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Clinical biochemistry > Kidney and Renal function > Flashcards

Kidney and Renal function Flashcards

1
Q

Name 3 nitrogenous wastes

A

Urea, creatinine and uric acid

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2
Q

Functions of renal system

A

Endocrine, metabolic, homeostatic, excretory

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3
Q

What happens blood volume when there is many salts in the body

A

blood volume increases

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4
Q

How many litres are filtered by kidneys per day

A

180L

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5
Q

What molecular weight is forced out of glomerulus

A

<68,000

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6
Q

What happens in the DCT

A

Exchange of Na+ for K+ under aldosterone control

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7
Q

What happens in loop of henle

A

Descending H2O is lost, ascending Na+ is lost

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8
Q

What is the average GFR

A

125ml/min

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9
Q

What is GFR influenced by

A

Filtration pressure and filtration coefficient

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10
Q

What hormones are synthesised by the kidney

A

Renin and erythropoietin

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11
Q

Function of aldosterone

A

Regulate sodium and potassium levels and increase water retention

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12
Q

Function of antidiuretic hormone

A

Water absorption in collecting ducts

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13
Q

What does pre renal refer to

A

Any condition that results in reduced blood flow to the kidneys

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14
Q

What does renal refer to

A

Damage to renal tissue, glomerular basement membrane/tubules

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15
Q

What does post renal refer to

A

Obstruction to urine outflow

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16
Q

Reference range for serum urea

A

1.7-8.3mmol/L

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17
Q

How does urea end up in the blood

A

End product of protein and amino acid catabolism

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18
Q

Suitable samples for serum urea testing

A

Serum, plasma, urine, amniotic fluid, other bodily fluids. Deprotinised whole blood

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19
Q

Why is refrigeration of urea necessary

A

Urea can be destroyed by bacteria

20
Q

Principle of urea assay

A

Measure nitrogen content of urea and not urea directly

21
Q

Enzyme used in urea hydrolysis

A

Urease

22
Q

What is nesselers reagent

A

Iodine salt of mercury and potassium

23
Q

What occurs in nesseleres reaction

A

Nesselers reagent is reacted with the amonia formed in the urease reaction. Forms brown colour which can be measured enzymatically

24
Q

Name the catalyst in the berthelot reaction

A

sodium nitroprusside

25
Q

What occurs in the berthelot reaction

A

Amonia formed in urease reaction reacts with phenol and sodium hypochlorite to form blue indophenol.

26
Q

Name 2 enzymes used in kinetic method

A

Urease and glutamate dehydrogenase

27
Q

Pre renal causes for increased urea

A

low blood pressure, decreased blood flow, increased dietary protein

28
Q

Renal causes for increased urea

A

renal disease with decreased glomerular filreation. Glomerular nephritis, renal failure from diabetes

29
Q

Post renal causes for decreased urea

A

UTI’s, kidney stones, bladder tumour

30
Q

Pre renal causes for decreased urea

A

liver disease, high fluid intake, decreased dietary protein, increased protein synthesis.

31
Q

Where is creatine formed

A

Liver and pancreas

32
Q

What is creainine

A

A waste product of creatine formed during normal muscle metabolism

33
Q

Reference range for creatinine serum

A

Men 62-115umol/L Women 53-97 umol/L

34
Q

What happens in the Jaffe reaction

A

Creatinine is reacted with alkaline picrate solution to form a complex which is read

35
Q

What produces falsely elevated creatinine values in the Jaffe reaction

A

Interferences. Presence of noncreatine chromogens or Jaffe positive substances

36
Q

Examples of Jaffe positive substances

A

Acetoacetic acid, pyruvic acid and hydantoin

37
Q

What is different in the modified jaffe reaction

A

Absorbance is measured at two different pH levels

38
Q

Urea:creatinine ratio

A

10:1 to 20:1

39
Q

When would you see an increase in the ratio

A

Following GIT bleeding, fever and burns

40
Q

When would you see a decrease in the ratio

A

Protein intake, severe liver disease

41
Q

Rate that plasma is filtered in glomeruli

A

140ml/min

42
Q

How is GFR measured

A

Clearance test, eGFR

43
Q

What is clearance

A

The number of mls of blood cleared of a substance by per unit time

44
Q

Formula for clearance

A

C=(UxV)/P

45
Q

Limitations of clearance test

A

Expensive, difficult assay, invasive

Clinical biochemistry (11 decks)

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