KEY wk 9, lec 3 Flashcards

1
Q

division of water in body

A

2/3 intracellular
1/3 extracellular (20% blood plasma. 80% interstitial fluid)

fluid and salt go into ECF easily not ICF
–> water expands both
–> saline expands ECF
–> salt expands ECF and shrinks ICF

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2
Q

nephron reabsorb vs excrete

A

eabsorb essential substances such as water, glucose, amino acids, and ions while secreting waste products like urea, creatinine, and excess ions into the tubular lumen for excretion in urine.

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3
Q

passive diffusion

A

move down [ ] gradient without energy

lipid soluble substances (i.e. urea), gases, small ions, water

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4
Q

facilitated diffusion

A

carrier proteins or channels move molecules down concentration gradient without energy

i.e. glucose and amino acids

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5
Q

active transport

A

move against [ ] gradient via ATP

Na+/K+ ATPase pump (sodium out, k in)

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6
Q

secondary active transport (symport and anti port)

A

active transport; coupled movements of 2+ molecules

symport: same direction (sodium glucose cotransporter SGLT) (Na-3HCO3 symporter for bicarbonate)

anti port: opposite (sodium calcium exchanger, sodium in, ca out) (Na-H anti porter)

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7
Q

endocytosis vs exocytosis

A

Endo: engulf extracellular substance via invagination of cell membrane = form vesicle

exocytosis: reverse; vesicles with substance fuse with membrane and release content into extraceullar space

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8
Q

extraceullar vs intracellular ions in both

A

extracellular:
lots: Na+, Cl-
some: Ca2+, HCO3-, protein

intracellular
lots: K+, PO4 and organic anions
fair bit: Mg2+, protein

~100 of Na+, Cl- in extracellular
~30 of HCO3- in extracellular
~100 K+ in intracellular

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9
Q

water gain and loss

A

insensible= not aware of (NOT sweat)

input: food, drink, metabolism
output: insensible via skin and lung, sweat, feces, urine

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10
Q

2 routes for transporting substances in renal tubules

A

transcellular: apical transporter –> cytoplasm –> basolateral surface –> peri-tubular capillaries

paracellular: across tight junctions, in ECF space between cells

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11
Q

what cells are in the collecting tubules

A

principal and intercalated cells

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12
Q

parts of the tubule and their function

A

PCT- reabsorb nutrients ans 60% of water and most solutes

loop of henle thin limb: passive reabsorb water (descending) and NaCl (ascending)

loop of henle thick tiling: ionic gradient for countercurrent multiplication; dilutes urine, makes interstitial hypertonic

DCT: Na+, Cl-, water balance

collecting tubules: principal cells for absorption of Na+, K+, water and intercalated cells for acid.base and K+ homeostasis

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13
Q

main thing for osmolality in ECF

A

NaCl

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14
Q

ICF has how much water

A

2/3 of body osmotic content and therefore water

(1/3 in ECF)

but ECF and ICF is osmotic equilibrium bc water crosses cell membranes easily

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15
Q

water transport in tubules

move from what osmolality

A

always reabsorbed; never secreted

moves from low to high osmolality

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16
Q

na, cl and water

A

water and salt are freely filterable at renal corpuscle ‘

cl is passive and because of electroneutrality (- and +) its tied to Na trasnport

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17
Q

where does majority of Na, Cl and water get reabsorbed? how much?

A

2/3 in proximal tubule

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18
Q

where does sodium get reabsorbed

what goes to urine

A

65% in proximal tubule

25% un thin ascending limb and thick ascending limb of henle

little bit in DCT and collecting duct ~10%

NONE in descending thin limb of henle loop

urine= <1% of total filtered sodium

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19
Q

all nephron segments have what for active transceullar sodium reasbosption? keeps sodium [ ] in intracellular space ____, despite the negative charge inside the lumen (that’s why need ATP for Na+ to go against electrochemical gradient)?

