Renal 3.1 Flashcards
True or False,
Bicarbonate, HCO3- is the main tampon for acid in the urine
FALSE wow
All of the HCO3- needs to be reabsorbed
instead phosphates and ammonical
What is Acidité titrable?
la quantité d’ions hydrogènes sécrétés dans la lumière tubulaire et tamponnés par le phosphate
What is the issue with the phosphate mecanism of acid tamponage? What is the solution?:
It is fixed and limited to 40% of all acid
Solution: excretion of acid with ammonium
What would you excpect to be increased in a marathon runner who is constantly complaning of bein in acidosis?
His amonia production
The phosphate system can only clear as much acid. The kidney will be responsible for increasing or decreasing ammonia produciton to help with the acidosis
A urine with a pH of 5 could indicate what?
insuffisance rénale sévère
the kidney is not able to produce ammonia
What is associated with le tamponage of an H+ in the urine whether it is via phosphore or ammoniac?
The re-absorption of a HCO3- on the plasmatic side
What would be the concentrations of creatinine in relation to urea in a patient who is dehadrated?
Higher urea concentration in the blood and low in urine
Il faut donc toujours éliminer une déshydratation chez le
patient dont l’élévation de l’urée est beaucoup plus
grande que la hausse de la créatinine plasmatique
How is glucose absorbed in the kidneys?
In the medulla
SGLT1 and SGLT2 on the apical side will absorbe glucose (Na+ GLUCOSE symporter)
GLUT2 on the basal side will allow glucose to pass into the plasma side
Can you have glucose in urine and why?
Normally no
but sometimes you can (example diabetes)
the reabsorption of glucose is saturable in the kidneys. YOu can only absorb so much (around 10mmol/L) and so anything beyond that will be secreted
What is a great treatment for a diabetic patient and why would this work?
inhibiteurs des SGLT2
SGLT2 allows for the absorption of glucose in the kidneys
if you block it, the person will piss more glucose = reduced blood glucose levels!
True or false,
95% of all amino acids will be reabsorbed
FALSE
ALL AMINOACIDS ARE REABSORBED
This means that there are no amino acids in the urine
You have come across a new treatment for diabetes that target SGLT2 in the ascending branch and colletor tube. Would this be a good medication to give to your patient?
NO
Reabsorption of glucose happens in the proximal tube!!!
No point to block the channels in other parts
What is the secretion rate of acid urique?
Just like any other substance it is fully filtered
After that, it is reabsorbed and re filtered and re absorbed in the proximal tube
and then only 10% is secreted
Lactate action in uric acid?
Lactate, which gets generated in high alcohol consimption
is an inhibitor of uric acid secretion > goutte
What does it mean for calcium filtration when we say that 40% of it is bound to albumin?
It means that 40% of it cannot be filtered becasue proteins are never filtered
