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Older Adult 1 > Kidney: producer, regulator, excretor > Flashcards

Kidney: producer, regulator, excretor Flashcards

1
Q

What are the synthetic functions of the kidney?

A

Production of EPO, active form of vitamin D

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2
Q

Explain the mechanism and result of EPO production

A

Fall in oxygen level in renal tissues causes EPO to be secreted in kidney, stimulates RBC precursors in bone marrow

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3
Q

Explain the mechanism and result of vitamin D production-include chemical symbols of products

A

Skin+UV: cholecalciferol produces from dietary precursors (D3)
Liver: converted to 25-hydroxycholcalciferol (25-OHD3)
Kidney: converted to 1, dihydroxycholecalciferol (1,25-(OH)2D3) known as calcitriol

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4
Q

What cells produce EPO?

A

peritubular cells

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5
Q

What are tight junctions?

A

Fusion of adjacent cells to create a barrier to passage of water and dissolved particles

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6
Q

Describe the tight junctions in the PCT, DCT and collecting duct

A

PCT=loose DCT=tight CD=very tight

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7
Q

What is the main role of the glomerulus?

A

Producing filtrate

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8
Q

What is the mechanism of glomerulus function?

A

High pressure filtration of blood

Podocytes covering the ball of glomerular capillaries have very small negatively charged filtration channels

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9
Q

What are the properties of a marker used for GFR measurement?

A

Readily filtered, not metabolised, reabsorbed or secreted

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10
Q

What is the equation for GFR? What is the value to be found?

A

Filtrate flow (unknown) x filtrate concentrate (plasma concentration) = urine flow x urine concentration

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11
Q

What are three markers that can be used for GFR?

A

Creatinine: product of muscle metabolism, minor tubular secretion, results will be overestimated
Cystatin C: protein produced by mast cells
Inulin: Plant extract

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12
Q

If creatinine production is constant what can be used to give a GFR estimate?

A

Plasma creatinine concentration

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13
Q

What two different mechanisms of autoregulation in a broad sense?

A

1: Afferent arteriole dilates, improving renal blood flow at lower arterial pressure
2: Efferent arteriole constricts, improving GFR at a lower renal blood flow

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14
Q

What are the three tubulo-glomerular feedback mechanisms?

A

1) Adenosine-Produced when we are hydrated, constricts afferent arteriole, inhibits renin release, inhibited by low filtrate flow
2) Angiotensin II-RAAS system, constricts efferent
3) PGE2-Produced in DCT in response to low filtrate flow, dilates afferent arteriole, cytoprotective to tubule, antagonist to ADH

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15
Q

What is the main role of the proximal convoluted tubule?

A

Conservation of majority of useful filtrate components

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16
Q

What transporters are on the side of the tubule lumen in the PCT?

A

Na+/H+ Antiporter

Na+/Glucose symporter

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17
Q

What are the transporters on the side of the interstitial fluid in the PCT?

A

Na+/HCO3- cotransporter

Na+/K+ pump

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18
Q

How is H+ and HCO3- produced in the PCT?

A

H20 and CO2 enter cell through leaky junctions, forms H2CO3, forms H+ and HCO3-

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19
Q

What is the main role of the loop of henle?

A

Producing hypotonic tubular fluid and hypertonic interstitial fluid, and ion reabsorption

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20
Q

How does the loop of henle achieve it’s mechanisms?

A

Selective permeabilities to ions and H20 in each limb, plus countercurrent multiplier

21
Q

What is reabsorbed in the descending limb of the loop of Henle? Through which channels?

A

H20 through AQP1 by osmosis

22
Q

What is reabsorbed in the ascending limb of the loop of henle?

A

Ions

23
Q

What transporters are on the tubular side in the ascending LoH?

A

K+ Na+ 2Cl- co-transporter

24
Q

What is on the side of the interstitial fluid in the ascending LoH?

A

K+ channels, K+/Na+ active pump

25
Q

What transporter do loop diuretics act on?

A

K+ Na+ 2Cl- co-transporter

26
Q

Why is a hypertonic environment produced in the medulla?

A

So the collecting duct can reabsorb water

27
Q

What is the main role of the DCT?

A

Final regulation of Na+, K+ and H+ that are secreted in urine

28
Q

How does the DCT perform its main function?

A

1) Principal cells reabsorb, sodium secrete K+, controlled by aldosterone
2) Intercalated cells reabsorb potassium, secrete H+, ATP-ase driven

29
Q

What is the sodium channel in principal cells called?

A

ENaC

30
Q

What transporters are on the tubular side of principal cells?

A

Coupled Na+ and K+ channels

31
Q

What transporters are on the interstitial side of principal cells?

A

K+ channel, Na+/K+ active pump

32
Q

What does aldosterone stimulate in principal cells?

A

ENaC synthesis

Pump activity

33
Q

What stimulates principal cells?

A

Mainly aldosterone, high potassium, alkalosis, high tubular flow

34
Q

What transporters are on the tubular side of intercalated cells?

A

H+/K+ active pump

35
Q

What transporters are on the interstitial side of intercalated cells?

A

K+ channel, Na+/K+ active pump

36
Q

What stimulates intercalated cells?

A

Acidosis and low potassium

37
Q

What is the main role of the collecting duct?

A

Final H20 regulation of urine concentration

38
Q

What is the mechanism of the collecting duct?

A

Insertion of aquaporins into luminal membrane by ADH

39
Q

What do aquaporin membranes contain?

A

Peptide helices

40
Q

What significant feature is part of AQP structure?

A

Narrow charged channel

41
Q

What receptor does ADH bind to in the CD?

A

V2

42
Q

What effect does ADH cause in the CD?

A

Insertion of AQP-2 into luminal side of membrane to allow uptake of water

43
Q

What are the 3 ADH receptors, location, role?

A

1) V1a: Peripheral circulation, vasoconstriction
2) V2: Collecting duct and endothelium, AQP-2 insertion, clotting factor release
3) V3 (V1b): CNS, ACTH release

44
Q

What buffers H+?

A

HCO3-, HPO42-, NH3

45
Q

How much HCO3- is reabsorbed?

A

99%

46
Q

What produces NH3 in cells?

A

Glutamine

47
Q

Where is the Juxtaglomerular apparatus located?

A

Between afferent arteriole and DCT

48
Q

What does juxtaglomerular apparatus sense, and by which cells?

A

Granular: Decrease in pressure

Macula densa cells: Decrease in tubular Na+ flow

49
Q

What cells release renin? What can this stimulated by?

A

Granular cells, sympathetic B1 stimulation

Older Adult 1 (3 decks)

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