
Q

What might cause Proteinuria and Hematuria

A
  • Hypertension

- Kidney infection ( infection of podocytes and slits )

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7
Q

Why might leukocytes be seen in urine

A

UTIs

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8
Q

What is the net filtration pressure

A

difference between pressures that force fluid out vs in

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9
Q

What affects the arterial end NFP

A

The hydrostatic pressure in the artery causes fluid to be pushed out
Osmotic pressure in artery keeping fluid in

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10
Q

What type of pressure is greater in arterial end NFP

A

Hydrostatic pressure is greater than osmotic causing fluid to move out of capillary

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11
Q

What type of pressure is greater in venous end NFP

A

Osmotic pressure is greater than hydrostatic pressure causing fluid to move into venule

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12
Q

What determines hydrostatic pressure in glomerular capillaries

A

1- arterial pressure

2- greater resistance in efferent than afferent

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13
Q

What determines hydrostatic pressure in Bowman’s capsule

A

1- pressure of filtrate in capsule

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14
Q

Is HPgc greater than or less than HPbc

A

greater

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15
Q

What effects the osmotic pressure in glomerulus and Bowman’s capsule

A

the protein in the plasma and filtrate

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16
Q

Does plasma in GC or filtrate in BC have more proteins and thus osmotic pressure

A

Plasma has more protein as filtrate has close to none and thus plasma in GC has higher osmotic pressure

17
Q

What determines the GFR

A

the net filtration rate and a constant that represents the ease which fluid can move through pore

18
Q

What is the NFP for Glomerular filtration

A

Usually net filtration number causes fluid to be pushed out since hydrostatic pressure is greater than osmotic.

19
Q

How is GFR measured

A

By measuring the clearance rate of a substance from blood into the urine. substance is freely filtered and not reabsorbed or secreted by kidneys.

20
Q

What’s the equation for GFR

A

( Urine substance x urine flow) / plasma substance

21
Q

What can be used to measure GFR

A

1- Inulin IV with repeated blood and urine collections.

2- creatinine levels

22
Q

What is the side effect of using inulin to measure GFR

A

inaccuracy due to incomplete bladder voiding

23
Q

Why is creatinine used to measure GFR and what are the possible complications

A
  • naturally produced by body and freely filtered in glomerulus
  • creatinine is secreted by peritubular capillaries so creatinine clearance might overestimate GFR but if measured in plasma levels then its more accurate
24
Q

can the measuring of GFR be completely accurate

A

No , equations are used to count in age, sex, weight and still not fully accurate

25
Q

What factors may affect GFR

A

1- Kidney disease : reduces
2- Hypertension : damage to GC
3- Sleep : hormonal and oncotic variations
4- exercise : blood flow diverted to muscles
5- Renal blood flow reduced

26
Q

Why is measuring renal blood flow important clinically

A

to determine nature of renal disease

27
Q

What keeps GFR constant

A

normal range of Blood pressure because renal blood flow stays constant

28
Q

What keeps renal blood flow constant

A

autoregulation myogenic vasoconstriction in kidney

29
Q

What is important to think about when wanting to measure renal blood flow

A

Substance should be cleared in 1 circuit through Kidney

30
Q

What is used to measure renal blood flow and why

A

Para-aminohippuric acid ( PAH). Doesn’t effect kidney function , not metabolized by body and more than 90% is extracted in 1 circuit

31
Q

What is the disadvantage of using PAH to measure renal blood flow

A

PAH is confined to plasma so doesn’t directly measure renal blood. must measure plasma flow first then convert it to renal blood flow once taking into account Haematocrit

32
Q

What is the formula for measuring Renal plasma flow by PAH

A

( Urine of PAH x urine flow rate ) / arterial plasma of PAH

33
Q

Formula to change Renal plasma flow to renal blood flow

A

RPF / ( 1-HCT )

GERR Physiology (18 decks)

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