Renal Anatomy and Disease Flashcards by Omole Aigbokhaode

What is acute renal failure ?

Fall in GFR - leads to an increase in serum urea and creatinine.

Reversible

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What is chronic renal failure ?

Defined as a fall in GFR - leads to an increase in serum urea and creatinine.

Irreversible - dialysis or transplant needed

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What is the difference between acute and chronic renal failure.

Chronic - long history
reduced haemoglobin levels
reduced renal size
peripheral neuropathy present (nerve damage)

Acute - short history
same haemoglobin levels
same renal size
peripheral neuropathy absent (nerve damage)

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What is the uraemia of renal failure ?

Damge glomeruli
Nephron atrophy lost
Progressive scarring glomeruli
Thickening glomerular membranes

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What does failure to excrete salt and water do ?

Hypertension
Hyperkalaemia
Mild acidosis

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What does poor excretion of urea and creatine do ?

Anorexia
Nausea
Vomiting

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What does leak of protein into urine do ?

Neuropathy
Pericarditis
Inflammation of pericardium

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What does failure to produce erythropoietin cause ?

Anaemia

Lethargy

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What does failure to excrete phosphate do when it lowers serum Calcium ?

Metestatic calcification

Bone disease

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What are the different stages of Renal failure ?

Mild renal - below 75 ml/min
Mild - 50-75
Moderate - 25 - 50
Severe - 10 - 25
End-stage - below 5-10

Below 125 ml per min is classed as mild renal failure.

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What are the main causes of Renal failure ?

Diabetes
Hypertension
Polycystic kidney disease
Glomerulonephritis

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What is the pathway of ultra filtrate down the nephron ?

Bowmans capsule
proximal tubule
loop of Henle
distal tubule

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What can pass through Glomerulus into Bowmans Capsule ?

Water
Glucose
Na+
K+

not proteins

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What can pass through Glomerulus into Bowmans Capsule ?

Water
Glucose
Na+
K+

not proteins

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What is transcellular reabsorption ?

Transcellular reabsorption – across the cell. Ions solutes and water use specific transport proteins to move across cells from apical to the basal lateral membrane. Into peritubular capillaries.

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What is transcellular secretion ?

Transcellular secretion – transport utilises specific transport protein, oves water, ions and solutes from peritubular capillary to tubule lumen.

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What are the effects of the NaPiII knockout mouse phenotype ?

Less Pi reabsorption

More loss in urine

Issues renal mineralisation (seen in patients too)

What is Bartter’s syndrome and what does it cause ?

genetic inheritance, affects renal genes, ROMK

Causes
Salt wasting and polyuria
Hypotension
Hypokalaemia
Metabolic alkalosis
Hypercalciuria
Nephrocalcinosis

What happens when ROMK is knocked out of mice ?

Salt wasting increase
Polyuria increase
plasma K+ conc decreases

What happens in the early distal tubule ?

Reabsorbs Na+, Mg 2+ and Cl-
Sensitive to thiazide diuretics

NCC channel on apical membrane
CLCK and Barttin on basolateral membrane

What does Gitelmans syndrome ?

Salt wasting and polyuria
Hypotension
Hypokalaemia
Metabolic alkalosis
Hypocalciuria
The gene NCC is effected

How does Furosemide and Bumetanide effect the kidney ?

treats high blood pressure

Bartter’s Syndrome side affects

Hoe does Chlorothiazide affect the kidney ?

treats high BP

side effects like Gitelman’s syndrome

What are the principal cell diseases in the late distal tubule ?

Diabetes insipidus - AQAP2
Liddle’s syndrome - ENaC
Pseudohypoalsoterionism

What is Amiloride used to treat ?

High BP

What is Oliguria what does it result in and what is the treatment for it ?

it is a fall in GFR, due to hypotension, pre-rental cause Results in Rhabdomyolysis, renal cause, high K+, low HCO3- Treatment IV saline HCO3- consumption Rehydration Dialysis

What is Vasopressin ?

Also known as ADH Reulates body fluid osmolality A hormone Released from posterior pitutary but target is the kidney In the cell bodys it is trafficked down the axon and stored in the posterior pituitary. The AP causes the fusion of vesicles, vasopressin is released.

What is the negative feedback system of vasopressin ?

Increased body fluid osmolality = increased vasopressin, solute ingestion or water deficiency Decreased body fluid osmolality = decreased vasopressin, excess fluid ingestion

What happens when vassopresin is released from posterior pituitary gland ?

Feeling of thirst - stimulated hypothalamic osmoreceptors

Why does urine osmolality increase when plasma vasopressin also increases ?

The more plasma vasopressin, the more water you retain, the less water you excrete in urine, the more concentrated the urine is.

What happens to a cell water model when vasopressin is present ?

Increased number of Aquaporins in membrane PKA activated

What is Diabetes insipidus ?

Diabetes insipidus is a rare condition where you pee a lot and often feel thirsty.

What is Aldosterone ?

Released from cortex of the adrenal gland - zona glomerulosa layer Mineralocorticoid, regulates plasma Na+, K+ & body fluid volume

What does Aldosterone respond to ?

increased plasma K+ - 0.1 mM decreased plasma Na+ - minor, concentration maintained by osmoregulation decreased ECF volume - via renin-angiotensin

What does Aldesterone act on and what does it cause ?

Late distal tube Collecting duct Causes increased reabsorption Na+, H2O and ncreased secretion of k+ AND H+

What does aldosterone stimulate the production of ?

ENaC channels

What is the net effect of alpha IC cells ?

Co-ordinate regulation with renin-angiotensin system ( hormome system that works with aldosterone) inrease in plasma Na+ and ECF volume decrease in plasma H+ and K+

What is Liddle's Syndrome ?

Liddle’s syndrome: hypertension High Na+ reabs at Collecting Duct, Low aldosterone increased no. Na+ channels principal cell

What is Pseudohypoaldosteronism

Pseudohypoaldosteronism: Salt loss but high aldosterone Loss response to aldosterone Mineralocorticoid receptor problem

What does renin-angiotensin regulate ?

Body fluid volume, plasma Na+ & K+

What does renin-angiotensin regulate ?

Body fluid volume, plasma Na+ & K+

What is renin released from

Renin - released from juxtaglomerular apparatus (JGA)