intro lecture Flashcards
4 main functions of renal system
- BP control
- Vit D activation
- toxin removal
- RBC production
inner portion of the kidney; goal is to be hyperosmotic
meulla
collection of capillaries which leak filtrate into bowman’s space
glomerulus
primary site of reabsorption & H+ secretion
PCT
sets up concentration gradient for medulla; water passively passes from descending part
loop of henle
where ion exchange happens & where JG apparatus is
DCT
secondary urine concentration; where ADH acts
collecting duct
primary function of the JG complex
- maintain blood flow despite MAP changes
via Na sensation & BP regulation
what part of the JG apparatus senses sodium?
macula densa– sends info back to JG cells
site of synthesis, storage and release of renin
JG cells of arterioles
3 mechanisms that cause release of renin
- decreased sodium sensed by macula densa
- decreased perfusion pressure to kidneys
- sympathetic nerve activation
4 things angiotensin II does
- arteriole vasoconstriction (raise BP)
- stimulates ADH secretion (stimulate thirst and raise BP)
- enhace NaCl reabsorption in proximial tubules
- stimulates aldostrone secretion
2 things aldosterone does
- hold Na to increase BP (kick out K+)
- increase salt appetite & thirst
where do Renin inhibitors work (ends in – kiren)
stops angiotensinogen activation into angiotensin I
where do ARBs work?
at adrenal cortex to stop aldosterone release
ADH/vasopressin is secreted from post pit in response to what two things
high Na– to trigger water retention at DCT and collecting duct
low BP
2 general EFFECTS of ADH secretion
increases water reabsorption
causes vasoconstriction
what 2 things inhibits ADH release
low Na and high BP
3 general causes of prerenal kidney failure
- decreased ECF
- decreased renal blood flow
- altered intrarenal hemodynamics
2 conditions that can cause decreased ECF resulting in prerenal failure
GI losses
hemorrhage
2 conditions that can cause decreased renal blood flow causing prerenal failure
heart failure
renal artery stenosis
5 things that cause altered intrarenal hemodynamics, in turn causing prerenal failure
- medications
- sepsis
- hypercalcemia
- cirrhosis/hepatorenal syndrome
- abdominal compartment syndrome
4 general meds that cause altered intrarenal hemodynamics
NSAIDs/COX-2 inhibitors
calcineurin inhibitors
ACE-i
A-II receptor blockers
2 general causes of postrenal kidney failure
- anatomic obstruction: bladder outlet or uretral issues
- tubular obstruction– crystals, drugs, proteins (myeloma cast nephropathy)
2 general causes of intrarenal kidney failure
- tubulointerstital disorders– tubular injury or interstitial nephritis
- glomerular disorders– glomerulonephritis, thrombotic microangiopathies, atheroembolic disease
what 2 drugs can cause tubular obstruction
indinavir
MTX
