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Clinical Chemistry LEC > Renal Function > Flashcards

Renal Function Flashcards

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1
Q

Size of kidney

A

10-12cm

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2
Q

Location of kidney

A

Between T12-L3

12th thoracic vertebrae
3rd lumbar vertebra

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3
Q

Renal medulla is ___ Shaped

A

heart shaped

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4
Q

Functional unit of kidneys

A

nephrons

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5
Q

filter the substance needed to be filtered

A

Glomerulus

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6
Q

___ Made up of tuft of capillaries and covered by the ___

A

Glomerulus, Bowman’s capsule

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7
Q

Site of filtration of the substances

A

Glomerulus

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8
Q

Kidney functions

A
  1. Urine formation
  2. Fluid and electrolyte balance
  3. Regulation of acid-base balance
  4. Exretion of the waste products of protein metabolism
  5. Exrection of drugs and toxins
  6. Secretion of hormones
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9
Q

Hormone reponsible for production of RBC

A

Erythropoietin

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10
Q

Discreased vit D means

A

rickets

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11
Q

Process of the substances from the glomerulus to the bownman’s space to the urine

A

Glomerular filtration

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12
Q

Reabsorbs from the tubules to the capillaries back to the blood

A

Tubular Absorption

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13
Q

Molecular cutoff value of about

A

66,000 Da or 66kDa

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14
Q

The basement membrane is ___-charged

A

Negatively

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15
Q

The renal blood flow is ___mL/min

A

1,200 - 1,500 mL/min

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16
Q

Glumerular filtrate is ___ mL/min

A

130 - 150 mL/min

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17
Q

CAN pass through the glomerulus:

A

● Water
● Electrolytes
● Glucose
● Amino acids
● Urea
● Creatinine

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18
Q

CANNOT pass through the glomerulus:

A

● Plasma proteins
○ Albumin, hemoglobin
● Cellular elements
○ RBC, WBC, PLT
● Protein-bound molecules (lipids, bilirubin)

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19
Q

uses energy, transport mechanisms, carriers,
proteins to transport the substance from the
tubules back to the capillaries

A

Active transport

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20
Q

uses energy, transport mechanisms, carriers,
proteins to transport the substance from the
tubules back to the capillaries

A

Active transport

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21
Q

Freely flowing

A

Passive transport

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22
Q

Sodium is reabsorbed but controlled by
aldosterone

A

Distal convoluted tubule

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23
Q

ADH controlled H20 reabsorption

A

Collecting duct

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24
Q

○ Excess of aldosterone
○ If there will be excess of aldosterone, sodium
will be reabsorbed.

■ Sodium in urine = decreased
■ Sodium in blood = increased

A

Conn Syndrome

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25
Q

○ Deficiency of aldosterone
○ Sodium will not be reabsorbed
■ Sodium in urine = increased
■ Sodium in blood = decreased

A

Addison’s Disease

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26
Q

○ Excess in ADH
○ Water will be reabsorbed from the tubule to the
blood
○ Water in the urine will be decreased
○ Urine will be more concentrated
○ Water in the blood will increase

A

Syndrome of Inappropriate ADH secretion (SIADH)

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27
Q

○ Decrease in ADH
○ Water will be freely flowing and will not be
reabsorbed
○ Water in the urine will increase
■ Urine will be more dilute
○ Water in blood will decrease

A

Diabetes Insipidus

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28
Q

Movement of the substances from the peritubular
capillary plasma to the tubular lumen

A

Tubular Secretion

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29
Q

RENAL FUNCTION TESTS

A
  1. Glomerular Filtration Tests
  2. Tubular Reabsorption Tests
  3. Tubular Secretion Tests
  4. Renal Blood Flow Tests
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30
Q

Standard test used to measure the filtering capacity of
the glomeruli

A

Clearance test

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31
Q

Measures the rate at which the kidneys are able to
remove a filterable substance from the blood

A

Clearance test

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32
Q

Substances that can be filtered by the glomerulus:

A

○ Urea clearance test
○ Creatinine clearance test
○ Inulin clearance
○ Cystatin C

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33
Q

Often the first function to be affected in renal disease

A

Tubular Reabsorption Tests

34
Q

Tests to determine the ability of the tubules to reabsorb
the essential salts and water that have been
non-selectively filtered by the glomerulus

A

Tubular Reabsorption Tests

35
Q

measures the amount of
solute-free water excreted in the kidney

A

Free water clearance

36
Q

24 hours fluid deprivation

A

Fishberg Test

37
Q

Day vs Night concentration
function

A

Mosential Test

38
Q

Sodium, chloride, & water will be filtered by the
glomerulus but the body needs these, so the tubules will
reabsorbed those substances

A

Tubular Reabsorption Tests

39
Q

➢ non toxic substance
➢ not present on the body so it is being
taken orally
➢ loosely bound to plasma protein

A

PAH (p-aminohippuric) test

40
Q

measure the amount of acid present
in the solution

A

Titratable acidity

41
Q

total acidity - titratable acidity
(hydrogen ion present) =
concentration of ammonia

A

Urinary Ammonia

42
Q

NON-PROTEIN NITROGEN COMPOUNDS

A

● Urea
● Uric acid
● Creatinine
● Ammonia

43
Q

NPN with the highest concentration in the blood

A

urea

44
Q

Major excretory product of protein metabolism
○ When the proteins in the body are
metabolized or broken down, it becomes urea

