Renal Flashcards
Waste products
urea
Uric Acid
creatinine
Nephron with short loops of Henle
cortical nephrons
7/8 of all nephrons
cortical nephrons
1/8 of all nephrons
juxtamedullary nephrons
basic renal processes
filtration
reabsorption
secretion
excretion
Excretion rate formula
EX=(filtration rate - reabsorption rate) + secretion rate
Relaxation of the detrusor muscle
sympathetic input via the B-3 receptor (Gs-cAMP)
In addition, sympathetic input contracts the internal sphincter via α-1 receptors
Only force that promotes filtration
hydrostatic pressure of the glomerural capillaries
Main force driving reabsorption at the proxima tubule
oncotic pressure in the peritubular capillaries
glomerulus membran structures
capillary endothelial wall
glomerular basement membrane
epithelial cell layer of podocytes
materials easily or freely filtered
major electrolytes metabolic waste products metabolites nonnatural substances lower-weight proteins and peptides
Normal renal plasma flow
600 ml/min
normal filtration fraction
20%
osmolarity of ultrafiltrate
300 mOsm/kg
Effect of catecholamine and angiotensin II in sodium
enhance the fraction of sodium reabsorbed in the proximal tubule
Canagliflozin mechanism of action
blocks SGLT-2, inhibiting the proximal tubule reabsorption of glucose
Calbindin function
Facilitates calcium reabsorption
Gitelman syndrome
Mutated NaCl transporter
Patients are hypokalemic, alkalotic, and low urinary calcium
H+ buffers
Phosphate
Ammonia
most common cause for chronic renal failure
diabetic nephropathy
Winter’s equation
Predicted PACO2= (1.5*HCO3-) + 8
Expected PaCo2 equation
(0.7*rise in HCO3-) + 40
major plasma cation
Na+
estimated PAG formula
PAG= Na+ - (Cl- + HCO3-)
Normal PAG
12 +/- 2
MUDPILES
methanol uremia diabetic ketoacidosis paraldehyde iron; isoniazid lactic acidosis ethylene glycol; ehtanl ketoacidosis salicylates; starvation ketoacidosis; sepsis
HARDUP
Hyperchloremia Acetazolamide Renal tubular acidosis Diarrhea Ureteral diversion Pancreatic fistula
Acute respiratory acidosis compensation ratio
1:0.1
Chronic respiratory acidosis compensation ratio
1:0.35
Acute respiratory alkalosiscompensation ratio
1:0.2
Chronic respiratory alkalosis compensation ratio
1:0.5
Adenosine effect on coronary blood vessels
Vasodilates
Effect of adenosine on renal blood vessels
Vasoconstrict the afferent arteriole
Normal GFR
120 mL/min
180 L/day
Causes for renin release
Decreased flow in afferent arterioles
Increased sympathetic drive to JG cells
Low luminal NaCl at the macula densa
Filtered load formula
GFR*Px
Excretion rate formula
Ux*V
Clearance equation
Excretion rate / Px = (Ux*V)/Px
Glucose TM
375 mg/min
Where is phosphate mainly reabsorbed?
proximal tubule
Which hormone inhibits phosphate reabsorbtion?
PTH
Where does bicarbonate is reabsorbed?
proximal tubule
Which hormone stimulates Na+H+ antiporter?
angiotensin II
In which portion of the nephron do you absorb the most water?
proximal tubule
Most of the uric acid is reabsorbed where?
proximal tubule
In which portion of the nephron is the luminal pH the lowest?
Collecting duct
Barter syndrome
genetic mutation of the Na, 2Cl-, K transporter in the loop of Henle
Genetic disorder that affects the CaSR
Familial hypocalciuric hypercalcemia
Gitelman syndrome
mutation of the NaCl transporter
Clinical manifestations of gitelman syndrome
hypokalemia
alkalotic
low urine calcium
Where does PTH work on the neprhon?
Distal tubule
Nephron cell that synthesises bicarbonate
intercalated cell
Liddle syndrome
gain of function of ENaC channels in the collecting duct
Liddle syndrome treatment
amiloride
Difference between metabolic alkalosis from vomiting and from diuretic use
urine chloride is low in vomiting, high in diuretic use
Fanconi syndrome
defect in proximal tubule transport process and carbonic anhydrase inhibitors
Causes for distal RTA
autoimmune disorders sjögren's syndrome systemic lupus erythematosus rheumatoid arthritis isofamide amphotericin B, lithium carbonate, toluene inhalation sarcoidosis
most common RTA
hypoaldesterone states
type IV
Chronic levels of elevated PTH will cause…
sub-periosteal resorption
