Kidney Flashcards
Kidney funct tests used for
assess function
water balance
acid base balance
3 process of kidney
g
t
t
golmerulor filtration
tube reabsorbtion
tube secretion
NH3
filtered and secreted
not reabsorbed
Glucose
filtered and partically reabsorbed
AA
filtered and completly reabsorbed
Golmerular filtration
first part of?
filters?
based on?
blood filtered per min is?
first part of nephron
filters incoming blood
based on BP/membrane
blood filtered per min = GFR
Proximal tube
waste products/valuble products
tubular reabsorb/secretion
Loop of henly
hyperosmolality
concurrent flow
Distal tubule
filtrate similar to?
balance?
what is secreted in response to increased osmolality?
stims?
makes what?
filtrate similar to final compound
electrolyte/acid base balance
AVP sec by posterior pituitary in response to inc osmolality
stims H20 reabs
makes distal tubes permeable to water
Aldosterone
where is it located?
system?
adrenal cortex
RAAS
Na absorb
K/H excretion
Collecting duct
final site
AVP/Aldosterone
Cl/urea
highly permeable
NPN elimination
synth?
readily filt by?
waste products from body
3 princ compounds
urea/creatininine/uric acid
UREA MOST
synth in liver
readily filtered by golm
Creatinine
how much becomes waste?
creatin phosphate muscle fuel
20% muscle creatinine becomes waste
levels tied to muscle mass
not reabsorbed
Uric acid
what kind of metabolism
filtered by?
how much is excreted?
purine metabolism
filt by glom
6-12% excreted
Water balance
reg by
dehydration
excess hydration
reg by AVP
dehydration - tubes reabs h20 until osmol 1200
Excess H20- excretion of large diluted urine 50 osmol
Sodium
prim extracell cation
controlled by excretion
RAAS mechanism
K+
major intracell cation
H ions in exchange for Na
filtered and reabsorbed
Cl
extracellular anion
extracell fluid balance
passively reabs
Phosphate
higher intra than extra
controlled by PTH
Calcium
2nd most dom intracell cation
Endocrine functions
what hormones?
primary: produce hormones
2nd: target for hormones
Renin, EPO, 1,25 D, prostaglands
1,25(OH)sD
what balance?
active Vit D
phosphate/calcium balance
Prostoglands
increase
oppose
a/n
increase renal blood flow
oppose vasoconstriction
angiotensin/norepinephrine
Analytic procedures
creatinine clearance
creatininine clearance
ideal substance to measure
constant rate
cleared only by glom filt
correlate w muscle mass
Estimated GFR
reported with….
based on…
what is not required?
should pick up?
reported w serum creatinine level
based on serum creatinine, age, body, size gender
no 24hr test required
should pick up CKD impairment
Cockcroft-Gaut formula
was 1st
didnt correct for body surface area and women having low creatininie
Mod of diet in renal disease
no weight or body surface area measured
CKD-EPI
still uses race, less weight bias
Cystatin C
what kind of protein
rises faster than… in AKI?
uneffected by?
rise seen before….
bio?
better for?
LWM protein
levels rise faster than creatinine in AKI
uneffected by diet/age
rise seen before GFR/creatinine
bio variation
better for minor imparement
B2 macroglobulin
what is shed at constant rate?
filt?
increased levels =
assesses?
plasma membrane shed at constant rate
filt by glom
incease levels increase cell turn over
asses renal tube function
Myoglobulin
what kind of protein
acute…
binds/trans…..
rhabdomyelosis -
early
LWM protein
acute skeletal/caridac injury
bind/trans oxy from plasma to mitochondria
Rhabdomyelosis - acute renal failure
early diagn/treament required
Albuninuria
important for?
if found early?
decrease to prevent?
what is preformed?
what ratio?
microalbumin
important for pt w diabetes
if found early - rapid glucose control
decrease hypertension to prevent kidney fail
24hr urine preformed
ALB/creatinine ratio
Acute glomerulonephritis
what is present
decreased
casts?
what kind of infections?
lesions
decreased GFR
rbc casts
B heme strep infections
Chronic glomerulo
what kind of damage?
s
loss of?
minor decrease in?
length inflammation
scarring
loss of nephron function
minor dec in renal function
Nephrotic syndrome
caused by?
increased perm?
massive?
e
hyper
injury
increase permeablility of golm basement membrane
massive proteinuria/hypoalb
edema
hyperlipidemia
Tubular diseases
occurs in progress….
RTA clinically important….
affects
what cant keep up pH
what decrease bicarb reabsorption?
occur in progress of all renal disease as GFR fails
RTA clinically important affects acid base balance
Distal tubes cant keep up pH
proximal tubes decrease bicarb reabs
UTI
called what in the kidney?
what is diagnostic
whats it called in bladder/urinary?
what increases pressure?
upper?
pyeloneph in kidney
wbc casts diagnostic
cystitis - bladder/urinary
obstruction increases pressure
Upper: const lesions below collecting duct
Renal calculi
whats most common?
reduced?
kidney stones crystal substance
Calcium oxolate most common
reduced urine flow/saturation
AKI
sharp decline in….. due to
common?
prerenal aki:
aki:
post renal:
sharp decline in renal function due to acute toxic/hypoxic
common and serious
Prerenal AKI: cardiovasc sysmtem failure/hypovolermia
AKI: tube necrosis, vascular obstruction
Post renal: lower fraction
CKD
grad…
leading cause?
renal…
how many stages?
describe stages
what is being added?
gradual decline >3mos
diabetes leading cause
renal hypertension
5 stgs
A1-opt/mild
A2
A3 severe increase
alburmia being added
Therapy for AKI
kidney unable to..
methods?
h
c
h
irreversable damage only?
kidney unable to sec waste products
hemodyalsis
CAPD
hemofiltrate
irreversable damage
dialysis/transplantation only
