Renal Function and RFT Flashcards
1
Q
3 Functions of Kidney
A
- Maintain Homeostasis
- Excrete Waste Products
- Maintain BP and Erythropoiesis
2
Q
4 Renal Function#
A
- Renal Blood Flow
- Glomerular Filtration
- Tubular Reabsorption
- Tubular Secretion
3
Q
This supplies blood to kidney
A
Renal Artery
4
Q
The kidney receives how many percent of blood flow?
A
25%
5
Q
Average Body Size
A
1.73 m²
6
Q
Total Renal Blood Flow?
A
1200 mL/min
7
Q
Total Renal Plasma Flow
A
600-700 mL/min
8
Q
The flow of Renal Blood Flow (7)
A
- Renal Artery
- Afferent Arteriole
- Glomerulus
- Efferent Arteriole
- Peritubular Capillaries
- Vasa Recta
- Renae Vein
9
Q
The Glomerulus consist of _____
A
Capillary Tuft
10
Q
This serves as a sieve or a filter of plasma substance
A
Glomerulus
11
Q
The Glomerulus is located within?
A
Bowman’s Capsule
12
Q
3 Factors that influence the actual filtration process
A
- Cell Structure of Capillary Walls
- Glomerular Pressure
- Feedback mechanism of RAAS
13
Q
2 types of glomerular pressure
A
- Hydrostatic
- Oncotic
14
Q
Main Goal of Glomerulus Cellular Layers?
A
Prevent Large molecules to pass through urine
15
Q
Cellular layer that contains pores referred to as Fenestrated
A
Capillary Wall Membrane
16
Q
Cellular layers with the restriction of large molecules
A
Basement Membrane or Basal Lamina
17
Q
Cellular layer with thin membranes covering the filtration slits formed by the intertwining foot processes of the podocytes
A
Visceral Epithelium of Bowman’s Capsule
18
Q
Glomerular pressure that is related to the activity of efferent and afferent Arterioles
A
Hydrostatic Pressure
19
Q
Hydrostatic Pressure is the autoregulatory mechanism within what part of the Glomerulus?
A
Juxtaglomerular apparatus
20
Q
Dilation of afferent Arterioles and constriction of the efferent Arterioles occur when?
A
BP Drops
21
Q
Meaning of RAAS
A
Renin Angiotensin Aldosterone System
22
Q
It regulates the flow of blood to and within the Glomerulus
A
RAAS
23
Q
RAAS Responds to changes in _____ and ______
A
Blood Pressure and Plasma Sodium Content
24
Q
RAAS is monitored by what apparatus?
A
Juxtaglomerular Apparatus
25
4 Functions of Angiotensin II
1. Vasodilation of Afferent A. & Vasoconstriction of Efferent A.
2. Stimulate Sodium Reabsorption in PCT
3. Release of Aldosterone from Adrenal Cortex
4. Release ADH from Hypothalamus
26
2 Reabsorption Mechanisms
1. Active Transport
2. Passive Transport
27
Substance to be reabsorbed must combine to a carrier protein contained in the membranes of renal tubular cells
Active Transport
28
Plasma Concentration at which active transport stops
Renal Threshold
29
Renal Threshold for Glucose is?
160-180 mg/dl
30
Movement of molecules across membrane as a result of differences in their concentration or electrical potential
Passive Transport
31
All parts of the tubules can reabsorb water except?
Ascending Loop of Henle
32
4 Substances under Active Transport and their locations
1. glucose ( PCT )
2. Amino Acid ( PCT )
3. Salts ( PCT )
4. Sodium (PCT/DCT)
33
3 substances under Passive Transport and their locations
1. Water ( PCT, DLH, CD)
2. Urea ( PCT, ALH )
3. Sodium ( ALH )
34
Tubular Concentration begins in?
Descending/Ascending Loop of Henle
35
What is removed by Osmosis in the DLH?
Water
36
2 that are reabsobred in the Ascending Loop of Henle
1. Sodium
2. Chloride
37
This serves to maintain the osmotic gradient of the medulla
Tubular Reabsorption
38
Reabsorption in the Collecting Duct Concentration depends on? (2)
1. Osmotic Gradient in Medulla
2. Vasopressin ADH
39
If Body Hydration is High:
Low ADH and High Urine Volume
40
If body hydration is low?
