Kidney Biochem Flashcards

1
Q

Different part of a nephron

A
Glomerulus 
Proximal tubule 
Descending limb 
Loop of henle 
Ascending limb 
Distal tube 
Collecting duct
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2
Q

Excretory function of kidney

A

Remove waste product from bloodstream

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3
Q

Type of waste eliminated by kidney

A
Urea 
Uric acid
Creatinine
Urobilina
Acids, drugs
Excess Na, K, Cl, Ca, HPO4, Mg, S, HCO3
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4
Q

Homeostatic role of kidney

A
Blood pressure , blood volume regulation
Water balance 
Blood ph maintenance 
Electrolytes balance
Regulation of red blood cells
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5
Q

Reabsorptive function of kidney

A

Reabsorption of glucose , aa, electrolytes, proteins

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6
Q

Metabolic function of kidney

A

Synthesis of gluthatione, glycogen, ammonia

Breaking of hormones and cytokines

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7
Q

Endocrine functin of kidney

A

Synthesis of erythropoitein
Vitamin D activation
Renin release

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8
Q

Urinary ph norm

A

4.5-5

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9
Q

3 general causes to acute renal failure

A

Prerenal causes
Renal causes
Post renal causes

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10
Q

Renal causes to acute renal failure

A

Vascular disorders
Glomerulonephritis
Interstitial nephritis
Tubular necrosis

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11
Q

Tubular necrosis causes

A

Ischemia
Toxins
Pigments

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12
Q

Main cause of acute renal failure

A

Prerenal causes , renal perfusion disorders - 55%

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13
Q

2nd main cause of acute renal failure

A

Disease of renal parenchyma - 40 %

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14
Q

Is ARF reversible

A

Yes most of the time

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15
Q

What is prerenal azotemia

A

Renal hypoperfusion which is rapidly reversible but can lead to ischemic renal renal parenchyma injury and intrinsic renal azotemia if prolonged

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16
Q

Majors causes of prerenal ARF

A

Hypovolemia

Low CO
Increased renal systemic vascular resistance ratio

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17
Q

Diseases of renal azotemia causing ARF

A

Renovascular obstruction
Disease of glomeruli
Acute tubular necrosis ( ischemia, toxins)
Interstitial nephritis ( allergy, infection, infiltration , idiopathic)

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18
Q

Postrenal azotemia causes

A

Ureteric (calculi ,blood clots ,cancer )

bladder neck (neurogenic bladder ,prostatic hyperplasia , calculi , blood clot, cancer )

urethra stricture

19
Q

What is the mechanism of post Renal disease leading to ARF

A

Glomerular filtration continues in early stage of obstruction
increased intraluminal pressure upstream to the obstruction
gradual distention of proximal ureter ,renal pelvis and calyces
fall in GFR

20
Q

What are some Renal injury that can lead to chronic renal failure

A

Glomerulonephritis
diabetes mellitus
hypertension
tubulo interstitial nephritis

21
Q

What is GFR

A

sensitive index of overall renal excretory function

22
Q

What is the consequence of decreased GF our

A

Retention and accumulation of the excreted substances in the body fluids

23
Q

What does uremia indicates

A

Profound loss of renal function

24
Q

What impact the severity of the signs and symptoms of uremia

A

The magnitude of reduction in functioning renal mass

the rapidity with which renal function is lost

25
Urea clinical abnormalities
Anorexia malaise Vomiting headache
26
Consequences of excessive salt ingestion
Congestive heart failure hypertension Ascites edema
27
Excessive water ingestion can lead to
Hyponatremia | Weight gain
28
How is potassium level in chronic renal failure
Stable until final stages of uremia
29
Why could there be metabolic acidosis in chronic renal failure
Because of reduction in Reno mess limiting amount of ammonia and bicarbonate that can be generated
30
Why is there hypocalcemia in chronic renal failure
Due to impaired ability of kidney to synthesize active vitamin D
31
What can cause hyperphosphatemia in chronic renal failure
Due to decreased GFR
32
Why is there renal and metabolic osteodystrophy
Increased PTH Disordered vitamin D metabolism Chronic metabolic acidosis
33
HDL level and tryglycerides and cholesterol level in uremia
Hypertriglyceridemia Decreased HDL Normal cholesterol
34
Level of lipoprotien lipase in uremia
Decreased which explains high triglycerides
35
Signs and symptoms of renal failure
``` Uremia symptoms ( nausea, vomiting, lethargy) Micturation disorders Urine volume disoderds Urine composition alteration Pain Edema ```
36
When to do renal function
``` Older age Family history of CDK Decreased renal mass Low birth weight diabetes mellitus Hypertension Autoimmune disease Systemic infections UTI Nephrolithiasis Obstruction to lower urinary tract Drug toxicity ```
37
Renal function tests
``` GFR measurements ( clearance test, plasma creatinine, urea, uric acid, B2 microglobulin) Renal tubular function test ( osmolality measurements, proteinuria, glycosuria, aminoaciduria ) Urinalysis ( appearance, gravity, osmolality, pH, glucose, protein, urinary sediments ) ```
38
First step in kidney function test
Simple inexpensive screenig test of random urine sample
39
`anuria
Less tha 100ml/24h
40
Causes of anuria
Urinary tract obstruction (Prostatic hyperplasia ,Tumors ) Heart failure , severe hypotension ( renal ischemia ) Glomerular nephritis (acute, subacute, chronic ) Hemolitic rxn with blood transfusion
41
Oliguria
Less than 400 ml/day
42
Causes of oliguria
``` Dehydration Vomit Diarrhea Sweating Ascites Hypoperfusion Edema AKI Terminal CKD Glomerulonephritis ```
43
Polyuria
More than 3000 ml / day
44
Causes of polyuria
``` Polydipsia Extreme protein intake Caffein Alcohol Diuretic DM, DI Deficit ADH ```