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Physiology II > Kidney functions- regulation and quantification > Flashcards

Kidney functions- regulation and quantification Flashcards

1
Q

Kidney functions include?

A

excretion, ABB maintenance, metabolic and endocrine functions

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2
Q

Physiological basis of urine formation includes…?

A

glomerular and tubular filtration

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3
Q

What is glomerular filtration?

A

Filtration of plasma through 3 layers that make up the glomerular membrane.

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4
Q

Name layers of glomerular membrane?

A
  • endothelial cells of the capillary wall
  • basement membrane
  • and the inner layer of Bowman’s capsule (podocytes)
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5
Q

What is tubular filtration?

A

occurs when the glomerular liquid passes into the renal tubules.

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6
Q

What happens under glomerular filtration?

A

Volume of the liquid decreases (secondary urine) and the composition gets changed by processes of reabsorbtion and secretion.

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7
Q

Which system does the glomerulus represent?

A

A high pressure system, the high hydrostatic pressure facilitates filtration.

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8
Q

Which system does the peritubular capillaries contribute to?

A

A low pressure system, the low hydrostatic pressure facilitates reabsorption from the tubulus.

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9
Q

Filtration can be inflluenced by?

A
  • altered renal blood flow
  • changes in hydrostatic pressure (glomerular capillaries)
  • alterations in systemic BP
  • Constriction of vas afferens or efferens
  • changes of HP in Bowmans capsule
  • alterations in plasma protein concentration
  • changes in permeability of glomerula capillaries
  • changes in the effective filtration surface
  • obstruction in ureter, edema in kidney capsule etc.
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10
Q

What is RAAS ?

A

Renin-angiotensin-aldosterone system –> is a hormone system that regulates blood pressure and fluid balance.

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11
Q

Granular cell function in kidneys?

A

Internal baroreceptors

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12
Q

Which cells are sentisitve to NaCl?

A

Macula densa cells –>area of closely packed specialized cells lining the wall of the distal tubule.

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13
Q

What happens when there is a fall in NaCl concentration or BP in afferent arteriole?

A

Granular cells start producing the hormone renin.

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14
Q

What are Granular cells innervated by, and what does this enable?

A

The sympatic nervous system, enables a reflex response to BP failure by stimulating renin secretion.

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15
Q

What induces renin production?

A

Fall of :

  • conc. of NaCl
  • ECF volume
  • Blod pressure
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16
Q

What happens with renin after secretion?

A

Acts as an enzyme and by cleavage it activates angiotensinogen –> angiotensin I

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17
Q

What is angiotensionogen?

A

A precursor, plasma protein synthesized in liver

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18
Q

What happens with angiotensin I?

A

It passes through the lungs during circulation, and there it gets converted to angiotensin II.

19
Q

Which enzyme converts angiotensin I –> angiotensin II?

A

ACE –> angiotensin converting hormone, produced by endothelial cells of lung capillaries.

20
Q

Function of angiotensin II?

A

a active hormone causing vasoconstriction and increases BP. It is also the primary stimulus for aldosterone secretion.

21
Q

What is aldosterone and where is it produced?

A

Promotes the synthesis of Na+/K+ carriers in the distal and collecting tubules of the kidney. It increases Na+ reabsorption followed by water reabsorbtion –> produced in adrenal cortex.

22
Q

Agonist of angiotensin II?

A

Vasopressin/ADH –>both is constrictors of the systemic arterioles –> incr. BP

23
Q

What is ANP, and where is it produced?

A

Atrial natriuretic peptide, produced in the right atria of the heart in response to being streched by Na+ retention, expansion of the ECF and increase in atrial BP

24
Q

what is ANP’s role in the RAAS system?

A

it promotes in turn natriuretic, diuretic, and hypotensive effects to help correct the original stimuli that resulted in it’s release. –>promotes excretion of water and sodium from the kidneys when their level gets too high

25
Q

How is glomerular filtration rate measured?

A

As a clearance of insulin in plasma –> plasma clearance.

26
Q

What is plasma clearance?

A

How quickly a substance is removed froom blod plasma. –> important for drug function

27
Q

Which factors do you need to calculate PC?

A

V= volume (urine flow rate) [mL/min]
U= concentration in urine [mg/mL]
P= concentration in plasma [mg/mL]
[P and U MUST have same units!!!!!]

28
Q

Formula for plasma clearance?

A

C inuli [mL/min] = U x V / P

29
Q

Criterias for suitable substances to measure the clearance…?

A
  • not secreted by kidneys
  • not be eabsorbed by kidneys
  • not be metabolized or stored in body
  • freely filtrated in glomerulus
  • not toxic
  • not bound to plasma proteins
  • easily detectable in urine
  • not have any influence of glomerular filtration rate
30
Q

Clearance considers…?

A
  • GMF
  • blood flow through the kidneys
  • filtration fraction (fraction of the plasma flowing through the glomeruli and filtered into tubules)
31
Q

Plasma clearance equals the GFR?

A

a substance is filtered but not reabsorbed or secreted

32
Q

Plasma clearance is less than GFR ?

A

a substance is filtered and reabsorbed but not secreted.

33
Q

Plasma clearance is higher than GFR ?

A

a substance is filtered and secreted but not reabsorbed.

34
Q

Which polysaccharide is used for measurement of GFR because it meets all the criteria?

A

Inulin

35
Q

What is used to estimate renal blood flow?

A

Substances with 100% clearance –> excretion of the substance after one circulation through the kidneys.

36
Q

What must be considered using a substance t measure renal blood flow?

A
  • 90% of the blood form a. renalis passes the active parenchyme
  • 10% nourishes the non-active tissues.
37
Q

What is one of the suitable substances for RBF?

A

PAH –> para-aminohippuric acid

38
Q

Renal plasma flow = ?

A
  • effective renal flow of plasma = clearance of PAH

- renal blood flow (1-Htc)

39
Q

How can we easily determine filtration fraction?

A

By knowing the PAH clearance and the inulin clearance.

40
Q

What is filtration fraction?

A

Fraction of the plasma flowing through the glomeruli and filtered into the tubules.

41
Q

FF -formula ?

A

FF = GFR (plasma inulin clearance) / renal plasma flow

42
Q

What does the result mean?

A

A percentage of the plasma which is entering the glomerulus is filtered. 20% normally refers to a normal filtration level.

43
Q

Formula for hematocrit?

A

MCV x RBC

Physiology II (37 decks)

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