ADH increases and Urine Volume Decreases
41
2 Major Functions of Tubular Secretion
1. Eliminate Waste products
2. Regulates Acid-Base Balance
42
Acts as buffer to the blood maintaining normal pH
Bicarbonate
43
Standard test to measure filtering capacity of glomeruli
Clearance Test
44
Standard Test for Glomerular Filtration Rate
Urea Clearance Test
45
Reference Method for Glomerular Filtration Rate
Inulin Clearance Test
46
This demonstrates progression of renal disease
Urea Clearance Test
47
This test is not routinely done for continuous IV Infusion
Inulin Clearance Test
48
Priming Dose of Inulin Clearance Test
25 ml 10% Inulin Solution
49
Continuous Infusion under Inulin Clearance Test
500 ml of 1.5% Inulin Solution
50
Inulin Clearance Test Reference Values
Female - 118 ml/min
Male - 127 ml/min
51
Commonly Used and Screening method of Glomerular Filtration Rate
Creatinine Clearance
52
Waste product of muscle metabolism
Creatinine
53
Creatinine Clearance Reference Values
Female = 75-112 ml/min
Male = 82-125 ml/min
54
Standard Body Surface?
1.73
55
Creatinine Clearance Significance (3)
1. Extent of Nephron Damage
2. Effectiveness of treatment
3. Feasibility of administering medications
56
6 Disadvantages of Creatinine Clearance Test
1. Some crea is secreted by tubules
2. Chromogens in Plasma
3. Medications causing False Decrease
4. Crea breakdown by bacteria
5. Heavy Diet Influence
6. Muscle Wasting Disease Interference
57
Normal Creatinine Clearance Value
120 ml/min
58
Normal Reference Range of Plasma Creatinine
0.5-1.5 mg/dl
59
Clearance Test that is indirect estimate of GFR?
Cystatin C
60
Specimen for Cystatin C?
Serum or Plasma
61
Increased levels of Cystatin C indicates? (2)
1. Acute and Chronic Renal Failure
2. Diabetic Nephropathy
62
Method used for Cystatin C?
Immunoassay
63
Dissociates from human leukocyte antigens at constant rate
Beta 2 Microglobulin
64
Clearance Test not reliable for patients who have history of immunologic disorder
Beta 2 Microglobulin
65
Method used for Beta 2 Microglobulin
Enzyme Immunoassay
66
Monitor Patients already diagnosed with renal disease or at risk
Estimated Glomerular Filtration Rates
67
Meaning of MDRD
Modification of Diet in Renal Disease
68
Stage 3 Chronic Kidney Disease Description and GFR
Moderate decrease // 30-59 ml/min
69
at what stage of Chronic Kidney Disease does 15-29 ml/min categorize?
Stage 4
70
GFR of Stage 1 Chronic Kidney Disease
≥90
71
GFR of Stage 2 Chronic Kidney Disease
60-89 ml/min
72
The ability of tubules to reabsorb the essential salts and water that have been nonselectively filtered by glomerulus
Concentration Test
73
Specific Gravity of Urine before entering the renal tubules
1.010
74
2 Tests for Specific Gravity
1. Fishberg Test
2. Mosenthal Test
75
Test wherein patients were deprived of fluids for 24 hours prior to measuring SG
Fishberg Test
76
Test wherein it compares the volume and specific gravity of urine day and night samples
Mosenthal Test
77
Tubular Reabsorption Test wherein number of particles are involved
Osmolality
78
Specific Gravity is influenced by ____ and ____ of particles
1. number
2. density
79
What does not contribute to the evaluation of renal concentration? (2)
1. Glucose
2. Urea
80
2 Types of Osmometers
1. Freezing Point
2. Vapor Pressure
81
Principle of Freezing Point Osmometer
Measurement of Freezing Point Depression
82
Temperature at which water and ice are in equilibrium
Freezing Point
83
Temperature at which water vapor condenses to a liquid
Dew Point
84
Standard Reference for Osmometers
NaCl
85
Inadequate presentation of the substance to the capillaries owing to decreases renal blood flow
Impaired Tubular Secretory Ability
86
Inadequate presentation of the substance to the capillaries owing to decreases renal blood flow
Impaired Tubular Secretory Ability
87
Test commonly associated with tubular Secretion and renal blood flow
p-aminohippuric acid test (PAH)
88
A normal person excretes approximately ______ of Titratable Acid
70 mEq/day
89
When was the urine at it's lowest pH?
Night
90
H+ is used for?
Secretion
91
NH³ is used for? (2)
Production and Secretion
92
The inability to produce an acid urine in the presence of metabolic acidosis
Renal Tubular Acidosis
93
Renal Tubular Acidosis is the impaired tubular secretion of _____ associated with the _____
Hydrogen Ions / PCT
94
Defects in ______ secretion associated with _____
Ammonia / DCT
