Renal Function

Question 1

Name two important hormones synthesised by the kidneys.

Answer 1

Renin and erythropoietin

Question 2

__________ is the cessation of renal function, although much damage is required.

Answer 2

Uraemia

Question 3

List three signs and/or symptoms of uraemia.

Answer 3

Vomiting, inordinate urine volume, and oedema

Question 4

True or false: acute renal failure (ARF) or acute kidney injury (AKI), is usually observed in the hospital setting, most commonly in the severely ill.

Answer 4

True

Question 5

_____________ AKI involves the loss of proper blood supply, via blood loss and hypovolemia.

Answer 5

Prerenal

Question 6

What causes renal stage AKI?

Answer 6

Intrinsic damage to the kidney tissue, due to a variety of diseases, such as glomerulonephritis

Question 7

In which phase of AKI is urinary drainage impaired by obstruction?

Answer 7

Postrenal

Question 8

At what level of glomerular filtration rate do symptoms appear in chronic kidney failure?

Answer 8

10%

Question 9

Diabetes can cause _________ kidney failure.

Answer 9

Chronic

Question 10

List three causes of acute nephritic syndrome (acute glomerulonephritis).

Answer 10

Group A Streptococcus infection of the pharynx or skin, systemic disease, and reaction to drugs

Question 11

Rapidly-progressing glomerulonephritis will present with ____________-shaped nephrons.

Answer 11

Crescent

Question 12

___________ ____________, such as pyelonephritis, causes alterations in tubular function, leading to kidney damage.

Answer 12

Interstitial nephritis

Question 13

_____________ nephropathy is derived from prolonged high blood pressure.

Answer 13

Hypertensive

Question 14

Renal tubular acidosis impairs ______________.

Answer 14

Homeostasis

Question 15

___________ ___________ causes the kidneys to be unable to conserve water, due to a deficiency of, or insensitivity to, anti-diuretic hormone

Answer 15

Diabetes insipidus

Question 16

____________ ____________ ______ is the rate at which substances are filtered through the kidneys’ glomeruli, measured in mLs/minute.

Answer 16

Glomerular filtration rate

Question 17

What is the approximate glomerular filtration rate?

Answer 17

240 mL/min

Question 18

What commonly used analyte is used to calculate GFR?

Answer 18

Creatinine

Question 19

State the formula for GFR.

Answer 19

GFR = (urine creatinine)(urine (mL/min)) / serum creatinine

Question 20

The ________ _______________ test assesses the ability of the kidneys to concentrate urine.

Answer 20

Water deprivation

Question 21

Serum ______________ is synthesised in the liver, kidneys, and pancreas.

Answer 21

Creatine

Question 22

What is the waste product of creatine?

Answer 22

Creatinine

Question 23

In measuring creatinine, Jaffe’s 1886 reaction with ___________ ________, yields an orange-red complex.

Answer 23

Alkaline picrate

Question 24

List three sources of interference in the Jaffe method.

Answer 24

Protein, glucose, and bilirubin

Question 25

Modified Jaffe methods use ___________ measurement, and alterations in reactant concentration.

Answer 25

Kinetic

Question 26

For creatininase measurement, an indirect _____________ method is used.

Answer 26

Enzymatic

Question 27

What are the reference ranges for creatinine?

Answer 27

Male: 80 - 145 µmol/L
Female: 62 - 97 µmol/L

Question 28

True or false: In AKI, values may increase to three times the upper reference limit.

Answer 28

False

Question 29

Serum urea is the nitrogen-containing product of protein catabolism, synthesised by ____________ enzymes in the urea cycle.

Answer 29

Hepatic

Question 30

Creatinine and _______ are generally measured together.

Answer 30

Urea

Question 31

The enzymatic __________ method uses urease to convert urea into ammonia and water.

Answer 31

Berthelot

Question 32

In urea measurement, ammonia is reacted with phenol and hypochlorite in alkaline media, to form coloured ______________.

Answer 32

Indophenol

Question 33

The modified Berthelot method uses ____________ instead of phenol.

Answer 33

Salicylate

Question 34

The _______________ ___________________ reaction is coupled to oxidation of NADH, giving rise to the formation of a coloured complex, which may then be monitored.

Answer 34

Glutamate dehydrogenase

Question 35

What is the reference range for urea?

Answer 35

2.8 - 6.8 mmol/L

Question 36

Blood urea nitrogen (BUN) is used frequently, with a conversion factor of approximately _____.

Answer 36

0.5

Question 37

_____________ is an increase in amount of protein in urine, when glomerular basement membranes prevent plasma proteins from entering the nephron, and an indication of loss of glomerular function.

Answer 37

Proteinuria

Question 38

List three methods for detecting proteinuria.

Answer 38

Biuret, turbidimetric, and dye-binding

Question 39

______________ is the measurement of the osmotic concentration of the urine.

Answer 39

Osmolality

Question 40

What is the normal osmolality of urine?

Answer 40

≥600mOsm/kg

Question 41

If the urine:plasma osmolality ratio is not approximately ____, water is not being reabsorbed.

Answer 41

1:1

Question 42

In the water deprivation test, what should the sample’s osmolality be?

Answer 42

<300mOsm/kg

Question 43

Urinary ____ is used to diagnose renal tubular acidosis.

Answer 43

pH

Question 44

What two analytes does specific proteinuria testing measure?

Answer 44

β2 microglobulin and α1 microglobulin