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PPP > Kidney Function I: Filtration, Reabsorption, Secretion and Clearance > Flashcards

Kidney Function I: Filtration, Reabsorption, Secretion and Clearance Flashcards

1
Q

What are the 3 main functions of the kidney?

A
  1. EXCRETION OF METABOLITES OR INGESTED SUBSTANCES
  2. CONTROL OF BODY FLUID COMPOSITION
  3. ENDOCRINE
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2
Q

List 5 examples of metabolites/ingested sub excreted by kidney and their origin

A
  1. Urea from protein catabolism
  2. Uric acid from nucleic acid breakdown
  3. Creatinine from muscle creatine
  4. End products of haemoglobin breakdown
  5. Foreign chemicals eg. drugs, pesticides
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3
Q

Why are metabolites/ingested sub excreted from kidney?

A

Prevent acc in body and toxicity

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4
Q

How is the kidney involved in control of body fluid comp?

A
  • directly control plasma composition
    – indirectly controls comp of interstitial fluid and then intracellular fluid comp
  • Volume Regulation i.e. linked to sodium concentration in plasma
  • Osmoregulation i.e. water balance – reg osmolarity of plasma
  • pH regulation of plasma
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5
Q

Name 5 hormones that act on kidney

A
  1. ADH
  2. Aldosterone
  3. Natriuretic peptides
  4. Parathyroid hormone
  5. Fibroblast growth factor 23
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6
Q

What is origin, location of action on kidney and function of ADH?

A
  • secreted by pos pit gland
  • CD
  • cause water reabsorption
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7
Q

What is origin, location of action on kidney and function of aldosterone?

A
  • secreted by adrenal cortex
  • CD
  • cause Na+ reabsorption
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8
Q

What is location of action on kidney and functions of natriuretic peptides?

A
  • CD
  • cause Na+ excretion
  • syn + secrete cardiac cells
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9
Q

What is origin and functions of parathyroid hormone?

A
  • secreted by parathyroid gland

– involved in Ca2+ reabsorption, phosphate excretion and vit D production

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10
Q

What is origin and functions of FGF23?

A
  • secreted by both osteocytes

– involved in inhibiting vit D production and causing phosphate excretion

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11
Q

Name 4 hormones produced by the kidney

A
  1. renin
  2. vit D
  3. erythropoietin
  4. prostaglandins
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12
Q

What is function of renin?

A

controls Na+ conc in plasma

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13
Q

What is function of vit D?

A

acts at gut to cause Ca2+ + phosphate absorption

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14
Q

What is function of erythropoietin?

A
  • syn in response to hypoxia (deficiency in amount of O2 reaching tissues)
  • stimulates bone marrow to inc production of RBCs
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15
Q

What is function of prostaglandins?

A

control vascular tone

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16
Q

Where are the kidneys located and what’s the diff between the R + L?

A
  • Kidneys between T12 + L3 vertebrae

- R slightly lower than left due to liver

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17
Q

Approx how many nephrons are in kidneys?

A

> 1 million/kidney

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18
Q

What is main structure of nephron?

A
  1. Renal corpuscle

2. Tubule

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19
Q

What is function of efferent arteriole?

A

where blood leaves glom

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20
Q

What is function of afferent arteriole?

A

supplies glom with blood

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21
Q

What happens to plasma in glom and how?

A
  • Blood enters through afferent arteriole and 20% of plasma leaves glom + filtered into Bowman’s space
  • 80% of plasma that’s entered A arteriole leaves through E arteriole
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22
Q

What are 3 layers of renal corpuscle?

A
  1. Capillary endo
  2. Basement mem
  3. Tubular epithelium (podocytes)
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23
Q

What is structure of capillary endo and how does it relate to its function?

A
  • pores (100nm)

– means its highly perm

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24
Q

What is charge and main structure of BM?

A
  • has –ve charged sites

- 3 layers

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25
Q

What is main structure of tubular epithelium (podocytes)?

A

have filtration slits (8nm)

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26
Q

What are important filtration slit proteins in podocytes?

A
  • Nephrin

- podocin

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27
Q

What are the 4 main regions of renal tubule?

A
  1. Proximal tubule
  2. Loop of Henle
  3. Distal convoluted tubule
  4. Collecting duct
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28
Q

Name the 2 sections the PT is split into

A
  1. Proximal convoluted tubule

2. Proximal straight tubule

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29
Q

Name the 3 sections the LOH is split into

A
  1. Thin descending limb
  2. Thin ascending limb
  3. Thick ascending limb
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30
Q

Name the 2 sections the CD is split into

A
  1. Cortical CD

2. Medullary CD

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31
Q

Name the 2 sections the renal corpuscle consists of

A
  1. Glomerulus/glomerular capillaries

2. Bowman’s capsule (Bowman’s space)

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32
Q

List all 11 features of the nepron from start to finish

A
  1. Glom
  2. BC
  3. PCT
  4. PST
  5. Thin DL
  6. Thin AL
  7. Thick AL
  8. DCT
  9. Cortical CD
  10. Medullary CD
  11. Renal pelvis
33
Q

At what level do nephrons merge?

A

CD

34
Q

Name the 2 types of nephron and % they make up in kidneys

A
  1. Cortical (85%)

2. Juxtamedullary (15%)

35
Q

Where are cortical nephrons located and how does their structure and function differentiate them from juxt nephrons?

A
  • outer 2/3 of cortex.
  • short Loop of Henle
  • producing dilute urine
36
Q

Where are juxt nephrons located and how does their structure and function differentiate them from cortical nephrons?

A
  • inner 1/3 cortex
  • long Loop of Henle
  • producing concentrated urine
37
Q

Where does glom filtration occur?

