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Renal > Renal DSA > Flashcards

Renal DSA Flashcards

1
Q

What are the three layers of the glomerular filtration barrier?

A
  1. capillary endothelium
  2. glomerular basement membrane
  3. podocyte

*must pass these three barriers to go from the capillary lumen to Bowman’s capsule

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2
Q

What does the glycocalyx make? what is it made of?

A
  1. biogel (provides molecular filling to the fenestrae of the capillary)
  2. hyaluronan, heparan sulfate
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3
Q

What is the function of Tamm-Horsfall protein?

A

antimicrobial molecule combating UTIs

-does appear in the urine, but is not filtered

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4
Q

As size increases, filtration…

A

decreases

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5
Q

Filtered load of X=

A

plasma concentration of X x GFR

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6
Q

Urinary excretion

A

amount filtered - amount reabsorbed + amount secreted

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7
Q

Tubular excretion

A

glomerular filtration - urinary excretion + amount secreted

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8
Q

If excretion is greater than filtration, what must have occurred?

A

tubular secretion

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9
Q

Urine excretion rate of x=

A

Ux X V

  • Ux: the [} of a substance in the urine in a given volume
  • V: rate at which urine is produced
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10
Q

What is renal clearance (C)?

A

the volume of plasma completely cleared of a substance by the kidneys per unit of time

C=(Ux X V)/Px=mL/min

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11
Q

Glomerular filtrate is similar to plasma except that it is…

A

protein free and cell free

*represents 20% of RBF

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12
Q

Filtration Fraction (FF)=

A

GFR/RBF

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13
Q

As FF increases, the oncotic pressure of the ____ arteriole increases

A

efferent

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14
Q

What is the difference between filtered load and filtration fraction?

A

a. a rate in mg/min

b. a ratio of GFR to RBF

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15
Q

GFR is directly proportional to renal clearance if what four things are true?

A
  1. Substance must be freely filterable in the glomeruli
  2. Substance must be neither reabsorbed nor secreted by the rental tubules
  3. Substance must not be synthesized, broken down, or accumulated by the kidney
  4. Substance must be physiologically inert (not toxic)

ex. Inulin and creatinine

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16
Q

Three mxns by which the sympathetic nervous system increases BP

A
  1. JG cells to secrete renin (beta 1)
  2. Na+ increased reabsorption (alpha 1)
  3. Vasoconstriction (afferent»efferent; alpha 1)
17
Q

What are the immediate effects of sympathetic stimulation?

A

a. Angiotensin II–> exert thirst, vasoconstriction, acts on efferent arteriole
b. stimulates renin secretion
c. GFR is stabilized
d. systemic BP is raised
e. Na+ reabsorption in PCT/DCT

18
Q

What are the eventual effects of sympathetic stimulation?

A

a. decreased urinary output
b. decreased urinary Na+ excretion
c. increased water intake

19
Q

How are plasma creatinine and GFR related?

A

inversely proportional

20
Q

How would you recognize a pre-renal problem?

A
  1. BUN>20:1
  2. Mxn: BUN reabsorption is increased
  3. example: hypovolemia, dehydration, reduced renal perfusion, high protein diet
21
Q

How would you recognize a post-renal problem?

A
  1. Bun levels are normal

2. Mxn: post renal disease

22
Q

How would you recognize a intrarenal problem?

A
  1. BUN<10:1
  2. Mxn: renal disease reduces BUN reabsorption
  3. example: Liver disease, low protein diet
23
Q

What is PAH used to measure?

A
  1. Renal blood flow
  2. PAH is not typically in the human body, so it must be administered by continuous intravenous infusion

*we can assume all PAH presented to the kidneys is excreted in the urine

24
Q

Signals that increase GFR

A

NO, dopamine, prostaglandins

25
Q

Signals that decrease GFR

A

NE, Epi, Endothelin

26
Q

Signals that maintain GFR

A

Angiotensin II (prevents decrease in GFR + preferentially constricts efferent arterioles)

*prostaglandins and bradykinin oppose vasoconstriction in the afferent arteriole–>their presence is why angtiotensin II constricts the efferent arteriole

Renal (8 decks)

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