A

Na-K-ATPase pump

low

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20
Q

what anions balance out sodium (cation)

A

mainly chloride, some bicarbonate

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21
Q

main reabsorption of chloride

A

proximal tubule

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22
Q

Cl- gets transported where

A

intracellular (even through negative inside)
–> need energy to move against gradient

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23
Q

how to excrete water in excess of salt and vice versa

A

seperate reabsorption

-the same in proximal tubule, but differs beyond
-water reabsorbed in descending henle
-Na reabsorbed in ascending henle

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24
Q

sodium reabsorbed in loop of henle is always ____ than water

A

greater

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25
Q

main water reabsorption via

A

aquaporins in plasma membranes of the tubular cells, and in the proximal tubule through the tight junctions between the cells.

i.e. proximal tubule and descending thin limb of henle highly permeable

i.e. ascending limb of henle is somewhat impermeable bc of tight junctions

i.e collecting duct in variable

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26
Q

Na+/K+ pumps Na+ into interstitum (basolateral side) which causes

A

water to follow (Pull/ solvent drag)

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27
Q

sodium reabsorption across apical membrane via

across basolateral

A

H+ and Cl-

Na+/K+ pump

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28
Q

SLIDE 29 DIAGRAM

A
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29
Q

PCT reabsorbs what %? and via what?

A

60-70% most solutes
80% bicarbonate
100% amino acids and glucose

transcelular (i.e. sodium) and paracellular

(water and anions follow sodium)

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30
Q

how does PCT reabsorb bicarbonate, sodium and water

A

Uses carbonic anhydrase and carbon dioxide production to reabsorb bicarbonate, sodium, and water

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31
Q

sodium glucose co transport in PCT

A

sodium- glucose co-transporter 2 (SGLT2) or sodium-glucose co-transporter 1 (SGLT1).n –> both go into PCT

glucose then exits via facilitated diffusion via GLUT1 or GLUT2 and go into bloodstream

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32
Q

amino acid transport in PCT

A

via secondary active transport mechanisms involving sodium co-transporters

after in cell, then can go into bloodstream by transporter proteins

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33
Q

phosphate reabsorption in PCT

A

via sodium-dependent phosphate co-transporters.

uses NaK ATPase pumps to get phosphate to go against concerntraion gradient

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34
Q

bicarbonate reabsorption in PCT

A

into PCT exchange HCO3 for Cl- via sodium-bicarbonate co-transporter (NBC)

helps with acid base balance

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35
Q

water reabsorption in PCT

A

passive, osmosis
driven by reabsorption of glucose and sodium

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36
Q

sodium reabsorption in PCT

A

active,
sodium-glucose co-transporters, sodium-phosphate co-transporters, and sodium-bicarbonate co-transporters.

once in the cell go to basolateral NAK ATPase to

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37
Q

potassium and chloride reabsorption in PCT

A

paracellular (between cells) along with water via passive diffusion driven by electrochemical gradients

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38
Q

method 1 of sodium reabsorption in PCT

A

Na/K+ ATPase pump on basolateral side

Na+ enters cell then other channels on apical membrane

water and chloride follow

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39
Q

method 2 of sodium reabsorption in PCT

A

HCO3 combines with H+
–> converted to carbon dioxide by carbonic anhydrase

CO2 diffuse into cell and then gets converted back into HCO3 and H+

▪ H+ exchanged with Na+ at the apex

▪ HCO3- co- transported across the basolateral membrane with sodium

–> can be increased by ATII

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40
Q

2 drivers of sodium reabsotpuon in PCT

A

Na/K ATPase

HCO3 and H (into CO2)

41
Q

early vs pars recta (latter) part of PCT absorption

A

early: everything (i..e HCO3, glucose, inulin, amino acids, Na+, Cl-, H2O)

latter: Na+, Cl-, H2O

42
Q

organic solutes reabsorbed in? rely on?

A

PCT

i.e. glucose, amino acids

via sodium gradient or negative membrane potention

43
Q

what gets degraded in PCT

A

Many proteins (i.e. albumin and peptide/protein hormones such as insulin, GH) are degraded in the PCT and a.a.’s re-used
▪ Taken up via a process of continuous endocytosis (pinocytosis)

44
Q

for apical and basal membrane which transporter for glucose

when is it saturated

A

Glucose is taken up across the apical membrane by sodium-glucose symporters (SGLT family) and leaves across the basolateral membrane via glucose uniporters (GLUT family)

