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CPR > Renal Function > Flashcards

Renal Function Flashcards

1
Q

What are the 3 layers of the Glomerular Filtration Barrier?

A
  1. Capillary Endothelium
  2. Glomerular Basement Membrane
  3. Podocyte Epithelium
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2
Q

What are the layers from internal to external of the Glomerular Basement Membrane?

A
  1. Lamina Rara Interna
  2. Lamina Densa
  3. Lamina Rara Externa
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3
Q

What are the Lamina Rara Interna and Externa of the Glomerular Basement Membrane composed of?

A

Proteoglycans

- Specifically, Heparin Sulfate

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4
Q

What is the purpose of the Proteoglycans in the Lamina Rara Interna and Externa in the Glomerular Basement Membrane?

A

Provide Electronegative charge that repels negatively charged substances like proteins

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5
Q

What in the Capillary Endothelium of the glomerular filtration barrier forms a sticky biogel in the capillary lumen?

A

Glycocalyx

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6
Q

What is the job of the Glycocalyx in the Capillary Endothelium of the glomerular filtration barrier?

A

Repels charged proteins and forms initial barrier for filtrates to pass through
- found in the fenestrations of the capillary endothelium

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7
Q

List of the order of things that a filtrate would encounter from first to last if it were attempting to be filtered at the Glomerulus

A 
Glycocalyx
Capillary Endothlium
Lamina Rara Interna
Lamina Densa
Lamina Rara Externa
Podocyte Epithelium
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8
Q

If something is reabsorbed while in the nephron of the kidney, where does it get taken?

A

From the nephron back INTO the BLOOD

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9
Q

Urinary Excretion calculation equation?

A

= Amount filtered - Amount reabsorbed + Amount secreted

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10
Q

Can things get secreted from the blood into the nephron once past the glomerulus?

A

YES - “amount secreted”

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11
Q

What goes into the kidney, must come out.

Arterial input =

A

Venous output + Urine output

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12
Q

Ux stands for?

A

Urinary concentration [x]

= Concentration/Volume

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13
Q

V stands for?

A

Urinary FLOW rate

= Urine Volume/Time

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14
Q

What is the equation for urine excretion rate of x?

A

Ux * V

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15
Q

What is Renal Clearance?

A

Rate at which a certain substance is removed from the plasma and excreted in the urine

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16
Q

What is the equation for Renal Clearance of x?

A

Urine excretion rate of x/plasma [x]

Cx = Ux * V/Px

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17
Q

What is Glomerular Filtration Rate?

A

Volume of plasma filtered into both kidneys per unit time

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18
Q

What is Glomerular Filtrate?

A

Fluid filtered into Bowman’s Capsule

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19
Q

GFR

A

Glomerular Filtration Rate

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20
Q

GFR is about ___% of Renal Blood Flow (RBF)

A

20%

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21
Q

What is the Filtration Fraction?

A

= GFR/RBF (ratio)

  • Usually about 20%
    • Amount of filtered fluid at the kidney compared to the TOTAL Amount of fluid that reached the kidney
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22
Q

If the Filtration Fraction increases, the oncotic pressure of which arteriole increases and why?

A

Efferent arteriole oncotic pressure increases

  • Due to more fluid being filtered and more solutes left in the efferent arteriole
  • The increased oncotic pressure will increase tubular reabsorption!
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23
Q

What is a normal GFR?

A

125 mL/min

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24
Q

What can you use to estimate GFR?

A

Renal Clearance - if molecule is not reabsorbed or secreted

25
Q

If you are estimating GFR using Renal Clearance, what is the equation?

A

GFR = Ux * V/ Px

26
Q

What are 2 molecules to use to calculate GFR (via Renal Clearance estimation)?

A

Inulin

Creatine

27
Q

Filtered load equation for x?

A

= GFR * Px

28
Q

Sympathetic effect on which arteriole through what receptor?

A

Vasoconstriction of afferent arteriole through alpha -1

29
Q

Sympathetic effect on Juxtaglomerular Cells through what receptor?

A

Increased Renin release through beta -1

30
Q

Sympathetic effect on Tubular Epithelial cells?

A

Na+/K+ ATPase to increase sodium reabsorption through alpha -1

31
Q

Starling forces that FAVOR filtration at the glomerulus

A
  1. Hydrostatic pressure of Glomerular Capillary

2. Oncotic pressure of Bowman’s Capusle

32
Q

Starling forces that DO NOT favor filtration at the glomerulus

A
  1. Hydrostatic pressure of Bowman’s Capsule

2. Oncotic pressure of Glomerular Capillary

33
Q

Based on the starling forces, if the number is (+), did filtration occur?

