Renal 2 Flashcards by Sachi Seaburn

How much fluid an hour does your kidneys produce?

7 L of fluid per hour

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Endocrine function of the kidney:

production of EPO and activation of vitamin D: cofactor for intestinal calcium absorption

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Nearly all the cells in the nephron have what?

A single cilium, which have mechanoreceptors and chemoreceptors, to sense flow rate and composition of filtrate

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Smooth muscle cells in the glomerulus have two phenotypes?

contractile and secretory

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3 types of cells in the glomerulus

endothelial cells, podocytes, mesengial cells

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Name the order of layers from the glomerulus inside out

mesangial cells, mesangial matrix, endothelial cells, basement membrane, podocytes

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What type of cells line the nephron/glomerulus?

columnar epithelial cells

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What prevents the passing of cells and large proteins in the glomerulus?

basement membrane and proteins in the slit pores

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What is normal GFR?

125 ml/min

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What is the purpose of mesangial cells?

structural support of glomerular capillaries, secretion of matrix proteins, phagocytosis and regulating GFR; by contracting and relaxing mesangial cells can alter available surface area for filtration and affect GFR.

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What is the most important factor for determining GFR?

blood volume, if blood volume increases GFR increases. auto regulation protects the glomerular cappilary

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What is filtered load?

The amount of a particular solue filtered per time

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What makes up the glomerular filtration barrier?

endothelial cells, basement membrane, podocytes. Macula densa cells are part of the juxtaglomerular apparatus and sense the chloride concentration in the distal tubule and adjust the diameters of arterioles accordingly.

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Proximal convoluted tubule characteristics:

cuboidal epithelium and contains microvili

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What transporters are on the proximal convoluted tubule?

Apical: Na/Glucose cotransporter, Na/H exchanger; NaCl go through the tight junctions;Na K atpase on the basolateral side

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What does the PCT reabsorb?

2/3 of water, electrolytes, all of glucose, amino acids, proteins, vitamins

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Loop of Henle thin descending loop is permeable to what?

water, and the thick ascending limb is IMPERMEABLE to water

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What transporter is on the apical side of the thick ascending limb?

Na K 2CL (pumps ions into the interstitial) = this is where loop diuretics work!

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Which nephrons are vital to make concentrated urine?

juxtamedullary nephrons

Order of blood flow in capillaries

lobar, interlobular, afferent arteriole, glomerulus, efferent arteriole, peritubular capiliaries, interlobular vein

Intercalated cells secrete what?

secrete H or HCO3 and reabsorb K

Principal cells reabsorb and secrete what?

secrete K and reabsorb Na

Where is the fluid hyposmotic?

In the distal convoluted tubule; further reabsorption is due to hormonal control

Where does aldosterone and angiotensin II work?

In the principle cells: overall NA reabsorption and K excretion; angiotension II up regulates the amilaride transporter; aldosterone up regulates the NaK pump on the BL side.

Where does ADH work?

Principal cells; makes aquaporins

In the distal convoluted tubules what do ANP and urodilatin do?

urodilantin inhibits Na reabsorption at the amilaride pump on the apical side

What pumps are in the intercalated cell on the apical side?

H/Na pump (uses ATP) and the H/K pump (uses ATP) on the BL side there is a CL/HCO3 counter transporter recycling bicarb (no ATP used)

What forms the medullary pyramids?

the collecting duct which empty into the minor calicoes through the papilla to the renal pelvis

Intercalated cells contain what pumps?

H ATPase, H/K pump; they reabsorb HCO3 via the Cl/HCO3 exchanger on the basolateral side

Principle cells contain what pumps?

Na/K ATPase and reabsorb NA (aldoserone) on the BL side and H2O channles via aquaporins on the apical side

What are the components of the juxtaglomerular apparatus?

glomerulus, macula densa, juxtaglomerular cells that produce and release renin

3 ways to promote renin release

Macula densa senses NaCl, nerve, baroreceptor

Macula densa senses concentrations of solutes in the distal tubule via what transporter?

Na 2Cl K, then it will affect renin release

What are important chemical mediators of arteriolar resistance?

ANGIOTENSIN II, Adenosine,NO, prostaglandins

Where does glucose get reabsorbed and how?

By the sodium dependent cotransporter: SGLT2

True or false: bicarb is freely filtered by the glomerulus and must be reabsorbed to maintain acid base balance?

True; but bicarb is not directly reabsorbed across the renal epithelium it must do the carbonic acid equation. The H's get across the apical/tubular membrane via a H/Na exchanger

When regulating acid base balance, where is the Na/H exchanger located? apical or basolateral?

apical side, its pumping H out into the tubule to buffer, and pumping Na back into the interstitium.

Secretion of potassium is promoted by what?

The Na-K pump on the basolateral side, this is regulated by ALDOSTERONE, potassium is also regulated by the K/H exchanger on the basolateral side!!

Osmotic diuretics

Work at the PCT; increase osmolality of the filtrate causing more water to remain in the tubule

ACE inhibitors

Work on the H/K pump in the DCT

Loop diuretics work where?

the Na K 2Cl pump in the ascending loop of henle

Thiazide like diuretics:

block Na reabsorption (DCT)

Potassium wasting diuretics

osmotic, ACE inhibitors, loop and thiazide like diuretics

Aldosterone blocking agents are:

POTASSIUM SPARING; still cause an increase in urine volume though

The infant:

has low GFR in the post-natal period, has reduced ability to make concentrated urine due to immature kidneys, predisposed to fluid depletion.

The adult/elderly

kidneys diminish at 40 and significantly by 60. loss of nephrons, diminished renal blood flow, decreased GFR, can't conserve salt and water, most susceptible to electrolyte imbalances.

order of the glomerular membrane

fenestrated epithelium, basement membrane, space between podocytes, filtration slit, bowman's space