Lecture 1 - intro

Question 1

How much plasma goes in the kidney ?

Answer 1

125 ml/min

Question 2

How much plasma is filtered per day?

Answer 2

180 L per day and it goes through the whole circulatory system in about 40 mins.

Question 3

Is there bacteria in urine?

Answer 3

There is bacteria in all urine however if there are high levels of bacteria then there usually is an infection. This is done by doing the agar test thing, and if 8-10 colonies form.

Question 4

What is the function of the kidney?

Answer 4

It maintains homeostasis for solutes and water in the face of changes in dietary intake or endogenous production rate.

Question 5

What does the kidney maintain homeostasis in?

Answer 5

1. ) Electrolytes (sodium, pottasium, chloride)
2. ) Water (osmolality)
3. ) Acid-base: bicarbonate (ECFV buffer)
4. ) Minerals (Calcium, phosphorus and magnesium)
5. ) Waste material: urea (protein), creatinine (muscle), uric acid (nucleic acids)

Question 6

How does the kidney maiantain homeostatsis in regards to creatinine?

Answer 6

It recycles phossphate in the muscle

Question 7

What does an elevated level of creatinine mean?

Answer 7

It means that there is kidney failure because it is not filtering correctly.

Question 8

Test for creatinine?

Answer 8

eGFR and based on plasma concentration of creatinine.

Question 9

The functions of the kidney are?

Answer 9

1. ) regulate body fluid volume
2. ) Regulate osmotic balance
3. ) Regulate electrolyte composition
4. ) Regulate acid base balance (HCO3 most important base)
5. ) Regulate blood pressure (medium to long term balance)
6. ) Erythropoiesis
7. ) Excretion of waste products and foreign substances

Question 10

What are the requirments for the renal system?

Answer 10

1. ) Process large amounts so a large surface to volume ratio
2. ) Tight regulation with low energy cost
3. ) Retain nutrients and excrete waste

Question 11

Why do we need to excrete waste?

Answer 11

Because there will be mroe ammonia and so there will be more amino acids and so acids in the body will increase. Decreasing the pH.

Question 12

What are the different structures in the kidney?

Answer 12

1. ) Cortical radiate artery
2. ) Afferent arteriole
3. )Efferent arteriole
4. ) Glomerular capillaries
5. ) Glomerular capsule
6. )rest of renal tube containing filtrate
7. ) Peritubular capillary

Question 13

What are the three major renal processes?

Answer 13

1. ) glomerular filtration
2. ) Tubular reabsorption
3. ) Tubular secretion

Question 14

What is the filtration factor?

Answer 14

20% gets filtered assuming a permeability of 1

Question 15

What is the likelyhood of getting filtered?

Answer 15

1. ) positive molecules
2. ) Neutral
3. ) Negative

Question 16

What percentage of molecules gets secreted?

Answer 16

80 %

Question 17

How does sodium ions move to the capillary?

Answer 17

1. ) sodium ions are reabsorbed by active transport at the tubule
2. ) Negatively charged ions are attracted to postively charged ions
3. ) As concentration of ions (solute) increases in plasma, osmotic pressure increases
4. ) water moves from proximal tubule to capillary by osmosis

Question 18

What is the compostion of urine?

Answer 18

1. ) 90-95 % water
2. ) Other 5 % is the following things
   - Metabolic wastes (urea, uric acid, creatinine)
   - Ions (NA+, K+, PO43-, SO42-, CA2+, MG2+)
   - toxins, pigments and hormones

Question 19

Charecteristics of urine?

Answer 19

1. ) yellow in colour with slight aromatic or ammonia odour
2. ) pH slightly acidic (can vary from 4.5 to 8)
3. ) specific gravity 1.001 to 1.035

Question 20

What is a renal diagnostic procedure?

Answer 20

Urinalysis - with like a dip stick

Question 21

Disease of one rectal structure usually affects ….

Answer 21

others

Question 22

Urinary tract is especially susceptible to …..

Answer 22

bacterial infection

Question 23

What aremost glomerular diseases caused by?

Answer 23

Autoimmune reactions

Question 24

What is a common cause of kidney disease?

Answer 24

high blood pressure

Question 25

Renaltubules are metabolically very active so they are susceptible to ….. deprivation or …. damage

Answer 25

oxygen deprivation or toxic damage

Question 26

What is acute renal failure?

Answer 26

Sudden onset and there is a rapid reduction in urine output. Usually it is reversible and tubular cell death and regeneration take place.

Question 27

What is chronic renal failure?

Answer 27

progressive and is not reversible. There is nephron loss and sometimes 75% of function can be lost before it is noticeable.

Question 28

What is dialysis?

Answer 28

process of removiing waste products and excess fluids from the body. It is one of the primary modalities for peop;e with renal failure. It can do two principal functions of the kidney:

1. ) removal of endogenous waste
2. ) maintenance of water balance

Question 29

Who is a candidate for kidney transplant?

Answer 29

All patients with end stage kidney disease are except if they have:

1. ) systemic malignancy
2. ) chronic infection
3. ) severe cardiovascular disease
4. ) neuropsychiatric disorder
5. ) extremes of age