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326 Acute & Chronic > Kidney Functions > Flashcards

Kidney Functions Flashcards

1
Q

List the different functions of the kidney.

A
  • Filtration
  • Regulation of Acid Secretion
  • Regulation of Electrolyte Excretion
  • Renal Clearance
  • Regulation of Water Excretion
  • Erythropoetin Secretion
  • Activation of Vitamin D
  • Phosphate Regulation
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2
Q

Describe the nephron.

A
  • The nephron is the functional unit
    of the kidney.
    ~ Where filtration occurs
    ~ Where electrolyte resorption occurs
    ~ Where filtrate and urine are formed
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3
Q

Describe filtration in relation to the golmerulus.

A
  • The glomerulus, composed of capillaries, are supplied with blood by an afferent arteriole and drained by an efferent arteriole.
  • Blood pressure determines how fast and what pressure blood passes through the glomerulus.
  • Filtering occurs as blood flow through the glomerulus
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4
Q

Describe filtration in relation to fluid.

A
  • Water and small molecules pass through.
  • Fluid is filtered through the walls of the glomerular capillaries and enters the tubules.
    ~ This fluid is called filtrate.
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5
Q

Describe filtration in relation to larger molecules.

A
  • Larger molecules are not normally passed through the glomerulus.
  • They have a high molecular weight
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6
Q

List some examples of molecules with a high molecular weight.

A
  • Protein/albumin
  • Red blood cells
  • White blood cells
  • Platelets
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7
Q

What substances are normally filtered by the glomerulus and excreted in urine?

A
  • Na, Cl
  • Bicarbonate, K, glucose
  • Urea, creatinine, and uric acid.
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8
Q

What is Glomerular filtration rate (GFR)? What does it estimate?

A
  • Glomerular filtration rate (GFR) is a diagnostic test used to assess kidney function.
  • Specifically, it estimates how much blood/creatinine passes through the glomeruli each minute.
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9
Q

What are glomeruli?

A

Glomeruli are the filters within the nephrons of the kidneys that filter waste/excess from the blood.

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10
Q

What diagnostic tests can measure GFR?

A
  • Creatinine Clearance(CrCl) via a 24-hour urine.
  • eGFR via venipuncture
    ~ Which test is more accurate?
    ~ Which one is more convenient?
  • Note: Normal GFR is 90-120 ml/min
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11
Q

What do the kidneys do with hydrogen ions?

A
  • The kidneys are supposed to get rid of excessive amount of hydrogen ions in the body.
  • Hydrogen ions are acids within the body.
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12
Q

What happens if kidney function is compromised?

A
  • If kidney function is compromised, there will be retention of hydrogen ions.
    ~ Increased acidity of the blood (serum)
    ~ Lowered serum pH level
    ~ Normal pH of the blood is 7.35 to 7.45.
  • Metabolic Acidosis
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13
Q

What do the kidneys do with potassium?

A
  • The kidneys are supposed to get rid of excessive amount of potassium.
  • If kidney function is compromised, there will be retention of potassium (hyperkalemia).
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14
Q

Why can potassium be a life-threatening electrolyte?

A

This can be a life-threatening electrolyte because hyperkalemia causes myocardial depression

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15
Q

What do kidneys do with metabolites?

A
  • The kidneys are supposed to get rid of the components of cellular breakdown (metabolites), especially protein.
  • Also known as waste products
  • If kidney function is compromised, there will be retention of the metabolites.
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16
Q

What does the retention of metabolites lead to?

A
  • This leads to an increase in BUN and creatinine levels and subsequent uremia.
  • Uremia causes a a whole slew of problems to all systems in the body!
17
Q

What is discoloration of the skin secondary to? What is dryness secondary to?

A
  • Discoloration of the skin secondary to retained urochromes (uremia) which are normally excreted by the kidneys.
  • Dryness secondary to decreased activity of sweat and sebaceous glands
18
Q

What is excoriation related to? What are ecchymoses and purpura related to?

A
  • Excoriation, bleeding and infection related to scratching to relieve itching.
  • Ecchymoses and purpura related to abnormal blood clotting and capillary fragility in uremia.
19
Q

What happens if kidney function is compromised?

A
  • The kidneys are supposed to get rid of excessive amounts of water/fluid.
  • If kidney function is compromised, there will be retention of fluid in different areas of the body.
20
Q

What happens when GFR falls below 4-5 mL/min?

A

When GFR falls below 4-5 ml/min, significant amounts of water are retained in the blood–volume overload (hypervolemia)

21
Q

What do kidneys do with erythropoietin? What happens if kidney function is compromised?

A
  • The kidneys are supposed to secrete erythropoietin so red blood cells can be produced from the bone marrow. .
  • If kidney function is compromised, there will a decrease in EPO (erythropoetin) release and subsequent decreased red blood cell production (anemia)
22
Q

What is erythropoetin (EPO)? Where is EPO produced?

A
  • Erythropoetin (EPO) is the principal factor that stimulates RBC production.
  • In adults, about 80-90% of EPO is produced by epithelial cells of the renal peritubular capillaries.
  • A small amount is produced by the liver but this amount is not adequate to maintain a normal number of RBCs in the circulating blood
23
Q

Where can vitamin D be obtained?

A
  • Dietary intake
  • Exposure to ultraviolet light (natural or artificial).
24
Q

What do kidneys do with vitamin D? Describe the active form of vitamin D. What happens if kidney function is compromised?

A
  • The kidneys are supposed to convert Vitamin D (food and UV light) to an activated form.
  • Vitamin D has to be in its active form to be utilized by the body.
  • Active form of Vitamin D is needed for absorption of calcium in the GI tract.
  • If kidney function is compromised, hypocalcemia will occur.
25
Q

What do kidneys do with phosphorous? What happens if kidney function is compromised?

A
  • The kidneys are supposed to get rid of excessive amount of phosphorus.
  • If kidney function is compromised, there will be retention of phosphorus (hyperphosphatemia)

326 Acute & Chronic (3 decks)

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