Renal Disease

Question 1

what is minimal change disease?

Answer 1

when podocytes fuse together and do not have the finger like projections that filter out proteins. this leads to protinuria

Question 2

what is the most accepted mechanism between glomerular disease and edema?

Answer 2

increased filtration leads to hypoalbuminemia and reduced oncotic pressure leading to water movement into interstitial space

Question 3

with unilateral nephrotic syndrome without hypoalbuminemia, what is the effect on sodium excretion?

Answer 3

sodium excretion from the normal kidney is high while it is reduced in the nephrotic kidney

Question 4

describe the effect of water immersion on ANP with a normal and neprotic kidney.

Answer 4

normal- there is a gradual increase in plasma ANP with immersion
nephrotic- there is no increase initially with a jump in ANP later

Question 5

at what point does plasma hypoalbuminemia cause a disrupted oncotic gradient between the capillaries and interstitium? what does this call into question?

Answer 5

when albumin falls below about 2 (normal is 24)
calls into question the reduced oncotic pressure theory of edema with nephrotic syndrome because there are compensatory mechanisms to decrease interstitial oncotic pressure with reduced albumin