–> main SGLT2 for glucose reabsorption (1:1 of glucose and Na+)
–> late proximal tubule is SGLT1 (2:1)

pathologic hyperglycemia

45
Q

organic solutes in PCT

A

organic cation or organic anion transporters (OCT or OAT, respectively) and are found on the basolateral membrane

cations: histamine, serotonine, Ach, NE…
anions: bile salts,fatty acids…

46
Q

organic cation transporters and organic anion transporters in PCT

A

OCTs use inside-negative membrane potential to move cations from the bloodstream into the PCT cell

OATs use countertransport – the anion is transported from bloodstream into PCT cell, and alpha-ketoglutarate is exchanged in the opposite direction

47
Q

what do organic anion transporters use to get the negative charge into cell

A

alpha ketoglutarate

48
Q

principal cells regulate water and sodium transport in DCT via influence of which homrone

A

aldosterone

49
Q

DCT; principal cells and aldosterone secretion for

A
  • Sodium Reabsorption * Water Reabsorption
  • Potassium Secretion
50
Q

sodium reabsorption via principal cells

A

epithelial sodium channels (ENaC) in apical membranes

regulated by aldosterone which binds mineralocorticoid receptors in cytoplasm of principal cells which upregulates ENaC

aldosterone increases sodium reabsoprtion

51
Q

water reabsorption by principal cels

A

sodium reabsorption (via aldosterone) creates osmotic gradient for water reabsorption

  • Aquaporin-2 (AQP2) water channels on apical membrane
52
Q

potassium secretion via principal cells

A

aldosterone stimulates Na/K ATPase on basolateral side to pump sodium out and K+ in

increase intracellular potassium causes secretion through tubular lumen on potassium channels on apical membrane

53
Q

DCT principal cell action

A

Na and H2O reabsorb (via aldosterone)
K+ secrete

~~electrolyte balance

54
Q

dilute vs concentrated unirine via which part of nephron

A

nephron’s loop of Henle, which utilizes countercurrent exchange and multiplication mechanisms.

55
Q

countercurrent exhanger and multiplier in loop of henle to concentrate or dilute urine

A

descending: water
ascending: Na, Cl, potassium (impermeable to water)

countercurrent exchanger: water diffuse out of tubule into interstitum in descending limb increasing the osmolarity of medulla interstitium. in ascending limb Na and Cl are transported out into intersititumn, create concentration gradient in mdeulla

multiplier effect: amplify [ ] gradient in medulla; via sodium- potassium-chloride cotransporter (NKCC) channels in ascending limb. high osmolarity in renal medulla= water reasborb in collecting duct

56
Q

hypothalamic regulation of urine concentraion

A

hypothalamus monitors blood osmolarity and regulates ADH secretion from posterior pituitary

57
Q

hypothalamus when osmolarity increases (dehydrates) causes _____ secretion

A

ADH secretion (promotes water reabsorption in collecting ducts)

58
Q

ADH impacts on urine

A

increases permeability of collecting ducts to water via aquapoirn 2 channel addition in apical membrane

allows for passive reabsoprtion of water = more concentrated urine

59
Q

urea trasnporters have what impact on urine

A

in thin ascending limb
UT-A1 and UT-A3; concentrate urine

60
Q

NKCC channels impact on urine

A

concentrates urine

61
Q

aquaporins impact on urine concentraion

A

aquaporin2 on apical membrane

water reabsoprtion ; concentrate urine

via ADH; water out of tubule into interstitium

62
Q

hairpin loop structure of loop of henle and vasa recta for urine concentraion

A

henle hairpin loop to maximize countercurrent exhange and multipliers

allows for the close proximity of the descending and ascending limbs, facilitating the exchange of ions and water between these segments.

vasas rectae (peritubular capillaries running parallel to henle); when blood flows it exhanges ions and water in interstitium. concentrates medullary envo

63
Q

RAAS system for regulation of

controlled by

ultimately for which homrone

A

renal sodium excretion

sympathetic neural signal via vascular baroreceptors

alodterone (sodium and water retention, K excretion)

64
Q

RAAS system:::

where is angiotensinogen made

how to turn angiotensinogen to ATI

enzyme to make ATI to ATII

renin is made by? which cells?

A

liver

need renin to turn angiotensinogen into ATI

ACE

juxtaglomerular apparatus (renin secreting cells in late afferent arteriole before glomerulus); granular/ JG cells

65
Q

3 regulators that control renin secretion by JG/ granular cells

A

Sympathetic Input via the renal sympathetic nerve

Pressure in the afferent arteriole

Macula densa release

65
Q

renin has inverse relationship with

A

dietary sodium

A high sodium diet suppresses renin secretion

A low sodium diet leads to high levels of renin.

