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Clinical Chemistry > Kidney > Flashcards

Kidney Flashcards

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1
Q

Osmolaity Calculation

A

2(Na) + Glucose/20 + BUN/3

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2
Q

Major functions of Kidney

A
  1. Removal of unwanted substances from plasma (waste & surplus)
  2. Homeostasis (maintain equilibrium of body’s water, electrolytes, and acid/base status)
  3. Hormonal Regulation
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3
Q

Functional Unit of Kidney

A

Nephron

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4
Q

Glomerulus

A

receives & filters blood based on size and charge

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5
Q

Loop of Henle: Descending Loop

A

permeable to H20

impermeable to Sodium (Na) and Chloride (Cl

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6
Q

Loop of Henle: Ascending Loop

A

permeable to Sodium (Na) and Chloride (Cl)

Impermeable to H20

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7
Q

Aldosterone acts on what part of the nephron

A

Distal Convoluted Tubule

Collecting Ducts

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8
Q

What secretes Aldosterone

A

Adrenal Cortex

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9
Q

Aldosterone reabsorbs

A

Sodium (Na) and Chloride (Cl)

excretion of Potassium (K) and Hydrogen (H)

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10
Q

ADH acts on

A

Collecting Ducts

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11
Q

What secretes ADH

A

Posterior Pituitary

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12
Q

ADH’s Function

A

Reabsorb Water (H2O) from the collecting ducts

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13
Q

How much blood does the glomerulus filter a minute?

A

1200 - 1500 ml/min blood filtered

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14
Q

How much filtrate does the Glomerulus produce a minute?

A

125 - 130 ml/min filtrate produced

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15
Q

Clearance

A

Volume of plasma that will completely eliminate a measured amount of substance in urine

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16
Q

Conditions triggering ADH secretion

A

Increased serum osmolality

Decreased blood volume/prssure

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17
Q

Renin secreted by:

A

juxataglomerular apparatus

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18
Q

Renin Function

A

Converts Antiotensin I to Antiotensin II

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19
Q

Angiotensin II function

A

a. vasoconstriction to increase BP
b. proximal tubule reabsorbs Na
c. stimulates aldosterone secretion (by adrenal cortex to reabsorb Na)
d. stimulates ADH secretion (by posterior pituitary to reabsorb H20)

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20
Q

What conditions trigger Aldosterone?

A

Decreased blood flow

Decreased Sodium

21
Q

Clearance Calculation for Creatinine

A

UV/P X 1.73/A

U = urine concentration (creatinine)
V = urine volume (creatinine collection)
P = plasma concentration (creatinine)
1.73 = (correction for body mass)
A = body Surface
22
Q

Estimated Glomerular Filtration Rate (EGFR):

A

calculation based on serum creatinine, sex, age, weight, and race

23
Q

Nephrotic Syndrome Symptoms

A

Abnormally permeable glomerular membrane (doesn’t reabsorb / lets proteins through)

Lipidurea (fat in urine)
Hyperlipidemia (high lipids)
General edema 
Hypoalbuminemia (low albumin)
Proteinuria (protein in urine)
24
Q

Glomerulaonephritis

A

renal concentrating ability has become dysfunctional

Symptoms: 
hematuria (blood in urine)
proteinuria (protein in urine)
decreased GFR 
Elevated BUN/creatinine serum, Na&H20 retention
25
Q

GFR indicative of stages of Renal Disease

A

Normal GFR: > 60 ml/min

Kidney Damage 60-89 ml/min
Moderate 30-59 ml/min
Severe 15-29 ml/min
Renal Failure: < 10 ml/min

26
Q

Chronic Renal Failure

A

slow, progressive loss of nephron function

Glomerular Filtration Rate decreases
Glomerular inflammation
Caused by: glomerulonephritis and pyelonephritis

27
Q

Acute Renal Failure

A

sudden, sharp decline in renal operation

Glomerular Filtration Rate <10 ml/min

28
Q

Acute Renal Failure

Hypoxic Insult

A

Pre-Renal Cause of decline in renal operation

Compromised blood flow, septic, hemorrhagic, cardiac failure

29
Q

Acute Renal Faiure

Acute Toxic Insult

A

renal cause of decline in renal operation

hemolytic transfusion rxn, metal poisoning, aminoglycoside toxicity

30
Q

Post-Renal Failure

A

Blockage of urine by stones, tumors of prostate or bladder, severe UTI

31
Q

Significance of BUN/Creatinine Ratio

A

Urea is reabsorbed in tubules whereas as creatinine is not.

Ratio helps indicate what type of renal disease is present

32
Q

BUN/Creatine Ratio Values

A

> 20:1 extrarenal disease (pre or post renal failure)

<10:1 renal disease (glomerular or tubular

33
Q

Calculation for Total Urea

A

BUN x 2.14

34
Q

end product of purine metabolism

A

Uric Acid

35
Q

Causes of elevated Uric Acid

A
  1. metabolism defects
  2. increased cell destruction
  3. renal disease
36
Q

Analytic Method for Creatine

A

Jaffe Reaction

  1. picric acid in alkaline solution reacts with Creatinine
  2. complex forms orange chromagen
  3. measure spectrophotometrically
37
Q

Analytic Method for BUN

A

UV Enzymatic Reaction

hydrolysis of urea / quantification of ammonia
Urease and L-glutamate dehydrogenase monitors the rate of disappearance of NADH at 340nm

38
Q

Analytic Method for Uric Acid

A

Chromogen Spec

  1. Uric acid oxidized by uricase
  2. H2O2 produced
  3. Indicator reactin utilizes peroxidase
  4. Forms chromogen
  5. Read spectrophotometrically
39
Q

Analytic Method for Osmolarity

A

Freezing Point Depression

  1. Sample super cooled to -7 degrees and mechanically induced to freeze
  2. Equilibrium is reached
  3. Freezing point is measured

(more concentrated = longer to freeze/lower freezing point)
(less concentrated = faster to freeze/higher freezing point

40
Q

Samples for Creatinine

A

Urine
EDTA plasma
Heparin
Serum

41
Q

Samples for BUN

A

Urine
EDTA plasma
Heparin
Serum

42
Q

Samples for Uric Acid

A

Urine
EDTA plasma
Heparin
Serum

43
Q

Samples for Osmolality

A

Urine
EDTA plasma
Serum

(particle free)

44
Q

Steps of 24 Hour Urine

A
  1. patient voids bladder and discards (time starts now)
  2. collect all urine for 24 hours refrigerated
  3. at 24 hour mark patient voids bladder as final collection (end time
45
Q

Creatinine Reference Range

Creatinine Critical Values

A

Normal Serum: 0.4 - 1.2 mg/dl
Critical Serum: > 5.0 mg/dl
Normal Urine: 0.8 - 2.0 g/24hr
Clearance: 75 - 125 ml/min

46
Q

BUN Reference Range

A

Normal Serum: 5 - 25 mg/dl

Critical Serum: >90 mg/dl

47
Q

Uric Acid Normal Serum and Urine Value

A

Normal Serum: 2.0 - 80.0 mg/dl

Normal Urine 250 - 750 mg/24hr

48
Q

Serum osmolality normal range

A

285 to 305

Clinical Chemistry (5 decks)

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