renal function and acid/base disorders

Question 1

metabolic function of the kidney

Answer 1

activation of vitamin d3, gluconeogenesis, metabolism of endogenous compounds-insulin and steroid.

Question 2

clinical correlation vitamin D metabolism

Answer 2

renal failure patients have altered metabolism of vit. D. calcium/phosphorous abnormalities. parathyroid disease-secondary hyperparathyroidism. bone joint disease

Question 3

clinical correlation insulin metabolism

Answer 3

decreased insulin metabolism occurs in renal failure. alterations in insulin requirements as renal failure progresses. hypoglycemia can be the result in patients taking insulin or oral hypoglycemic agents.

Question 4

endocrine function of the kidney

Answer 4

renin secretion-juxtaglomerular apparatus. powerful regulator of BP. EPO secretion- interstitial cells. decreases with decreased renal mass. metabolism of PG and kinins.

Question 5

clinical correlation- renin

Answer 5

modulates blood pressure. plays a role in many types of hypertension.

Question 6

clinical correlation-pg

Answer 6

have a vasodilating effect on the renal vasculature. pg synthesis is increased (mostly in the glomeruli) during periods of vasoconstriction. NSAIDS can inhibit this effect and cause renal failure- in selected conditions.

Question 7

clinical correlation-EPO

Answer 7

as renal mass declines. EPO decreases. Hematocrit falls-this will be seen in renal failure of most causes. corrected by giving epogen.