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Renal Module > Lecture 2 - Renal Blood Flow, Glomerular Filtration And Clearance > Flashcards

Lecture 2 - Renal Blood Flow, Glomerular Filtration And Clearance Flashcards

1
Q

What is the distribution of renal blood flow in the kidney, brain, muscles, and coronary in ml/100g tissue/min?

A

Kidney = 340, coronary = 84, brain = 54, muscle = 3

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2
Q

Where does the 93% of the renal blood flow confined to the cortex come from?

A

Superficial and mid-cortical glomeruli

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3
Q

What region of the kidney is the most superficial?

A

The renal cortex

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4
Q

Where is the blood supply found in the kidney?

A

In the glomerulus

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5
Q

Describe the vasa recta in the kidney

A

It is small compared to the glomerulus blood supply, it has small arterioles than enter the medulla and small venules that leaves the medulla

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6
Q

What is the order of nephrons located in the kidneys?

A

Superficial nephrons are located near the surface, mid cortical nephrons found in the middle of the cortex, and juxtamedullary nephrons

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7
Q

What is the % renal blood flow that comes from the juxtamedullary nephrons?

A

7%

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8
Q

Describe the diffusion pressure - along the glomerular capillary

A

The diffusion pressure is held relatively constant

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9
Q

what is the glomerulus a site of?

A

Filtration

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10
Q

Where does the filtration barrier sit?

A

On the podocytes, close to the basal laminate and urinary space-line of the bowman’s capsule

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11
Q

Where are the distal convoluted tubules found in the renal corpuscle?

A

They are found wrapped along the top

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12
Q

Can you control filtration pressure?

A

Yes - if you increase the Afferent resistance by decreasing the lumen then you decrease overall renal blood through the capillary and glomerulus - this leads to a decrease in filtration pressure

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13
Q

What happens if you decrease Afferent resistance?

A

Renal blood flow will increase and the overall filtration pressure will increase

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14
Q

What happens if you increase efferent resistance?

A

Renal blood flow will decrease and the overall filtration pressure will increase

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15
Q

What happens if you decrease efferent resistance?

A

Renal blood flow will increase and the overall filtration pressure will decrease

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16
Q

How is renal blood flow kept?

A

It is kept relatively constant

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17
Q

What does a change in Afferent resistance do?

A

It controls blood pressure and glomerulus filtration

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18
Q

How does a nephron respond to an increase in arterial pressure?

A

It will increase resistance

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19
Q

What is the myogenic reflex?

A

When blood vessel contracts, pressure increases, when the blood vessels relax pressure decreases

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20
Q

What are the two mechanisms of autoregualtion of renal blood flow?

A

Myogenic reflex and glomerular tubular feedback (GTF)

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21
Q

What is the glomerular tubular feedback (GFR) known as?

A

A secondary mechanism

22
Q

Describe the glomerular tubular feedback mechanism

A

When there is ani increase in NaCl to the distal tubule, the macula dense senses and increased flow rate and constricts the Afferent arterioles, decreasing pressure in the single GFR

23
Q

What is the macula densa in close contact with?

A

The Afferent arteriole

24
Q

How can you measure the response of a single GFR pressure?

A

Blocking the nephron with wax - will perfuse the distal tubule and you can measure the response

25
Q

Increased delivery of isotonic Nacl =

A

An autoregulation effect on Single nephron GFR

26
Q

What is the effect on SNGFR when there is an increased delivery of isotonic mannitol?

A

There is no autoregulation

27
Q

What is the effect on SNGFR when there is an increased delivery of isotonic NaCl + furosemide?

A

There is no autoregulation

28
Q

What is the autoregulation method? - cellular mechanisms of TGF

A

High levels of na+ need to be pumped out, adenosine causes a ca2+ release and vasoconstriction which increases the Afferent arteriole and brings the blood pressure back down

29
Q

What are some hormonal vasoconstrictors?

A

Noradrenaline, adrenaline, angiotensin II and endothelin

30
Q

What are some local vasodilators?

A

Prostaglandins, nitric oxide, brandykinin and dopamine

31
Q

What is the renal response to a haemorrhage?

A

Arterial pressure decreases, renal secretion increases, which activates angiotensin II and the renal arteries constrict. There is also an increase in renal sympathetic nerves which releases noradrenaline

32
Q

What is required to maintain vasoconstriction?

A

Very low hormones, only catastrophic levels of blood loss is when GFR is abandoned

33
Q

What vessels is more sensitive to hormones, Afferent or efferent?

A

Efferent vessels are more sensitive

34
Q

When will Afferent vessels increase?

A

Afferent vessels will increase resistance when adrenaline gets very high

35
Q

What does a high concentration of adrenaline lead to?

A

Renal blood flow decreasing, GFR decreasing and the control of GFR is abandoned as blood is delivery to the systemic circulation

36
Q

What does low concentrations of adrenaline lead to?

A

A slight decrease in renal blood flow, GFR drops only slightly or is maintained despite a fall in renal blood flow

37
Q

What does prostaglandin release maintain?

A

Renal perfusion

38
Q

What does a decrease in renal blood flow and oxygen delivery cause?

A

Release of prostaglandins

39
Q

What does prostaglandin cause?

A

It causes both the Afferent and efferent arterioles to vasodilation

40
Q

What can the prostaglandin release mechanisms be inhibited by?

A

NSAIDS - leading to possible renal damage

41
Q

What leads to a nitric oxide release?

A

Shear stress, histamine, bradykinin and ATP

42
Q

What does a nitric oxide release lead to?

A

Renal and peripheral vasodilation

43
Q

Where can you find an abnormal production of NO?

A

In diabetes mellitus or hypertension - these can contribute to vascular damage

44
Q

What are the first layer of cells in the fenestrated endothelium?

A

Podocytes

45
Q

Describe podocytes

A

They have large pores, very little resistance to diffusion - the red blood cells can pass through

46
Q

What is the next layer of cells after podocytes?

A

Basal lamina - has a mesh size of 4nm, red blood cells cannot pass through

47
Q

What are pedicels?

A

Foot processes of the podocytes

48
Q

What can be filtered through the filtration barrier?

A

Water, ions, glucose, urea, creatinine and uric acid

49
Q

What cannot be filtered through the filtration barrier?

A

Red blood cells and serum albumin

50
Q

What is nephrin?

A

It is the major TM molecular, mutations in the nephrin gene can lead to abdominal pore sizes which means proteins can get through

51
Q

What is inulin?

A

It is a polysaccharide

52
Q

What is the collagen phase?

A

It is a negatively charged phase - negatively charged molecules become less permeable as they are repelled by the collagen

Renal Module (10 decks)

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