Renal final Flashcards
Kidney absorption
-Bowman:
-PCT: 80% reabsorption
-Loop: 6% reabsorption, H2O and salt conversion
-DCT: 9%, some secretion
-Collecting tubule: 4%
Proximal tubule
-secrete glucose, aas, ions
Henle’s Loop
-
Sources of renal failure
-HTN and diabetes
-NSAIDs, ACE/ARBs, cyclosporine
-ischemia, sepsis, nephrotoxinss
-bladder obstruciton
NSAID effect on GFR
-afferent resistance reduced
-dec prostaglandins
ACE/ARB effect on GFR
-efferent resistance reduced
-dec angiotensin
Nephr I tic syndromes
-Inflammation
-hematuria
-immediate onset
nephrOtic syndrom
-pOdOcyte damage
-prOteinuria
Glomerulonephritis
-inflammation of glomeruli
-acute or chronic
-infecction, drug, autoimmune induced
Pyelonephritis
-inflammation of kidney tissue
-flank pain and painful urination
-white cells in urine
-caused by bacteria
-could lead to sepsis
Interstitial nephritis
-injury to renal tubules
-undetected until sig dec in function
-mostly caused by antibiotics (PENICILLIN)
Autosomal Dominant (adult) polycystic kidney disease
-cysts
-PKD1 or 2 mutation
-blood in urine
-HNT an UTI is fatal, renal transplant needed
Autosomal recessive (childhood) poycystic kidney disease
-PKHD1 mutation (fibrocystin)
-young pt die quickly
-pt who survive get liver cirrhosis
Nephrolithiasis
-kidney stones
-saturation of calcium
-hematauria and pain
kidney stone tx
-analgesics
-hydration
-lithotripsy
-surgery
-prevention=limit Ca, diuretics
Diuretics
- block carbonic anhydrase (PCT)
- Osmotic diuretic
- blocks Na-K-Cl (loop)
- blocks Na-Cl (DCT)
5a. inhibts Na channels (collecting duct)
5b. MRAs
OAT and OCT
-diffusion out of capillaries to peritubular space
-transport across membrane
-secretion across luminal membrane
-competitive
-probenecid used to saturate OAT and slow PCN activity
-furosemide, thiazides, NSAIDs use OAT
Carbonic anhydrase inhibitor drugs
-sulfanilamide group
-acetazolamide
-dichlorphenamide
-methazolamide
carbonic anhydrase inhibitor uses
-low efficacy as diuretic but can be used for mountain sickness bc metabolic acidosis
-acetazolamide
Osmotic diuretic drugs
-Mannitol
-descending loop of henle
-shift osmotic flow from blood to urine
Loop diuretics
-inc Na-K-Cl excretion
-ascending loop (more sodium reabsorption)
-most potnent and good for edema
-furosemide, bumetanide, ethacrynic acid (not sulfa)
-ototoxicity, hypokalemia
Thiazide diuretics
-inhibit Na-Cl in DCT
-enhance potency of CA-I
Potassium sparing diuretics
-late DCT and collecting duct
-weak diuretics
-amiloride and triameterene
-HYPERkalemia!
