Renal anatomy Flashcards
What % of the total body weight is water?
50-70% of body weight (60%)
What is the average weight of a person?
70kg
What is average volume of water in a person in kg or L?
70kg x 0.6 = 42kg or 42L
What is the extracellular fluid?
- transcellular fluid
- plasma
- interstitial
How many litres is transcellular fluid?
1.5-2 litres (cerebrospinal) - 3%
How many litres is plasma?
3-4 litres (7 litres)
How many litres is interstitial fluid?
11-12 (28%)
How many litres of total body fluid is intracellular fluid?
25-30 litres (62%)
What are 2 examples of cations?
K+ (potassium)
Na+ (sodium)
Describe K+ & Na+ cations inside & outside a cell
- High levels of K+ inside cell, low inside cell
- Low levels of Na+ inside cell, high inside cell
What is an example of an anion?
chlorine (Cl-)
What does the volume of plasma determine?
determines blood pressure
How much sodium do we intake a day?
150 mmoles Na+/day
How much H20 do we intake a day?
2.6l/day
What 2 ways do we lose H20?
- urine
- respiration, stool, sweat
What are 2 ways we lose sodium?
- stool + sweat - 10 mmoles
- urine - 140 mmoles
What organs plays a critical role in regulating sodium content of the plasma, as well as plasma volume, which therefore determine our blood pressure?
Kidneys
How much does a kidney weigh?
150g
Where is the kidney located?
12th thoracic & 3rd lumbar
How large are the kidneys?
10cm tall, 5.5cm wide
What does the renal artery carry?
blood to the kidney
What does the renal vein?
blood away from kidney
What is micturition?
the expulsion of urine from the body
Describe how urine is drained from the body
Urine produced in the kidneys drain into the renal pelvis, into the ureter and into the bladder where it is stored and then expelled from the body via the process of micturition
How many foetuses experience Renal agenesis?
1 in 2500
How many people experience an ectopic kidney?
1 in 800 (damage & stones)
How many people have a horseshoe kidney?
1 in 1000
What is a horseshoe kidney?
Fusion of kidneys across the midline, leading to an increased risk of the development of kidney stones
What are the different parts of the gross structure of the kidney?
- capsule (outer layer)
- cortex
- medullary ray
- pelvis
- ureter
What is the capsule?
fibrous layer surrounding kidney, providing structural support & protection from damage
What are the medullary rays?
striations associated with the blood vessels that dip down into the medulla.
What is another name for tubule?
Nephron
What is the functional unit of the kidney?
nephron
How many nephrons are the per kidney?
1-1.5 million per kidney
Where is urine produced?
in the nephron
Where does the process of filtration through a nephron begin?
glomerulus
What arteriole brings blood into the capillary?
afferent arteriole
Where does filtrate that has travelled through the glomerulus then flow into?
Bowman’s capsule
What part of the kidney is the Bowman’s capsule?
in the cortex
What part of the kidney is the loop of Henle?
cortex & medulla
What part of the kidney is the distal tubule?
cortex
What part of the kidney is the collecting duct?
cortex & medulla
How many nephrons feed into 1 collecting duct, before draining into pelvic region?
6
What % of the nephron is superficial nephron?
85%
What % of the nephron is juxtamedullary nephron?
15%
What is the normal GFR (glomerular filtration rate)?
125ml/min
What is renal failure defined as?
fall in GFR (glomerular filtration rate), leads to an increase in serum urea & creatinine.
Is acute renal failure reversible?
yes
Is chronic renal failure reversible?
no
What is needed to treat chronic renal failure?
dialysis or transplant needed
What happens in haemoglobin level in acute & chronic renal failure?
Acute - haemoglobin not changed
Chronic - haemoglobin decreases
What happens in renal size in acute & chronic renal failure?
Acute - remains the same
Chronic - decreases
Is there peripheral neuropathy is acute renal failure?
no
Is there peripheral neuropathy is chronic renal failure?
yes
What is peripheral neuropathy?
peripheral nerve damage leading to problems with sensation & movement
What is uraemia?
the symptoms associated with renal failure
What is uraemia (what are the actual symptoms)?
- thickening glomerular membranes
- damage glomeruli
- progressive scarring glomeruli (glomerulosclerosis) & tubular atrophy, interstitial inflammation & fibrosis
- reduction in renal size
What are the results of the failure excrete salt & water?
hypertension (high blood pressure)
hyperkalaemia (high potassium blood levels)
mild acidosis (acid blood - lowered pH - lack of excretion of hydrogen ions)
What are the results of poor exertion urea/creatinine & lack of protein into urine?
- anorexia, nausea, vomiting
- pericarditis (inflammation of the lining around the heart)
- inflammation pericardium
What are the results of failure to produce erythropioetin?
- anaemia (lack of erythrocytes)
- lethargy (a state inactivity/lack of heart)
What are the results of failure excrete PO4 (phosphate)?
- metastatic calcification (itch)
- bone disease (osteomalacia - bone softening) & osteoporosis (weak bones)
What GFR is considered mild renal disease?
> 75 GFR ml/min
What GFR is considered mild?
50-75
What GFR is considered moderate?
25-50
What GFR is considered severe?
10-25
What GFR is considered end-stage?
<5-10
What is a big risk of dialysis?
risk of infection
What is Glomerulonephirtis (what % cause of renal failure)?
damage to glomerular barrier - consequence of immune conditions or infection - HIV
- 30%
What is diabetes mellitus (what % cause of renal failure)?
Individuals struggle to control their blood glucose levels (25%)
What is hypertension (what % cause of renal failure)?
high blood pressure (10%)
What is polycystic kidney disease (what % cause of renal failure)?
(inherited) nephron are replaced with fluid-filled cysts, causing a reducing in the number of functional glomeruli, leading to less filtration, plasma producing less ultra-filtrate & eventually leading to chronic renal failure (50% of people with this disease end up at end stage renal failure phase)
What are examples of reversible factors & complications that can be treated?
diet - restrict protein, salt, water
phosphate binders - hyperphos
Na bicarb - acidosis
Diuretics - Na retention
What is the purpose of reducing treatable factors?
reduce symptoms & slow progression
