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Renal I Final > Regulation of Ca, Mg, Pi > Flashcards

Regulation of Ca, Mg, Pi Flashcards

1
Q

Where is the majority of calcium in the body?

A

99% in bones

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2
Q

What is the percent filterability of calcium in a normal healthy person?

A

around 60%

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3
Q

What does hypoalbuminemia do to plasma Ca levels?

A

Increase Plasma Ca (less binding sites for Ca

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4
Q

What does hyperalbuminemia do to plasma Ca levels?

A

Decrease Plasma Ca

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5
Q

What does acidosis do to Plasma Ca levels?

A

Increased Plasma Ca

all the H+ are bound to albumin

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6
Q

What does alkalosis do to Plasma Ca levels?

A

decrease Plasma Ca levels (more are going to bind to albumin

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7
Q

What is a predisposer for hypocalcemic tetany?

A

Alkalosis

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8
Q

What are the effects of calcitriol on Ca and Pi?

A

Increase Plasma Ca+ and Pi

Increase reabsorption, resorption, absorption

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9
Q

What are the effects of calcitonin on Ca and Pi?

A

(regulate “tone”)
Decrease plasma Ca and Pi

Inhibit resorption

Promotes excretion

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10
Q

What are the effects of PTH on Ca and Pi?

A

Increase plasma Ca levels, but decrease plasma Pi levels
Increase Ca resorption, absorption, reabsorption
Decrease Pi reabsorption

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11
Q

What is the role of CaSR?

A

Monitor Ca levels by:

Inhibiting Ca reabsorption on apical membrane.

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12
Q

What receptor does calcitriol use to signal in the bone, intestines, and kidneys?

A

VDR (Vitamin D receptor)

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13
Q

What 3 conditions can be caused by excess PTH?

A

Hypercalcemia
Hypophosphatemia
Hypercholermic metabolic acidosis

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14
Q

What percent of Calcium is reabsorbed in the proximal tubule?

A

65-70%

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15
Q

Where does active transport of Ca occur?

A

Distal Tubule

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16
Q

What receptor is responsible for active transport of Ca in the distal tubule?

A

TRPV5

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17
Q

What is Calbindin?

A

Binds to Calcium within the cell to prevent a high intracellular concentration of Ca+

18
Q

What drives the reabsorption of Ca in the TAL?

A

A high positive TEPD repels Ca away.

Ca will travel paracellular and get reabsorbed

19
Q

What basolateral transporter is responsible for Ca reabsorption in the DT?

A

NCE

20
Q

What effect does Alkalosis have on Ca reabsorption?

A

Increase reabsorption

There’s less free plasma Ca+, so Alkalosis will stimulate TRPV5 to reabsorb more Ca

21
Q

What effect does Acidosis have on Ca reabsorption?

A

Increase excretion

There’s more free plasma Ca+, so acidosis will inhibit TRPV5

22
Q

What are the three big players in Pi reabsorbtion?

A

Na-P transporter
PTH and Ca+
FGF 23

23
Q

What percent of Pi is reabsorbed in the PT?

A

80%

24
Q

What is Na uptake coupled with?

A

BIG-PAL

Bicarbonate
Glucose
Phosphate
Amino acids
Lactate
25
Q

In the early PCT, what drives reabsorbtion of Na?

A

Na-K-ATPase

26
Q

What is the role of FGF 23?

A

Inhibits reabsorption, is secreted in response to PTH, calcitriol, and hyperphosphatemia

(So that you dont reabsorb too much Pi)

  • Made in the bones
27
Q

What’s the relationship between the kidney and Vit D?

A

The kidney has an enzyme that is responsible for activated Vit D –> Calcitriol

28
Q

What cells make calcitriol?

A

Proximal tubul epithelial cells

29
Q

What conditions stimulate an increase in calcitriol?

A

Low calcium
Low phosphate
High PTH

30
Q

What effect does chronic acidosis have on Pi reabsorption?

A

Increases Pi excretion

31
Q

What effect does chronic alkalosis have on Pi reabsorption

A

Decreases Pi excretion

32
Q

What effect does PTH have in the DT?

A

Increases reabsorption of Ca

33
Q

What effect does PTH have in the PT?

A

Inhibit Pi reabsorption

inhibits Na-P transporter

34
Q

What condition can PTH lead to in regards to urine?

A

Phosphotouria

concentrated Pi in the urine, since its all being excreted

35
Q

What is the primary site of reabsorption for Magnesium?

A

Thick Ascending Limb of LoH (70%)

36
Q

What percent of Mg is reabsorbed in the PT?

A

20%

37
Q

What drives the paracellular transport of Mg in the TAL?

A

Positive TEPD created by the NKCC2 transporter

38
Q

What percent of Mg is reabsorbed in the DT?

What receptor is responsible?

A

10%
(“fine tuning” stage)

TRPM6 on the apical side of cells

39
Q

What is the effect of met. acidosis on Mg reabsorption?

A

Decreased reabsoprtion

40
Q

What is the reabsorption of Mg similar to?

A

Reabsorption of Na/H2O

41
Q

What is the effect of ECF volume expansion on Mg reabsorption?

A

Decreases reabsorption

Renal I Final (7 decks)

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