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Kidneys and Hormones > Introduction to nephrology > Flashcards

Introduction to nephrology Flashcards

1
Q

What vessel supplies the kidney with blood?

A

Renal artery

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2
Q

What vessel drains the kidney with blood?

A

Renal vein

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3
Q

Where does the urine travel?

A

Down via the ureter to the bladder

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4
Q

What are the units that make up the kidney called?

A

Nephrons

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5
Q

How does the renal artery divide?

A

Renal artery -> capillary loop -> glomerulus

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6
Q

The capillary walls are specialised for transport of fluid and salt

TRUE or FALSE

A

True

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7
Q

Where does the fluid collect once it is filtered in the glomerulus?

A

In the Bowman’s Capsule

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8
Q

How many litres of blood are filtered a day?

A

180 L

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9
Q

How many litres of urine are produced a day?

A

2 L

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10
Q

Everyone starts with the same number of nephrons

TRUE or FALSE

A

FALSE

Not everyone starts with the same number of nephrons

Danish adults have less mean number of nephrons than Americans and Australians

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11
Q

What difference does nephron number make in the health of a kidney?

A

Nephron number accounts for differences in susceptibility to kidney disease

Premature babies = less nephrons and higher susceptibility to hypertension/ renal disease

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12
Q

What are the functions of the kidney?

A

Salt and water regulation

Maintains acid-base balance

Synthesises EPO

Activates vitamin D

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13
Q

Why is it important to regulate salt and water in the blood?

A

Maintains blood pressure

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14
Q

How do the kidneys maintain acid-base balance?

A

Absorbs and secretes electrolytes/ salts/ sugars

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15
Q

What is the role of EPO?

A

Stimulates RBC production

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16
Q

What does vitamin D regulate?

A

Calcium and phosphate concentration

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17
Q

What are methods by which we can measure kidney function?

A

Clearance of compounds

Filtration of water and electrolytes

Concentration of macromolecules in the urine

Production of vitamin D/ EPO

18
Q

Whic compounds can we use to measure the clearance by the kidneys?

A

Urea and serum creatinine

19
Q

What is creatinine?

A

Molecules formed by the breakdown of creatinine phosphate in the muscle

Produced at a constant rate by the body

Excreted unchanged by the kidneys

20
Q

Why is measuring the filtration of water or electrolytes not practical to determine kidney function?

A

Have to collect urine over time to eradicate minute to minute alterations

21
Q

Why is measuring the concentration of macromolecules in the urine a good way to determine kindey function?

A

A healthy filtration barrier should not let macromolecules pass through

22
Q

What are examples of macromolecules?

A

Proteins

RBC

23
Q

What are the 2 ways in which production of vitamin D or EPO can be measured in the blood?

A

Measure directly in blood

Can also measure indirectly - calcium phosphate balance or RBC count

24
Q

Do men or women have higher GFR?

A

Men

Higher muscle mass - higher GFR needed

25
Q

Do old or young people have higher GFR?

A

Young

Have higher muscle mass

26
Q

What is the relationship between GFR and serum creatinine?

A

Non-linear relationship

Large change in GFR leads to a small change in serum creatinine

Large change in serum creatinine leads to a small change in GFR

27
Q

How does renal function change with age?

A

GFR declines as we age - scarring of kidneys over time

Decline in GFR isn’t enough to lead to kidney disease

28
Q

What is the average decline of GFR as we age?

A

0.4 ml/min/1.73m2

29
Q

What are the symptoms of kindey failure?

A

Dirty blood - inadequate filtration

Fluid accumulation

High blood pressure

Anaemia

Bone disease

Lipid abnormalities

30
Q

Why does fluid accumulate in kidney disease?

A

Acid-base balance is disrupted

Oncotic pressure is created

Causes water to build up in body tissues

31
Q

Why does kidney disease lead to anaemia?

A

Imbalance in EPO synthesis

32
Q

Why does kidney disease lead to bone disease?

A

Bones attempt to maintain serum calcium levels

Bone resorption = osteomalacia

33
Q

Why does kidney disease lead to lipid abnormalities?

A

Disruption in the metabolism of lipids

34
Q

What is the difference between acute and chronic kidney disease?

A

Acute - sudden loss of kidney function

Chronic - level of function is reduced but patients maintain health

35
Q

Patients with CKD often maintain health

TRUE or FALSE

A

True

36
Q

What are causes of kidney dysfunction?

A

Developmental/ genetic - may not grow normally, malformed

Acquired problems

37
Q

What are examples of acquired problems that lead to kidney disease?

A

Blood supply problems

Blockage of urinary flow

Diseases (systemic or kidney-specific) that interfere with nephron function

38
Q

What are the treatments of kidney disease?

A

If drug toxicity or infection - treat underlying cause

If immunological disease - immunosuppression

39
Q

What can be done to slow down the progression of CKD?

A

Controlling blood pressure

This makes sure funcitoning nephrons last longer

40
Q

What happens if you can’t treat the underlying cause of kidney disease?

A

Patient may develop end-stage kindey failure

41
Q

What are the treatments for end-stage kindey failure?

A

Transplant

Maintenance hemodialysis - replaces kidney function

42
Q

Why should we care about kidney disease?

A

Affects up to 3 million people in the UK

Increasing due to increases in disease - diabetes, aging population

Dysfunction is often unknown due to few symptoms

Kidneys and Hormones (39 decks)

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