Phys of Renal Disease 2 Flashcards

1
Q

What is the osmolality of Water re-absorption along the nephron?

A
300mOsm/L in glom
300 in PCT
600 DEC Tub
1200 in Loop
100 in ascending tube
300 in DCT
600 in CD
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2
Q

What are the basic requirements for forming concentrated urine?

A
  1. High osmolality of renal medullary interstitial fluid

2. High ADH (vasopressin)

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3
Q

What is the ascending loop of henle permiable to?

A

Na but not water

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4
Q

What is the role of the counter multiplier system in the loop of Henle?

A

Produces Hypertonic Urine in the Renal Medulla

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5
Q

What is the Purpose of the vasa recta?

A

Serve as counter current exchangers minimizing washout of solutes from interstitium
Minimizes loss of solute from interstitium

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6
Q

How is ADH release initiated?

A

Inc in fluid osmolality, plasma Na Conc => Osmoreceptor cells shrink => supraoptic nuclei release ADH

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7
Q

What is charicteristic of the Autoregulatory range?

A

There is less rise in Renal BF and GFR in response to rise in Renal perfusion pressure. (Plateau)

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8
Q

How is Tubuloglomerular feedback mediated?

A

Changes in GFR by Afferent arteriolar and Efferent Arteriolar constriction

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9
Q

What is the role of Angiotensin II?

A

Powerful Na retaining Hormone

Increases Na and H2O re-absorption

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10
Q

What is the effectof of Aldosterone on the cells of the cortical collecting tubule?

A

Increase Na re-absorption and K+ secretion

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11
Q

How does our diet effect the serum levels of Aldosterone?

A

High Na decreases Aldosterone

High K increases Aldosterone

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12
Q

When does the Renal Sympathetic nerve activity effect GFR?

A

During Severe, Acute Disturbances

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13
Q

What is renal Clearance?

A

Volume of plasma that is completely cleared of the substance by the kidney per unit time

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14
Q

What is the Renal Clearance Equation?

A

Cx * Px = Vx * Ux

Cx = (V * Ux)/Px

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15
Q

What is represented by the variable V in renal Clearance? Ux? Px? Cx?

A
V= Urine flow rate
Ux = Urine Conc of X
Px = Plasma conc of X
Cx = Clearance of Substance x
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16
Q

How are GFR and plasma Creatinine Related?

A

They are inverely proportional

Dec GFR by 50% will mean a doubling of Creatinine

17
Q

What is the Cockroft & Gault Equation for Males? Females?

A
Ccr= ((140-Age) x (BW, kg))/72xPcr  mg/dl
For Females (mult by 0.85)
18
Q

What is the role of the Cockroft & Gault Equation?

A

Estimates GFR from Serum Creatinine

19
Q

What is the Effect of HTN on the kidney?

A

Exacerbate injury to the kidney by altering renal hemodynamic and tubular re-absorption

20
Q

What is the Effect of Kidney function on BP?

A

Renal lesions reduce the ability of the Kidney to excrete Na and H2O

21
Q

How can the kindey CAUSE HTN?

A

1) Inc renal vasular resistance
2) Dec Glomerular Cap filtration fraction coeff
3) Excessive tubular Na re-abs

22
Q

What are Pre- Renal causes of Acute Kidney injury?

A

Kidney Hypoperfusion

  • Vol depletion
  • MI
  • Anaph Shock, sepsis
  • Thromb of renal Art
23
Q

What are Renal causes of Acute Kidney injury?

A

Vascular- Vasculitis
Glomerular
Tubular- Ischemia, Toxins
Interstitial- Pyelonephritis

24
Q

What are Post- Renal causes of Acute Kidney injury?

A

Urinary Tract Obstruction

-Stones

25
Q

What are the effects of Acute Kidney injury?

A

Water and Na overload
Inc in K concen
Metabolic Acidosis
Anuria