Renal Flashcards
mesonephros
interim kidney for first trimester, contributes to male genital system
metanephros
permanent - becomes kidney
ureteric bud
from caudal end of mesonephric duct - gives rise to ureter, pelvises, calyces, collecting ducts
metanephric mesenchyme
blastema - ureteric bud interacts with this, formation of glomerulus through to DCT
ureteropelvic junction
last to canalize - most common site of obstruction - leads to hydronephrosis
potter sequence
starts with oligohydramnios - leads to lung hypoplasia, face flattening and limb deformities
- causes are ARPKD, obstructive uropathy, renal agenesis, placental insufficiency
unilateral renal agenesis
ureteric bud fails to develop
multicystic dysplastic kidney
failure of metanephric blastema to differentiate - usually unilateral
duplex collecting system
increased risk for vesicoureteral reflux and UTI
posterior urethral valves
leads to obstruction of bladder outlet
kidney taken during transplantation
left = longer renal vein
where are macula densa cells
against efferent arteriole in the DCT
how to measure extracellular volume
inulin or mannitol
components of kidney BM
type 4 collagen and heparin sulfate (negative charge)
renal clearance
(urine concentration)(urine flow rate)/(plasma concentration)
inulin
same as GFR - freely filtered and not secreted or reabsorbed
creatinine
slightly overestimates GFR because there is slight secretion
PAH
100% excreted by kidney because it is secreted
- used to estimate eRPF
renal blood flow
RPF(1-hematocrit)
filtration fraction
GFR/RPF
angiotensin II
constricts efferent arteriole, prostaglandins dialate afferent
FENa
fraction of sodium that is filtered that ends up being exreted
splay
region of substance clearance between threshold and Tm due to heterogeneity of nephrons
what does angiotensin II do to the PCT
increases Na/H exchange, leading to Na, water and base reabsorption (causing alkalosis)
PTH in kidney
inhibits phosphate reabsorption in PCT and increases calcium reabsorption in early DCT
fanconi syndrome
- reabsorptive defect in PCT
- excrete everything = metabolic acidosis
- causes = Wilson, tyrosinemia, GSD, cystinosis, ischemia, MM, drugs, lead poisoning
Barter syndrome
- defects in thick ascending limb
- Na/K/Cl transporter
- hypokalemia and metabolic alkalosis with hypercalciuria (like using furosemide)
Gitelmann syndrome
- defect in Na/Cl in DCT
- hypokalemia, hypomagnesemia, metabolic alakalosis, hypocalcinuria
- same as using HCTZ
Liddle syndrome
- more Na reabsorption in collecting tubules
- hypertension, hypokalemia, metabolic malkalois
syndrome of apparent mineralocorticoid exess
- 11beta hydroxyteroid dehydrogense deficiency
- activates mineralocorticoid receptor
creatinine and inulin concentrations along PCT
increase in concentration but not amount due to faster reabsorption of water
chloride reabosorbtion in PCT
water than water at first but then levels off
things increasing renin secretion
- low sodium in tubules
- low BP
- increase in beta1 activation
actions of angiotensin II
- constriction of vasculature
- constrict efferent arteriole
- secrete aldosterone
- secrete ADH
- increase in Na/H pump
- stimulate hypothalamus
how to beta blockers decrease blood pressure
inhibit beta1 receptors of JGA leading to decrease in renin release
EPO is released by…
peritubular capillary bed in response to hypoxia
dopamine in PCT cells
promotes natriuresis, increases RBF with no changes in GFR
things that shift potassium into cells
- insulin, beta agonists, alkalosis, hyperosmolarity
distal renal tubular acidosis (type 1)
- H+ cant be secreted so no bicarb is produced leading to metabolic acidosis
- associated with hypokalemia and risk for calcium stones
proximal renal tubular acidosis
- defect in bicarb reabsorption
- more bicarb is excrete and H+ is added to urine in collecting duct
- associated with hypokalemia
hyperkalemic renal tubular acidosis
- hypoaldosteronism leads to hyperkalemia, less ammonium synthesis in PCT and less acid excretion
maltese cross
fat in the urine from nephrotic syndrome
muddy brown casts
ATN
waxy casts
end stage renal disease
