Renal Flashcards
Ischaemia leads to inflammatory response in the kidney by which 3 mechanisms?
ATP depletion (necrosis)
Increased hypoxia inducible factor (HIF)
Reactive oxygen species generation (ROS)
Vasopressin/adh acts on which receptor in the kidney
V2 receptor
What is the equation for renal blood Flow?
RBF= (renal artery pressure- renal vein pressure)/ total renal vascular resistance
What G protein is V2 receptors linked with and what secondary messenger?
Gs and cyclic AMP —-> protein kinase A
What is the overall survival to discharge for dogs with AKI?
50-70%
Vaden JVIM 56%
Legatti Plos One 55%
Rimer JVIM 67%
What is the definition of IRIS AKI grade I?
Increase in 0.3mg/dL or 26.4umol/L
What are the stages of AKI?
5 phases
- Insult
- Initiation
- Extension
- maintenance
- Recovery
Name 5 drugs which are nephrotoxic
Aminoglycosides
Penicillins
Vancomycin
Amphotericin B
Sulfadiazine
Acetaminophen
Cimetidine
Apomorphine
Lithium
Azathioprine
Anti depressants
Vitamin D analogues
Heavy metals e.g Gold, lead, mercury
Name 5 non drug agents that are nephrotoxic
Snake venom
Bee venom
Grapes/raisins
Radiocontrast agents
Lilies
Mushrooms
Illicit drugs
Vitamin D containing rodenticides
What is the function of principal cells?
Reabsorb Na and water
Secrete potassium
Site of action of aldosterone and ADH
What stimulates aldosterone release?
Decreased circulating volume—> RAAS activation
Hyperkalaemia
ACTH release
Hyponatraemia
What is the function of intercalated cells?
Alpha -H +secreting
Beta- HCO3 secreting
What are the main controllers of Nacl and water excretion?
- Renal SNS
- RAAS
- Natriuretic peptides
- ADH
Where is ADH synthesised?
Supraoptic and paraventricular nuclei of hyothalamus
Where is ADH stored?
Posterior pituitary
What stimulates ADH release?
Increased osmolality
Hypovolaemia
Nausea
Angiotensin II
Pain
What is the filtration fraction?
FF= GFR/RBF
Represents proportion of fluid reaching the kidney that ends up in the tubules
20%
