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Renal 1 > Renal Blood Flow and GFR > Flashcards

Renal Blood Flow and GFR Flashcards

1
Q

Starling forces in Kidney

A

Pgc= filtration (+)
Pbc= reabsorption (-)
osmotic GC= reabsorption (-)
osmotic bc= filtration (+)

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2
Q

Net filtration pressure equation

A

Net filtration pressure= Pgc-Pbc- Oncotic (gc)

oncotic(bc) assume to be 0

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3
Q

Physical factors that contribute to GFR (3)

Equation that comes from these factors

A

1) Hydraulic conductivity
- permeability/porosity of fenestrated endothelium
2) Surface area for filtration
3) Capillary ultrafiltration pressure

GFR=Kf x Puf

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4
Q

Ultrafiltration Pressure (Puf)

  • what changes Puf
  • what determine Pgc? (3)
A

Puf= Pgc-Pbc- Oncotic (gc)

same as Ultrafiltration Pressure

Pgc changes Puf

Pgc determined by :

  • Renal arterial blood pressure
  • afferent arteriolar resistance
  • efferent arteriolar resistance
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5
Q

Ultrafiltration coefficient (Kf)

what role do glomerular mesangial cells play?

A

Kf= hydraulic conductivity x surface area

  • they shorten loops=> decrease SA
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6
Q

Changes in net filtration force that occur as blood travels along the glomerular capillary and hydrostatic pressure falls while colloid pressure increases

A

Sites of regulation (2)
-afferent arteriole
-efferent arteriole
== have sharpest declines in pressure (efferent lower)

Glomerular capillary= maintains high hydrostatic pressure

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7
Q

Why does oncotic pressure in glomerular capillary rise along capillary

A

due to continuous production of protein-free glomerular filtrate

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8
Q

Resistance to afferent and efferent arterioles on RBF, GFR, and peritubular capillary reabsorption. (4)

A

1) Afferent arteriole constriction
- decrease filtration pressure
- decrease GFR
- decrease flow

2) Afferent arteriole dilation
- increase ultrafiltration pressure
- increase GFR

1) Efferent arteriole constriction
- causes pressure to back up within capillary GFR
- increase GFR

2) Efferent arteriole dilation
- allows blood to escape capillary
- decrease pressure
- decrease GFR

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9
Q

RBF

Relationship between O2 consumption and Na+ reabsorption

A

directly related

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10
Q

Determinates of GFR (3)

A
  • sympathetic
  • vasoactive signals
  • hormones

all affect glomerular hydrostatic pressure and glomerular capillary oncotic pressure

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11
Q

Renal Hemodynamics control mechanisms for intrinsic (2) and extrinsic (3)

A

Intrinsic

  • autoregulation
  • tubuloglomerular feedback

extrinsic

  • sympathetic nerves
  • hormones
  • composition of blood
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12
Q

Alpha 1 are seen more in afferent or efferent arteriole

effects of alpha 1

A

AFFERENT

Alpha 1 is vasoconstriction

Decrease RBF and GFR

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13
Q 
Glomerulotubular balance
definition
mechanisms (3)
A
  • increases reabsorption rate within renal tubule when GFR rises

Mechanisms (when increase GFR)
1) higher oncotic pressure in efferent and peritubular capillary
2) increase filtered load
increase Na+ reabsorption
increase Cl- delivery
3) increase shear strain
upregulate apical sodium transporter insertion

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14
Q

Autoregulation

  • definition, range
  • how to increase pressure
A

-maintain RBF and GFR within range of BP (80-170mmHg)

increase pressure-> increase resistance via local reflex (vascular smooth muscle, myogenic reflex) and physiological feedback (juxtaglomerular apparatus, tubuloglomerular feedback)

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15
Q

Local Myogenic Feedback reflex

  • definition
  • ions
  • arteriolar effects
A
  • Resist stretch during high BP
  • Ca signaling
  • afferent arteriolar constriction
  • efferent arteriolar dilation
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16
Q

Role of

  • Mesangial Cells
  • Juxtaglomerular cells
  • Macula Densa
A
  • transduces message
  • secrete renin
  • senses
17
Q

Tubuloglomerular Feedback

  • components of juxtaglomerular apparatus(3)
  • function
A
  • Macula densa
  • juxtaglomerular (granular) cells - renin
  • extraglomerular mesangial (lacis) cells
  • senses tubular NaCl
  • feedback signal to adjust arteriolar resistance
  • signals between macula densa and JG cells
  • *** maintains constant Na+ delivery to distal tubule and constant GFR
  • Renin release
18
Q

Macula Densa Signaling

steps (4)

A

1) increases delivery of NaCl to macula densa
2) increase ATP/adenosine
3) Vasoconstricts afferent arteriole (calcium signaling)
4) decrease GFR

19
Q

What will body do in increased renal perfusion pressure? what is it mediated by?

A

Vasoconstriction of afferent arteriole

  • decrease GFR
  • mediated by adenosine
20
Q

What happens in decreased renal perfusion pressure? what is it mediated by?

A
  • decreased GFR, NaCl to macula densa

Cause

  • macula densa signals to JG cells to secrete renin -> angiotensin II (vasoconstrictor)
  • afferent arteriole dilation (NO)
  • efferent arteriole vasoconstriction (angiotensin II)
21
Q

Afferent arteriole - vasodilation

  • what hormones(5)
  • Effect on RBF, GFR, peritubular capillary hydrostatic pressure
A 
prostaglandins
bradykinin
NO
dopamine
ANP

increase RBF
increase GFR
increase peritubular capillary hydrostatic pressure

22
Q

Afferent arteriole - vasoconstriction

  • what hormones
  • Effect on RBF, GFR, peritubular capillary hydrostatic pressure
A

ACE inhibitors

decrease RBF
decrease GFR
decrease peritubular capillary hydrostatic pressure

23
Q

Efferent arteriole - vasodilation

  • what hormones
  • Effect on RBF, GFR, peritubular capillary hydrostatic pressure
A

Sympathetics

increase RBF
decrease GFR
increase peritubular capillary hydrostatic pressure

24
Q

Efferent arteriole - vasoconstriction

  • what hormones
  • Effect on RBF, GFR, peritubular capillary hydrostatic pressure
A

Angiotensin II

decrease RBF
increase GFR
decrease peritubular capillary hydrostatic pressure

Renal 1 (8 decks)

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