A

Urea

45
Q

Obsolete term because we have to measure
urea as a whole not just
the nitrogen in the urea

A

BUN → Blood Urea Nitrogen

46
Q

BUN x 2.14

A

Urea

47
Q

Has 2 amino groups and 1 carboxyl
group

A

urea

48
Q

Urea is formed in the liver from __ and __ (from
the deamination of proteins)

A

CO2, ammonia

49
Q

elevation of urea in the blood

A

Azotemia

50
Q

Elevation of urea with renal failure

A

Uremia

51
Q

Causes of azotemia in the blood

Before the kidney

A

Prerenal

52
Q

Causes of azotemia in the blood

Kidney

A

Renal

53
Q

Causes of azotemia in the blood

After Kidney

A

Postrenal

54
Q

CAUSES OF ABNORMAL PLASMA UREA
CONCENTRATION

Increased concentration
Prerenal (Reduced renal blood flow)

A

Congestive heart failure- Heart no longer
pumps blood efficiently kaya nagiging
congested with blood. If there is
congestion, there is improper functioning sa
pag pump ng heart. No proper renal blood
flow. Accumulation of urea concentration in
the body

Shock, hemorrhage
hemorrhage- bleeding
shock- not enough blood flow; life
threatening condition

Dehydration- lack of fluid, no waste
product is excreted

Increased protein catabolism

High-protein diet

55
Q

CAUSES OF ABNORMAL PLASMA UREA
CONCENTRATION

Renal(decreased
renal function)

A

Acute and chronic renal failure

Renal disease, including glomerular
nephritis and tubular necrosis

  • Nephritis- inflammation in your glomerulus.
    no proper filtration of urea
  • Necrosis- death in body tissue. Tubules
    cannot reabsorb properly
56
Q

CAUSES OF ABNORMAL PLASMA UREA
CONCENTRATION

Postrenal

A

Urinary tract obstruction

57
Q

CAUSES OF ABNORMAL PLASMA UREA
CONCENTRATION

Decreased concentration

A

Low protein intake- Low urea concentration

Severe vomiting and diarrhea

Liver disease

Pregnancy- Hormonal changes. Plasma urea concentration will
be decreased during pregnancy

58
Q

Normal BUN / Creatinine ratio is __

A

10:1 to 20:1

59
Q

increased BUN / Creat ratio 𝐼𝑛𝑐𝑟𝑒𝑎𝑠𝑒𝑑 𝐵𝑈𝑁
𝑁𝑜𝑟𝑚𝑎𝑙 𝐶𝑟𝑒𝑎𝑡
○ BUN is more susceptible to non-renal factors

A

Pre-renal

60
Q

○ increased ratio BUN / Creat ratio 𝐼𝑛𝑐𝑟𝑒𝑎𝑠𝑒𝑑 𝐵𝑈𝑁
𝐼𝑛𝑐𝑟𝑒𝑎𝑠𝑒𝑑 𝐶𝑟𝑒𝑎𝑡
○ Both BUN and Creat are elevated
○ We are looking at excretion

A

Post-renal

61
Q

○ Decreased BUN / Creat ratio 𝐷𝑒𝑐𝑟𝑒𝑎𝑠𝑒𝑑 𝐵𝑈𝑁
𝑁𝑜𝑟𝑚𝑎𝑙 𝐶𝑟𝑒𝑎𝑡
○ Low dietary protein or severe liver disease
○ Disclaimer: Could either be increased or
decreased
■ Depends on what specific renal
disease

A

Renal

62
Q

Formed from creatine and creatine phosphate in the
muscle

A

Creatinine

63
Q

Released to the plasma in proportion to muscle mass
○ The greater the muscle mass, the higher the
creatinine and serum in urine
○ Iba ang reference range ng males and females
○ Could also be affected by age and race

A

Creatinine

64
Q

Directly proportional to kidney function

A

Creatinine

65
Q

Creatine is synthesized by

A

Arginine, glycine, methionine

66
Q

These 3 will undergo transamination forming

A

guanidinoacetic acid

67
Q

The enzyme that will catalyze this reaction will be your __

A

L-Arginine:glycine amidinotransferase
(AGAT)

68
Q

Guanidinoacetic acid will undergo methylation with the
substance ___ forming creatine

A

S-adenosylmethionine

69
Q

Creatine with the help of the enzyme creatine kinase will form __ aka creatine phosphate.

A

phosphocreatine

70
Q

Creatinine is a byproduct of both

A

creatine and
phosphocreatine

71
Q

Creatine clearance forumla

A

(UV/P)(1.73/A)

72
Q

Average body surface sa isa ka tao

A

1.73

73
Q

V/1440 x U/P x 1.73/A

A

V/1440 x U/P x 1.73/A

74
Q

Product of the catabolism of purine nucleic acids

A

uric acide

75
Q

Guanine and Adenosine

A

Purine

76
Q

Purine

A

Guanine and Adenosine

77
Q

Relatively insoluble in plasma and, in high
concentrations, can be deposited in the joints and tissue
causing pain and inflammation

A

Gouty Arthritis

78
Q

98-100% of filtered uric acid is reabsorbed in the

A

Proximal Convoluted

79
Q

Most uric acid in the plasma is in the form of __

A

Monosodium urate

80
Q

At concentrations , the plasma is saturated
forming urate crystals

A

> 6.8 mg/dL

Clinical Chemistry LEC (5 decks)

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