Kidney Pathophysiology Flashcards
What shape are the kidneys? Where are the kidneys located? What is the kidney’s primary function?
Bean shaped
Back of the abdominal wall
Filter blood and removes wastes
What are the two waste products removed by the kidneys?
Uric acid and creatinine
What is one of the kidneys’ functions related to fluid and ion levels?
Balance electrolyte levels in plasma
How does blood enter the kidneys? How does blood exit the kidneys?
Via renal artery
Via renal vein
Name an electrolyte whose levels are balanced by the kidneys?
Sodium
How do the kidneys regulate blood pH?
Regulating loss of H+ and bicarbonate
What percentage of cardiac output goes to the kidney?
25%
What do the kidneys control and retain?
Blood pressure and valuable compounds
Name a hormone released by the kidneys.
What valuable compound do the kidneys retain?
Erythropoietin
Glucose
What is gluco-neogenesis?
Glucose generation pathway
How do the kidneys regulate blood volume? How do kidneys regulate RBC production?
Renin restricts water volume in urine
Releasing erythropoietin that stimulates reproduction
What stimulates the haemocytoblasts?
Erythropoietin
What empties into the ureter? What are the papillae made of? What makes up most of the medulla of the kidney?
Pelvis
Apices of 2 or more pyramids
The pyramids
What is the functional unit of the kidney? How many are there in total? What happens to the number after age 40?
Nephron
~1 million
Decreases by 10% every 10 years
Name a part of the main structure of a nephron. What is the function of the Renal corpuscle? List the parts of the renal corpuscle.
Bowman’s capsule
Filter
Bowman’s capsule and Glomerulus
List the different types of tubules in the nephron. Name two types of nephrons
PCT, DCT, Loop of Henle
Juxtamedullary and cortical nephrons
What do cortical nephrons lack?
Vasa recta
What is the function of the Afferent arteriole? What process occurs in the afferent arteriole? What is the function of the efferent arteriole?
Takes blood into glomerulus tubules
Ultrafiltration of blood under pressure
Takes blood out to capillaries
What are the two capillary types connected to the efferent arteriole? What arteriole brings blood into Bowman’s capsule? What arteriole takes blood away from Bowman’s capsule?
Peritubular capillaries and vasa recta
Afferent
Efferent
What is the function of the glomerulus?
Filtration of blood plasma
What are the three layers of the glomerular filtration barrier? What type of cells are in the Glomerular Filtration Barrier?
Cells, Basement Membranes, Podocytes
Capillary endothelial cells
What are the tubules made of? What supports the tubules?
Narrow, single celled layer
Basement membrane
How many segments do the tubules have? What are these segments?
8
Proximal convoluted, proximal straight, descending LoH (thin), ascending LoH (thin), ascending LoH (thick), distal convoluted, cortical collecting duct, medullary collecting duct
What three processes account for renal excretion? How is the urinary excretion rate calculated?
Filtration, Secretion, Reabsorption
Filtration - re-absorption + secretion
Which drug is removed completely on a single pass through the kidney? Which drug is cleared extremely slowly by the kidney?
Pencillin
Diazepam
What process refers to the movement of fluid and solutes from the Glomerular capillaries into Bowman’s space? What process refers to the movement of materials from the filtrate in the tubules into the peri-tubular capillaries? What process refers to the secretion of solutes from the peritubular capillaries into the tubules?
Glomerular filtration
Tubular reabsorption
Tubular secretion
What structure regulates water and electrolytes balance?
Collecting duct
Where does ultra filtration of blood under pressure occur? What is the filtrate similar to? What is the filtrate free of? Through what three structures does the filtrate pass?
Afferent arteriole
Plasma
Protein
Pores, basement membrane, podocytes
What two characteristics determine glomerular filtration of a molecule? Neutral solutes smaller than what size are freely filtered? Neutral solutes greater than what size are not freely filtered?
Size and charge
180 nanometres
360 nanometres
What is the normal glomerular filtration rate? What percentage of blood which enters the glomerulus is filtered?
110 to 130 ml/min
10-20%
What is renal clearance of inulin equal to?
Glomerular filtration rate (GFR)
How much filtrate is produced per day? What percentage of the filtrate is reabsorbed?
250L
99%
What is the typical glomerular capillary blood pressure? What is the typical plasma colloidal osmotic pressure? What is the typical net filtration pressure? What is the typical hydrostatic pressure of Bowman’s Capsule?
+ 60mm Hg
29mmHg
16mmHg
15mmHg
What is Kf? What is the formula for GFR? What is GFR directly proportional to?
Filtration coefficient
Kf x NFP
NFP
Changes in GFR normally result from changes in what?
Glomerular capillary blood pressure
Where do substances transported to tubule cells originally come from? How are substances secreted from the tubule cells into the filtrate? What is one reason substances move from tubule cells into the filtrate?
Blood tubular capillaries
Diffusion, osmosis, active transport
Dispose wastes
What is one waste product eliminated in the filtrate? Why is creatinine not eliminated in the filtrate?
Urea
Filtered only in the glomerulus
How is blood pH controlled in the tubules?
H+ is secreted in the PCT
What percentage of renal blood passes to capillaries in proximal tubules? What percentage of renal blood flow is filtered? What percentage of the filtrate produced does the PCT reabsorb?
80%
10-20%
60-70%
What is reabsorbed at the PCT?
Sodium
All nutrients
Cations
Anions
Water
Urea
Lipid-soluble solutes
Small proteins
What is reabsorbed at the DCT?
Na+
Cl-
What regulates water reabsorption at the DCT? What regulates Na+ and K+ reabsorption at the DCT?
ADH
Aldosterone
