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
