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physiology > kidney function 1 > Flashcards

kidney function 1 Flashcards

1
Q

what is the function of the kidneys ?

A

to excrete metabolites or ingested substances

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2
Q

what are some examples of the substances that kidneys excrete ?
where do these substances come from ?

A
  • urea from protein
  • uric acid from nucleic acids
  • creatinine from creatine
  • hormone metabolites
  • end products of haemoglobin breakdown
  • foreign chemicals
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3
Q

what are the 3 ways the kidneys control plasma ?

A
  • volume regulation
  • osmoregulation
  • pH regulation
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4
Q

what are some examples of hormones that act on the kidney ?

A
  • anti-diuretic hormone (ADH)
  • aldosterone
  • natriuretic peptides
  • parathyroid
  • fibroblast growth factor 23
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5
Q

what are some hormones produced by the kidney ?

A

renin
vitamin D3
erythropoietin
prostaglandins

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6
Q

where are the kidneys found ?

A
  • found behind the peritoneum
  • one kidney on either side of vertabarl coloumn
  • between T12 and L3 vertbrea
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7
Q

what is each nephron made up of ?

A
  • renal corpuscle

- tubule

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8
Q

what arteriole supplies the kidneys ?

A

afferent arteriole

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9
Q

where is the ultrafiltration found ?

A

in bowmans capsule

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10
Q

where is the filtration barrier ?

A

between bowmans spaces + glomerulus

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11
Q

what make up the 3 layers of the filtration barrier ?

A
  • fenestrated capillary endothelium
  • basement membrane
  • tubular epithelium ( podocytes )
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12
Q

what is a feature of the fenestrated capillary endothelium ?

A

has large pore sizes

up to 15 nm

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13
Q

what is a feature of the basement membrane ?

A

has fixed polyanions ( negative charges )

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14
Q

what is a feature of the tubular epithelium ?

A

has filtration silts

8nm

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15
Q

what are the podocyte foot process?

A

refers to large extensions of the podocyte

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16
Q

how are podocytes connected ?

A

they digilate with each other

do not touch

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17
Q

what are the 2 types of nephrons ?

where are the types found ?

A
  • cortical (85%)
    outer 2/3 of cortex
  • juxtamedullary (15%)
    inner 1/3 of cortex
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18
Q

what is a feature of the cortical nephron ?

A

has short loop of Henle

doesn’t penetrate into medullla

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19
Q

what is a feature of juxtamedullary nephrons ?

A

has a long loop of Henle

plunges deep into medulla

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20
Q

what is the juxtaglomerular apparatus ?

A

macula densa + juxtaglomerular cells

can sometimes include extraglomerular mesangial cells

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21
Q

what is interesting about the nephron blood supply ?

A

has 2 sets of arteiroles ( afferent + efferent )
has 2 sets of capillary beds (glomeruli + peritubular )
work in series

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22
Q

what are the 3 basic renal processes ?

A
  1. glomerular filtration
  2. tubular reabsorption
  3. tubular secretion
23
Q

what is glomerular filtration ?

what does it rely on ?

A

refers to the 20% of plasma that enters the Bowman’s capsule
relies on hydrostatic + osmotic gradients

24
Q

what is the tubular secretion ?

A

secretion of solutes from peritubular capillaries into the tubules
also refers to movement of solute from tubule epithelium to tubule lumen

25
Q

what is tubular reabsorption ?

where is it greatest ?

A

movement of materials from the filtrate in the tubules into the peritubular capillaries
greatest in proximal tubules

26
Q

what does the amount of substance excreted into urine depend on ?

A

amount excreted = amount filtered + amount secreted - amount reabsorbed

27
Q

what is another renal process ?

A

metabolism - removes substances from blood / glomeular filtrate + metabolise them

28
Q

what does glomerular filtration depend on ?

A
  • molecular size
  • charge
  • shape of substance
29
Q

what is not found in ultrafiltrate ?

A
  • cells + large proteins

- drugs + certain ions because they bind to proteins

30
Q

what can effect the glomerulus ?

A
  • infection
  • damage
  • high blood pressure
31
Q

what is the result of a damaged glomerulus ?

A
  • protein in urine ( proteinuria)
  • haemoglobin in urine ( haemoglobinuria)
  • red cells in urine (haematuria)
32
Q

what is the glomerular filtration rate (GFR)?

A

volume of fluid filtered from the glomeruli per minute ml/min

33
Q

what does GFR depend on ?

A
  1. net filtration pressure
  2. permeability characterisitc
  3. surface area

also regulated by hormonal + neural control

34
Q

what is GFR a good determinate of ?

what does a high GFR mean ?

A
  • renal functiton

- higher GFR = greater excretion of salt + water

35
Q

what are the 2 starling forces involved in filtrations ?

A

hydrostatic pressure difference

colloid osmotic pressure difference

36
Q

what determines the hydrostatic pressure difference ?

A

pressure of fluid against glomeularus wall

37
Q

what determins colloid osmotic pressure ?

A

pressure exerted by large molecules

38
Q

how does plasma flow across the capillary wall with reference to pressure ?

A
  • high to low hydrostatic pressure

- low to high colloid osmotic pressure

39
Q

what is the net glomerular filtration pressure ?

A

16 mmHG

40
Q

how can you decrease GFR ?

A
  • constriction of afferent arteriole = decreased glomerular capillary hydrostatic pressure = decreased GFR
  • dilation of efferent arteriole = decreased glomerular capillary hydrostatic pressure = decreased GFR
41
Q

how to increase GFR ?

A
  • dilation of afferent arteriole = increased glomerular capillary hydrostatic pressure = increased GFR
  • constriction of efferent arteriole = increased glomerular capillary hydrostatic pressure = increased GFR
42
Q

how does sympathetic influence effect the SA of filtration ?

A

increase sympathetic activity = contraction of mesangial cells = decreased SA for filtration = decreased GFR

43
Q

why is urine output much less than GFR ?

A

because reabsorption occurs

44
Q

describe the structure of the cells found in the proximal tubule :

A
  • walls are a single layer of columnar cells
  • have lots of microvilli
  • lots of mitochondria
45
Q

how are organic nutrients reabsorbed ?

A

Na coupled co-transporter in the luminal membrane
a tubular maximum system
specific transporters for specific molecules

46
Q

how is glucose reabsorbed ?

A

SGLT-Na dependent glucose co-transporter on the luminal membrane
glucose enters the proximal tubules + leaves via a GLUT faciliated transporter on the basolateral membrane

47
Q

how are amino acids reabsorbed ?

A
  • reabsorbed in proximal tubule

- different transporters for different groups of amino acids e.g ones for neutral AA, basic AA + acidic AA

48
Q

how is protein reabsorbed ?

A
  • mostly reabsorbed in the proximal convulated tubule
  • absorbed by endocytosis + degraded into amino acids
  • amino acids are later reabsorbed by transporters on basolateral membrane
49
Q

how does secretion take place in the proximal tubule ?

A
  • 2 stage process

- involves basolateral + luminal membrane transporters

50
Q

what are examples of some organic acids secreted in the proximal tubules ?

A
  • bile salts
  • fatty acids
  • drugs e.g penicillin
  • para-aminohippuric acid ( PAH)
51
Q

how are organic anions secreted ?

A
  • anion enters epithelial cells via transporters

- enters tubule lumen via ATP dependent transporter

52
Q

what are some examples of organic cations

A
  • choline
  • creatinine
  • morphine
  • atropine
53
Q

how are cation secreted ?

A

enter cell via transporters

enter tubule via countertransporters

physiology (18 decks)

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