66
Q

sympathetic input affecting renin secretion

A

NE –> beta1 adrenergic receptors on JG cells–> activate cAMP–>release renin

vasculature: high pressure suppresses renin, low vascular volumes via baroceptosr increase renin

67
Q

afferent arteriolar pressure impact on JG/granular cells and renin

A

decrease pressure, increases renin

unless major recall arterial blockage

act as baroreceptors

drop in pressure= secrete renin to increase pressure

68
Q

impact on macula densa to control renin production

A

high Na: release adenosine/ ATP
low Na: release NO and prostaglandins
—-

macula densa respons to high tubular sodoium –> adenosine/ ATP binds purinergic receptors on JG/granular cells –> increase Ca+ and reduce renin and decrease GFR

reduce renin and excrete more (have too much)

if have low tubular sodium macula densa will release nitric oxide and prostaglandin’s –> cAMP –> renin production, increase GFR

69
Q

angiotensinII to preserve blood volume and blood pressure via

A

Vasoconstriction
Stimulation of sodium tubular reabsorption
Stimulation of the CNS: Salt appetite, thirst, and sympathetic drive Stimulation of aldosterone secretion

70
Q

vasoconstriction via AT2

A

reduce renal blood flow, reduce GFR, decrease filtered load of sodium

71
Q

ATII stimulates what in the proximal and distal tubule to cause Na+ reabsorption

A

proximal: NHE3 (Na+/H+ antiporter on antiporter) and Na/K+ ATPase

distal: NCC (Na+/Cl- symporters and sodium channels (ENaC)

In the proximal tubule it stimulates the NHE3 sodium/hydrogen antiporter in the apical membrane and the Na-K-ATPase in the basolateral membrane.

In the distal tubule and connecting tubule it stimulates the activity of NCC sodium/chloride symporters and sodium channels (ENaC) that import sodium.

72
Q

how to help with blood pressure and volume

A

aldosterone stimulate sodium retention

reabsorb in distal tubule

73
Q

aldosterone crossing cell membrane

A

aldosterone has enough lipid character to freely cross tubular cell membranes

–> combines with mineralocorticoid receptors in the cytoplasm

–> binding promotes nucleus transcription factors….

increase activity of sodium channels (ENaCs) and basolateral membrane Na-K-ATPase pumps.

and luminal NCC sodium/chloride symporters when ATII elevated

74
Q

majority of calcium reabsorbed in

A

PCT

paracellular (tight junctions)

transceellular (calcium channels on luminal side, transporter on basolateral

75
Q

phosphate reabsorption in PCT

A

via sodium-dependent phosphate co-transporters

76
Q

calcium and phosphate in Thick Ascending Limb of the Loop of Henle

A

Ca2+ is minimal and paracellular

no phosphate reabsorption

77
Q

calcium and phosphate in Distal Convoluted Tubule (DCT) and Connecting Tubule (CNT):

A

Ca2+ finetuning via parathyroid hormone (incerate # of calcium channels)
–> also in collecting duct via PTH and calcitonin (minimal)

minimal phospahte reabsorb ; mostly secretion

78
Q

phosphate excretion in urine via

A

parathyroid hormone and fibroblast growth factor 23 (FGF23).

79
Q

buffer system in body to maintain pH balance by miming changes in H+ ions

A

Carbonic Acid-Bicarbonate Buffer System Protein Buffer System
Phosphate Buffer System
Ammonia Buffer System
Bone Buffer System

80
Q

carbonic acid-bicarbonate buffer system

location

A

in ECF, including blood plasma

carbonic acid (H2CO3) and bicarbonate ions (HCO3-) t

81
Q

protein buffer system

which proteins and where

A

hemoglobin in red blood cells and albumin in plasma, act as buffers in both intracellular and extracellular compartments.