A

at renal corpuscle

38
Q

Where is renal corpuscle located?

A

Renal cortex

39
Q

What is the juxtaglomerular apparatus?

A

structure formed by the distal convoluted tubule and the glomerular afferent arteriole and consists of 3 main cells.

40
Q

What are the 3 main cell types of JA?

A
  1. Juxtaglomerular cells
  2. Macula densa
  3. Mesengial cells
41
Q

What is function of juxtglom cells?

A

secrete renin into blood

42
Q

What is function of macula densa?

A

involved in control of Na+ conc in plasma

43
Q

What is function of mesengial cells?

A

lie over glom capillaries + contain smooth muscle

44
Q

What is the blood supply to the nephrons?

A
  • 2 sets of arterioles (afferent and efferent)
  • 2 sets of capillary beds (glomeruli and peritubular) in series (peritubular capillaries called vasa recta when they surround LOH)
45
Q

What are the 4 basic renal processes?

A
  1. Glomerular Filtration
  2. Tubular Reabsorption
  3. Tubular Secretion
  4. Metabolism
46
Q

What is glomerular filtration?

A

The movement of fluid and solutes from the glomerular capillaries into Bowman’s space.

47
Q

What % of plasma that enters the glomerulus filtered into BS?

A

20%

48
Q

What type of process is glomerular filtration and what does that mean?

A

Non-selective process = no specific protein involved – body able to excrete waste products without having a specific transporter/selective protein

49
Q

What is the filtrate produced from glomerular filtration and what its comp like?

A

Ultrafiltrate – has same comp of plasma except for some stuff

50
Q

What is tubular secretion?

A

The secretion of solutes from the peritubular capillaries into the tubules. Secretion of mol directly from walls of tubule.

51
Q

What mol are syn in tubule epi?

A
  • H+
  • HCO3-
  • NH4+
52
Q

What is tubular reabsorption?

A

The movement of materials from the filtrate in the tubules into the peritubular capillaries.

53
Q

Do all the basic renal process have to happen in order?

A

No - tubular secretion may not occur before tubular reabsorption

54
Q

How can u determine the amount excreted in the urine?

A

Amount filtered + amount secreted - amount reabsorbed

55
Q

What renal processes occur in case of glucose?

A

filtered and completely reabsorbed but never secreted + not normally in urine

56
Q

What renal processes occur in case of toxic sub, PAH?

A

filtered and secreted but not reabsorbed

57
Q

What renal processes occur in case of H2O and most electrolytes?

A

filtered and some of it is reabsorbed + little bit in urine.

58
Q

How does the kidney perform metabolism?

A

metabolises sub and eliminates them from body e.g. glutamine met in walls of tubule

59
Q

What gets through the glom filtrate barrier?

A

Ultrafiltrate

60
Q

What is ultrafiltrate?

A

Normally all plasma constituents MINUS proteins

61
Q

What doesn’t get through glom filtrate barrier and why?

A

large proteins - not able to cross filtration barrier.
+ve and –ve charged mol bind to proteins – can’t be filtered and won’t pass into BS e.g. 40% of Ca2+ binds to proteins – not able to be filtered

62
Q

What is one function of plasma proteins?

A

bind many drugs

63
Q

What is function of albumin?

A

binds acidic drugs

64
Q

What is function of α1-acid glycoprotein?

A

binds basic drugs

65
Q

How does size of mol smaller than 7kDa affect glom filtration and 2 examples?

A
  • small and can be freely filtered - have conc in ultrafiltrate that’s same as plasma
  • glucose, inulin
66
Q

How does size of mol larger than 7kDa affect glom filtration and 2 examples?

A
  • too large to freely filtrate across barrier - lower conc in filtrate –
  • larger proteins e.g. albumin, myoglobin
67
Q

How does charge of mol affect glom filtration?

A
  • Large +ve mol cross filtration barrier to greater extent compared to uncharged mol and –ve mol bcos BM has –ve charges
68
Q

What does infection, damage to glomerulus, very high

blood-pressure result in?

A
  • protein in urine (proteinuria)
  • haemoglobin in urine (haemoglobinuria)
  • red cells in urine (haematuria)
69
Q

What is glomerular filtration rate?

A

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

70
Q

What does GFR depend on?

A

combination of:

  1. Starling forces
  2. Hydraulic permeability (which is high in this capillary bed)
  3. Surface area
71
Q

How is GFR regulated?

A

neural and hormonal input

72
Q

Which 3 forces are involved in filtration?

A
  1. Starling forces (opposing)
  2. Hydrostatic pressure - capillary bp opposed by water – fluid in BS
  3. Osmotic/Oncotic
73
Q

How is net glomerular filtration pressure calculated?

A

Diff in pressure between Hydrostatic pressure in capillary lumen and capsular pressure in capsular space minus diff in oncotic pressure in capillary lumen and capsular space = 16mmHg

74
Q

What does diff in hydrostatic and capsular pressures cause?

A

higher pressure in capillary lumen cause movement of fluid from plasma to space

75
Q

What does diff in oncotic pressures in capillary lumen and capsular space cause?

A

lower pressure in space cause movement of fluid from space to plasma

76
Q

What does net glom filtration pressure show?

A

Overall movement of fluid from plasma to space (greater hydrostatic/capsular pressure diff)

77
Q

Why is oncotic pressure in BS considered to be zero?

A

protein concentration in Bowman’s space filtrate is so low

78
Q

What causes decreased GFR?

A
  • Constrict AA/dilate EA
  • restrict hydrostatic pressure/bp
  • Red driving force of filtration
79
Q

What causes decreased GFR?

A
  • Constrict EA/dilate AA
  • inc hydrostatic pressure/bp
  • inc driving force of filtration

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