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Renal System BDS1 > Kidney Tubular Function > Flashcards

Kidney Tubular Function Flashcards

1
Q

what does sodium transport facilitate?

A

reabsorption of nutrients, water and ions

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2
Q

how much is reabsorbed in the PCT?

A

65%

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3
Q

how much is absorbed in the ascending loop of Henle?

A

25%

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4
Q

how much is reabsorbed in the DCT?

A

up to 8%

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5
Q

how much sodium is reabsorbed?

A

98%

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6
Q

what does ADH do in the DCT?

A

targets the epithelium in the DCT and tells it to insert aquaporins

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7
Q

what is the overall function of ADH inserting aquaporins in the DCT?

A

to maintain homeostasis of the internal fluid compartment

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8
Q

what signals the release of the hormones in the DCT?

A

changes in blood pressure (decreased for ADH and aldosterone and increase for ANP)

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9
Q

if ADH inserts aquaporins the what does aldosterone insert in the DCT?

A

sodium channels

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10
Q

collectively what do ADH and aldosterone action result in in the DCT?

A

fluid reabsorption producing a small volume of concentrated urine which increases homeostatic regulation of blood pressure and volume

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11
Q

what is the action of ANP in the DCT?

A

fluid excretion which leads to large volume of dilute urine and then decreased homeostatic regulation of blood volume and pressure

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12
Q

what hormones does a decrease in blood pressure release?

A

ADH and aldosterone

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13
Q

what hormones does an increase in blood pressure release?

A

ANP

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14
Q

what is glomeruluar filtration rate?

A

the rate at which blood is filtered through the glomerulus into the Bowman’s capsule

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15
Q

what is GFR influenced by?

A

glomerular hydrostatic pressure, capsular hydrostatic pressure, glomerular osmotic pressure, systemic blood pressure, renin-angiotensin-aldosterone system and disease

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16
Q

if the GFR is greater what does it mean for sodium?

A

there is less time to reabsorb it in the glomerulus so there is a higher concentration of it in the DCT

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17
Q

what is reabsorbed in the PCT?

A

65% Na and water, 100% glucose and amino acids, 50% waste (urea)

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18
Q

what is reabsorbed in descending loop of Henle?

A

water

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19
Q

what is reabsorbed in the ascending loop of Henle?

A

25% Na (+ K and Cl)

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20
Q

what is reabsorbed in the DCT?

A

<8% Na and water

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21
Q

what does the juxta-glomerular apparatus do?

A

connects the DCT with the glomerulus and measures and responds to changes in Na+ concentration of the filtrate

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22
Q

what is reabsorbed in the collecting tubules?

A

water

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23
Q

what does excretion equal?

A

(filtration - reabsorption) + secretion

24
Q

what does the macula densa do?

A

detects concentration of sodium in the filtrate

25
Q

what do the juxtaglomerular cells do?

A

adjust the diameter of the afferent arteriole when it receives signals from the macula densa

26
Q

what are the modified smooth muscle cells?

A

mesangial cells and supporting cells

27
Q

what needs to happen for juxtaglomerular cells to be effected?

A

the macula densa must release adenosine

28
Q

what is the sequence of events if glomerular hydrostatic pressure is increased?

A

increased BP - increased glomerular hydrostatic pressure - increased GFR - increased sodium filtrate conc. - macula densa released adenosine - juxtaglomerular cells swell which constricts afferent arteriole and decreased hydrostatic pressure

29
Q

what does tubuloglomerular feedback regulate?

A

systemic blood pressure

30
Q

what happens when the macula densa shrivels?

A

they release prostaglandins

31
Q

why would the macula densa shrivel?

A

decreased sodium concentration in filtrate

32
Q

what happens when the macula densa swells?

A

release adenosine

33
Q

what makes the macula densa swell?

A

increased sodium filtrate concentration

34
Q

what is the sequence of events if the glomerular hydrostatic BP is decreased?

A

decreased BP - decreased glomerular hydrostatic pressure - decreased GFR - decreased sodium conc. in filtrate - macula densa release prostaglandins - juxtaglomerular cells maintain the afferent arteriole diameter but secretes renin to activate renin-angiotensin system

35
Q

how does the renin-angiotensinogen restore blood pressure?

A

via angiotensin 2

36
Q

describe the process in which renin-angiotensinogen restores blood pressure

A

1 - angiotensinogen released into circulation, 2 - renin converts angiotensinogen into angiotensin 1, 3 - angiotensinogen converting enzyme converts angiotensin 1 into 2, 4 - angiotensin 2 is a potent vasoconstrictor and rapidly increases blood pressure

37
Q

where is angiotensin released from?

A

the liver

38
Q

where does angiotensin 2 bind to target receptors on and for what?

A

arterioles for constriction, hypothalamus for thirst, pituitary gland for release of ADH, adrenal medulla for release of aldosterone

39
Q

how does angiotensin 2 restore blood volume?

A

via increased fluid and salt retention

40
Q

where is the ANP released from?

A

from epithelial cells in the lining of the atrium of the heart which have baroreceptors to know when to release the peptide

41
Q

summarise what happens when there is high concentration of sodium and it is detected by the juxtaglomerular apparatus?

A

release aldosterone - vasoconstriction - tubuloglomerular feedback

42
Q

what does tubuloglomerular feedback ensure?

A

that the capillaries do not get damaged

43
Q

summarise what happens when there is a low concentration of sodium and it is detected by the juxtaglomerular apparatus?

A

release of prostaglandins - renin release - activation of RAAS

44
Q

summarise the actions of ANP

A

it counteracts ADH and renin to remoe excess fluid and lower blood pressure

45
Q

what happens to GFR as kidney disease worsens?

A

it decreases

46
Q

how does kidney disease affect the CVS?

A

GFR is decreased which activates RAAS system which increases BP

47
Q

what are the consequences of chronic kidney disease?

A

inadequate removal of fluid and waste products of metabolism, inappropriate activation of RAAS

48
Q

what are the causes of chronic kidney disease?

A

hypertension, diabetes, high cholesterol, kidney infections, glomerulonephritis, polycystic kidney disease, kidney stones, long-term use of NSAIDs

49
Q

what two causes of kidney disease can be related to oral bacteria

A

kidney infections and glomerulonephritis

50
Q

when do kidney stones develop?

A

when waste starts to crystallise which blocks kidney function

51
Q

what are the symptoms of chronic kidney disease?

A

hypertension, nausea, oedema in hands., ankles feet or lungs, blood/protein in urine, anaemia and weak/painful bones

52
Q

how is hypertension regulated?

A

diet/weight loss, combination of anti-hypertensive treatments, diuretics, ACE inhibitors/angiotensin receptor blockers, aldosterone agonists

53
Q

how do ACE inhibitors/angiotensin receptor blockers work?

A

prevent conversion of angiotensin 1 to angiotensin 2

54
Q

what is kidney failure?

A

stage 5 kidney disease, end stage renal disease with less than 15% kidney function, dialysis and/or kidney transplant required

55
Q

what is dialysis

A

artificial removal of waste, solutes, water and toxins from blood

56
Q

what are the 2 types of dialysis?

A

haemodialysis, peritoneal dialysis

Renal System BDS1 (3 decks)

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