kidney function 3 Flashcards
how is constant plasma osomolality maintained ?
- urine formation
- thrist
what is concentrated urine ?
- anything above 300 mosmol/kg
what is obligatory water loss ?
0.428L/day
what is oliguria ?
urine output below 300mosmol/kg
what is dilute urine ?
- anything below 300 mosmol/l
- lots of water in urine
what is anti-diuresis ?
low volume of urine
what happens when the body is dehydrated ?
- increased plasma osmoolality
- stimulates osmoreceptors in hyptohalamus
- causes posterior pituitary to release more ADH
- means increased water reabsorption in the kidneys
- less water excreted in urine
what is diuresis ?
large volume of urine
what happens when the body is over- hydrated ?
- decreased plasma osmolality
- stimulates osmoreceptors in the hypothalamus
- posterior pituitary releases less ADH
- causes kidneys to decrease water reabsorption
- more water excreted in urine
what is osmolar clearance ?
the clearance of all osmotically active particles in the plasma
where do osmoreceptors signal to ?
paraventricular and supraoptic nuclei in hypothalamus
what controls ADH secretion ?
- plasma osmolality
- neural control
- hormonal control
what hormones increase ADH secretion ?
angiotensin II
what hormones decrease ADH secretion ?
natriuretic peptides
what other factors effect ADH levels ?
how do they effect ADH ?
pain ( stimulates) nausea (stimulates) nicotine (stimulates) stress (stimulates) alcohol ( inhibits)
what is water diuresis
dilute urine
lots of water in it
what is osmotic diuresis
abnormal concentrations of solute in urine
what are the characteristics of diabetes insipidus ?
- urination
- thirst
- nocturia
what are the 2 types of diabetes insipidus ?
- neurogenic (no ADH secreted) can be congenital or due to trauma
- nephrogenic (ADH present but kidneys dont respond to it) can be inherited or acquired
what are the characteristics of osmotic diuresis ?
- urination
- thirst
how is potassium maintained ?
- renal excretion
- gastrointestinal loses
- cellular shifts
what is hypokalaemia ?
lower than normal level of potassium in blood
what is hypokalaemia caused by ?
- increased external losses of potassium
- redistribution of potassium into cells
- inadequate potassium intake
what are the boundaries for hypokalaemia ?
- mild: 3.0-3.5
- moderate: 2.5-3.0
- severe: < 2.5
what are symptoms associated with hypokalemia ?
- irregular heartbeat
- weakness, paralysis of muscles
- nausea and vomitting
- polyuria
how can you treat hypokalemia ?
- eat foods rich in potassium
- administer KCL
- correct alkalosis
what is hyperkalaemia ?
too much potassium in the urine
what causes hyperkalemia ?
decreased external losses
redistribution out of cells
what are the boundaries of hyperkalemia ?
- mild : 5.5-6.5
- moderate: 6.5- 7.5
- severe > 7.5
what are symptoms of hyperkalemia ?
- irregular heartbeat
- weakness and paralysis of muscles
- nausea and vomiting
how can you treat hyperkalemia ?
- stabilize the cardiac membrane
- fix potassium shift into cells
- long term potassium will need to be removed from the body