The amino acid residues of proteins contain both acidic and basic groups that can accept or donate H+ ions

82
Q

phosphate buffer system

location

A

ICF and renal tubular fluid

(HPO4^2- and H2PO4^-) act as weak acids and bases, respectively,

83
Q

ammonia (NH3) buffer system location

location

A

renal tubular fluid and urine

into ammonium NH4+ in urine

84
Q

bone buffer system

location; what salts

A

bone tissue, calcium salts (calcium carbonate and calcium phosphate)

these alkaline salts neutralized excess H+ in blood

85
Q

which acid base component is highest in blood

where is it mostly in

A

bicarbonate

proximal tubule (doesnt change acid base balance in body

in distal/ collecting tubules it will secrete bicarbonate or proteins (H+) to alter body acid base status

86
Q

where is most bicarbonate reabsorbed

87
Q

2 ways to reabsorb bicatboante

A
  1. hydrogen ions and bicarbonate are generated from CO2 and water; via carbonic anhydrase

H+ secreted into lumen via Na+ antiporter or H-ATPase

  1. sodium-bicarbonate symporter moves bicarbonate into lumen

Na-H antiporter (NHE3)

bicarbonate that enters in symport with sodium enters via a member of the NBC family of transporters

88
Q

bicarbonate and hydrogen summary for renal transport

A

predominant proximal tubule mechanisms for reabsoprtion of bicarbonate. hydrogen ions and bicarbonate are produced intracellularly. the bicarbonate generated within the cell is transported into the interstitium via Na-3HCO3 symporter (member of NBC family). Most of the hydrogen ions are secreted via Na-H antiporter (member of NHE family); while some are secreted via an H-ATPase. Additional bicarbonate enters the cells via an Na-HCO2 symporter (another member of the NBC family with 1:1 stoichiometry) and leaves via the Na-3HCO3 symporter. The process is ultimately powered by the Na-K-ATPase that creates the sodium gradient that drives the Na-H antiporter.

89
Q

type A vs type B intercalated cells

A

type A: secrete H+ (H-ATPase) , reabsorb HCO3- via AE1 antiporter

–> H+ into lumen and HCO3 into blood (remove excess acid)

type B: secrete bicarbonate (pendrin antiporter)

–> into lumen to remove excess base from the blood

90
Q

glomerulotubular balance

A

intrinsic ability of the renal tubules to adjust their reabsorption rates according to changes in the filtered load of a substance

91
Q

water and solute reabsorption

bc of what force

A

peritubular capillaries and vasa recta

high hydrostatic pressure in peritubular causes renal tubules back to blood (reasbpsrption)

low hydrostatic pressure in vasa recta for to minimize washout of medullary concentration gradient (medullary gradient) (for urine concentration)

92
Q

sources of acids and bases from diet

A

carb metabolism: pyruvic acid (glycolysis) and lactic acid (anaerobic)

dietary weak acids: citrus fluids when metabolized produce alkalizing substances –> co2 + h2o

fat metabolism: beta oxidation –> acetyl coa –> co2 + h2o
but if incomplete oxidation –> ketone bodies –> acidic

protein metabolism: sulfure containing amino acids make acids… also keto acid intermediates

GI secretions (i.e stomach acid, bicarbonate from pancreas)

93
Q

renal disease impacting acid base

A

acidosis

cant excrete H+ or reabsorb bicarbonate

94
Q

renal response to acidosis and alkalosis

A

acidosis: reabsorb HCO3 and increase H+ secretion into urine

alkalosis: decrease bicarbonate reabsorption and decrease hydrogen secretion (less bicarb in blood, retain more H+)

95
Q

respiratory response to alkalosis or acidosis

A

acidosis: increase breathing; hyperventilate decreases CO2, reduce H+ (shift left to carbonic-acid bicarbonate buffer system)

alkalosis: decrease breathing; hypoventilation; increase CO2 (shift right in buffer system) increase H+

96
Q

4 categories of acid base disorders

A

(1) high pCO2 is a respiratory acidosis
(2) low pCO2 is a respiratory alkalosis
(3) low bicarbonate is a metabolic acidosis (4) high bicarbonate is a metabolic alkalosis.

97
Q

renal response to respiratory acidosis

A

i.e. COPD increased PCO2 and decrease pH so then increase bicarbonate in kidneys to help

98
Q

4 categories of acid base disorders

A

(1) high pCO2 is a respiratory acidosis
(2) low pCO2 is a respiratory alkalosis
(3) low bicarbonate is a metabolic acidosis
(4) high bicarbonate is a metabolic alkalosis.