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CARDIO TEST 3 > Lecture 4: Regulation of Kidney Development 1 > Flashcards

Lecture 4: Regulation of Kidney Development 1 Flashcards

1
Q

What % of CO and volume of blood does the adult kidney filter?

A

~25% of the CO (1.1L/min)

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2
Q

What do the kidneys regulate?

A

pH, water and salt balance, BP, renal hormones and waste removal

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3
Q

What is the number of nephrons you are born with and how much does this vary between people?

A

1,000,000

10 fold variation between people

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4
Q

What are the 3 pairs of excretory organs that form during development and where do they develop from?

A

Pronephroi, mesonephroi, metanephroi - develop from the intermediate mesoderm

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5
Q

What day does the pronephros form?

A

21-22 days gestation (human)

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6
Q

In what organism is the pronephros the final kidney?

A

Primitive organisms

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7
Q

What animals is the pronephros functionally important in?

A

Amphibians and fish

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8
Q

What is the position of the glomus in the pronephros?

A

Sits within the ceceum - blood filters and is collected by the pronephric duct

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9
Q

Where does the mesonephros develop?

A

Beneath degenerating pronephros

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10
Q

What does the pronephic duct give rise to and what does this structure then give rise to?

A

Wolffian duct

Mesonephros

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11
Q

When does the mesonephros develop?

A

Day 25

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12
Q

What things are not present in the mesonephros?

A

Juxtaglomerular apparatus and loop of henle

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13
Q

How many complete nephrons capable of excreting urine are present in the mesonephros?

A

40

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14
Q

When is the mesonephros at maximal size?

A

Day 33

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15
Q

What do mesonephric tubules form?

A

Efferent tubules of the testis in the male

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16
Q

When does the metanephros form?

A

Day 30

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17
Q

Why does the human kidney finish development just before birth?

A

Maximise nephron number and renal capacity

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18
Q

What is the final nephron number regulated by?

A

Ureteric bud branching, MET and apoptosis

19
Q

What does specification of the metanephric blastema form?

A

Glomerulus and tubules

20
Q

What is the functional kidney in mammals?

A

Metanephros

21
Q

Where does the UB outgrowth begin?

A

Caudal end of Wolffian duct

22
Q

What are the steps of ureteric branching and morphogenesis?

A
  • The UB invades the metanephric mesochyme (MM)

- Metanephric mesochyme and UB produce messages to communicate and cause induction of UB to branch

23
Q

What does the ureteric tree form?

A

Collecting ducts, calyces and renal pelvis

24
Q

What does the part of the UB that does not enter the MM form?

A

Ureter

25
Q

What are the steps of nephrogenesis?

A
  • UB induces MM to condense
  • Cap mesenchyme
  • Pretubular aggregate
  • Pretubular aggregate undergoes MET
  • Renal vesicle
  • Comma shaped
  • S-shaped body
  • Connects to ureteric tip to form function nephron
26
Q

What does the upper, central and lower portions of the s-shaped body form?

A
  • Upper portion of S shaped body forms distal convoluted tubules
  • Central portion forms proximal tubule, loop of Henle and distal straight tubule
  • Lower portion forms renal corpuscle
27
Q

When do tip branching and nephron formation occur at the same time?

A

Up until week 15

28
Q

Nephron formation continues after tip branching stops so what happens?

A

Arcade formation

29
Q

How many nephrons per arcade?

A

7-10

30
Q

Where do nephrons form after week 20?

A

Along length of collecting duct

31
Q

How many nephrons would be present if no arcades formed?

A

50,000

32
Q

When do adrenergic nerves develop and where do they form?

A

20 weeks - cortex (mature at 28 weeks) and medulla (reduce in later gestation)

33
Q

When are capillaries detected in UB?

A

The day after it enters the MM

34
Q

What happens to blood vessels at 8-10 weeks?

A

Vessels surround s-shaped bodies

35
Q

What does cortisol do?

A

Develop lungs and throat when swallowed by baby due to secretion into amniotic fluid by kidneys

36
Q

Why is urine important in utero?

A

Excreted by foetus into amniotic fluid - swallowed - contains important things for organ development

37
Q

How is the adult kidney functioning different to the foetus?

A

Kidney doesn’t function like an adult kidney in utero. Fetus has GFR but it is about half of that in the adult. The fetus produces 8 fold greater urine - no worry about water conservation/loss. Despite the large production of urine in fetal life - blood flow to kidney is low - don’t need to constantly filter blood through kidneys. The amount of sodium that the fetus reabsorbs is low - functioning from mother. Water returned is not important in fetus so isn’t the same as the adult

38
Q

What are the features of Potters Syndrome?

A

No kidneys formed, no urine formed in utero - no lung formation assistance - death soon after birth due to lung insufficiency. If babies receive glucocorticoids for lung development - they will then die of renal failure - require dialysis through peritoneum. Often get unilateral renal agenesis (live normal life) - then have half the number of nephrons - set up on a road to develop renal conditions more easily with age (less functional reserve if anything goes wrong)

39
Q

What are the features of CAKUT?

A
  • Congenital abnormalities of the kidney and urinary tract
  • 1/3 of renal abnormalities
  • Congenital deficits of the kidney and ureteric tract. Covers most renal deficits (accompanied by ureteric deficits)
  • Often caused by congenital deficits but frequently caused by genetic abnormalities
  • Quite common to have multiple malformations
40
Q

What are the conditions CAKUT can lead to?

A
  • Renal hypoplasia: small kidneys
  • Dysplasia: no kidneys
  • Hydroureter: large urine production - filling and dilating ureters
  • Vesicouteric Reflux: urine flowing back in wrong direction from bladder to kidney
41
Q

How do ACE inhibitors taken during pregnancy affect renal development?

A

ACE Inhibitors: used to treat hypertension, cross the placenta and inhibit fetal urine production, affect fetal renal development

42
Q

How do COX-1 inhibitors affect renal development during pregnancy?

A

COX-1 Inhibitors: used to treat polyhydraminos, inhibit renal function and development

43
Q

How do perturbations affect pregnancy?

A

Perturbations during pregnancy - earlier the event occurs the greater the damage. Timing of insult and gestation is important, as well as duration of insult

44
Q

What populations have reduced nephron numbers?

A

Australian aboriginals and some African populations

CARDIO TEST 3 (10 decks)

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