A

YES

34
Q

What is the Ultrafiltration Pressure (Puf)?

A

Hydrostatic pressure of Glomerular Capillary

(minus) - Hydrostatic pressure of Bowman’s capsule
(minus) - Oncotic pressure of glomerular capillary

35
Q

What are the 3 physical factors that contribute to the GFR?

A
  1. Hydraulic Conductivity (permeability)
  2. Surface Area for filtration
  3. Capillary Ultrafiltration Pressure (Puf)
36
Q

Hydraulic conductivity (Lp) X Surface area for filtration (Sf) is equal to?

A

Ultrafiltration Coefficient (Kf)

37
Q

Based on the physical factors, what is the GFR equation?

A

GFR = Kf X Puf

38
Q

Besides the hydraulic conductivity and surface area for filtration, what else can alter the Ultrafiltration Coefficient (Kf)?

A

Mesangial cells!

- Contractile properties alters the surface area for filtration

39
Q

What 2 sites are the sites of regulation for hydrostatic pressures?

A

Afferent and Efferent Arterioles

40
Q

Vasoconstriction of the afferent arteriole will have what effect on the GFR?

A

Vasoconstriction will DECREASE Puf (ultrafiltration pressure) which will DECREASE GFR

41
Q

Vasodilation of the afferent arteriole will have what effect on the GFR?

A

Vasodilation will INCREASE Puf (ultrafiltration pressure) which will INCREASE GFR and Renal Blood Flow

42
Q

Vasoconstriction of the efferent arteriole will have what effect on the GFR?

A

Vasoconstriction will INCREASE Puf (ultrafiltration pressure) which will INCREASE GFR

43
Q

Vasodilation of the efferent arteriole will have what effect on the GFR?

A

Vasodilation will DECREASE Puf (ultrafiltration pressure) which will DECREASE GFR but increase Renal Blood flow

44
Q

There are more alpha-1 receptors on which arteriole?

A

Afferent

45
Q 
Job of:
Sympathetics (catecholamines)
Endothelin
Angiotensin 2
ATP
A

Vasoconstriction

46
Q 
Job of:
Prostaglandins
Bradykinin
Nitric Oxide
ACE inhibitors
A

Vasodilation

47
Q

What maintains Renal Blood Flow and GFR across a range of arterial pressures?

A

Autoregulation

48
Q

What are the 2 mechanisms for Autoregulation?

A
  1. Myogenic

2. Tubuloglomerular feedback

49
Q

What is the myogenic (smooth muscle) response to Autoregulation?

A

High pressures results in vasoconstriction of the afferent arteriole and vasodilation of the efferent arteriole in order to protect the glomerular capillaries from the high pressures

50
Q

What 3 things are involved in the Juxtaglomerular Apparatus?

A

Macula Densa Cells - on distal tubule
Juxtaglomerular Cells - on afferent arteriole
Mesangial cells - beyond glomerulus

51
Q

What does the Juxtaglomerular Apparatus sense?

A

NaCl in the tubule

52
Q

What does the Tubuloglomerular feedback mechanism maintain?

A

Constant sodium delivery to the distal tubule and a constant GFR

53
Q

Describe the order of events that will occur if the Macula Densa senses HIGH NaCl

A
  • Increased Na+ reabsorption into cell using NKCC2 channel
  • ATP and Adenosine are released from cell
  • ATP and Adenosine bind to receptors
  • Calcium is released to vascular smooth muscle surrounding the Afferent Arteriole
  • Vasoconstriction occurs of arteriole
  • DECREASED GFR and Renin release
54
Q

Describe the order of events that will occur if the Macula Densa sense LOW NaCl

A
  • Decreased Na+ reabsorption into cell
  • Less ATP and Adenosine are released
  • No Calcium is released to smooth muscle
  • Afferent Arteriole vasoDILATES
  • INCREASES GFR and Renin release
55
Q

Renin secretion is promoted by ____ NaCl delivery to the Macula Densa

A

DECREASED

56
Q

Renin secretion is also promoted by sympathetic stimulation of?

A

Beta-1 receptors on the JG apparatus

57
Q

What is the Fractional Excretion?

A

% of what was filtered that actually got excreted

58
Q

What is the equation for the Fractional Excretion?

A

(Ux * V)/(GFR * Px)

= (Ux * Pcr)/(Px * Ucr)

CPR (48 decks)

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