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Renal Function Prt. 1 Flashcards

1
Q

KIDNEY
• Paired, bean-shaped organs found retroperitoneally in either side of the____
• About the size of a______
• Between_____

A

spinal column

fist (10-12cm)

T12-L3

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2
Q

make up the functional tissue of the kidney

A

cortex & medulla

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3
Q

MACROSCOPIC ANATOMY of the kidney (3)

A

Renal Cortex
Renal Medulla
Renal Pelvis

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4
Q

• Outermost region
• Contains blood vessels which is connected to the nephrons

A

Renal Cortex

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5
Q

Innermost region
• Contains the renal pyramid
•______ renal pyramids which contains about______ nephrons

A

Renal Medulla

8 - 12

1 million

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6
Q

• Central region

Located in renal sinuses (cavity inside the kidney)

Where urine is being collected and is connected directing to the ureter

A

Renal Pelvis

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7
Q

o is the functional unit of the kidney

A

Nephrons

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8
Q

Glomerulus & Convoluted Tubules
• Found in the_______

A

renal cortex

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9
Q

Collecting Ducts & Others
Found in the_____

A

medulla

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10
Q

5 main parts nephron in order

A

Glomerulus
Proximal convoluted tubules
Loop of Henle
Distal convoluted tubules
Collecting ducts

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11
Q

• Cluster or tuft of capillaries

A

Glomerulus

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12
Q

Single layer of epithelial cells

A

Bowman’s Capsule

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13
Q

TWO TYPES OF NEPHRON:

A

Cortical Nephron (85%)

Juxtamedullary Nephron (15%)

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14
Q

• Very short nephron loop

Glomerulus is further away from the cortex-medulla junction

Efferent arteriole supplies peritubular capillaries

A

Cortical Nephron (85%)

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15
Q

Capillaries that surround the PCT and DCT

Main function is more on re-absorbance.

A

peritubular capillaries

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16
Q

Very long nephron loop

Glomerulus is closer from the cortex-medulla junction

Efferent Arteriole supplies vasa recta

A

Juxtamedullary Nephron (15%)

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17
Q

• Capillaries that surround the Loop of Henle

• Main function is more on concentration gradient of the kidney

A

vasa recta

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18
Q

Functions of Kidney?!

A

• Urine formation
• Fluid and electrolyte balance
• Regulation of acid-base balance
• Excretion of the waste products of protein metabolism
• Excretion of drugs and toxins
• Secretion of hormones

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19
Q

Hormones secreted by kidney

REP1,25

A

Renin
Erythropoietin
1,25-Dihydroxyvitamin D3
Prostaglandin

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20
Q

Helps control blood pressure & indirectlv helps maintain the level of sodium & potassium

A

Renin (Renin-Angiotensin-Aldosterone-System)

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21
Q

• Stimulate RBC production

A

Ervthropoietin

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22
Q

• Hormone involved in the absorption of calcium

A

1.25-Dihydroxyvitamin D3 (Complete name of the active vitamin D)

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23
Q

(Pro-inflammatory substance)
• Help in the regulation of our renal blood flow

A

Prostaglandin

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24
Q

BASIC RENAL PROCESS
Renal Glo Tur Tus

A

• Renal blood flow
• Glomerular filtration
• Tubular reabsorption
• Tubular secretion

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25
Q

Renal Blood Flow

mL/ minute

A

• 1,200-1,500 mL/min

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26
Q

Renal Blood Flow

ARSIAC AGE PCAIRI

A

Aorta
Renal artery
Segmental artery
Interlobar artery
Arcuate artery
Cortical radiate artery

Afferent arteriole
Glomerulus
Efferent arteriole

Peritubular capillaries or vasa recta
Cortical radiate vein
Arcuate vein
Interlobar vein
Renal vein
Inferior vena cava

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27
Q

GLOMERULAR FILTRATION

What are the factors that make the glomerulus the best site for filtration?

Hi Se nega glo glo

A

High pressure in the glomerulus

Semi-permeability of the glomerulus

Negatively-charged basement membrane

Glomerular Filtrate = 130-150 mL/min

GLOMERULAR FILTRATION RATE

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28
Q

Glomerular Filtrate =

A

130-150 mL/min

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29
Q

What can pass through the glomerulus

A

Water
Electrolytes
Amino acids
Glucose
Urea
Creatinine

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30
Q

What cannot pass through the glomerulus

A

Plasma proteins
Cellular elements
Protein-bound molecules

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31
Q

TUBULAR REABSORPTION

Reabsorption occurs____% in the___
75% of the____, ____, ____
100% of the____

A

90% - PCT

sodium, chloride, water

glucose

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32
Q

TUBULAR REABSORPTION

Almost all of the _____,______,_____

Variable amounts of____,_____,____ (Ca, Mg, K, HCO3)

A

amino acids, vitamins, proteins

urea, uric acid, ions

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33
Q

TUBULAR REABSORPTION

•_______ of uric acid, only to be secreted at the DCT

• About only ____of glomerular filtrate actually leaves our body.

A

98-100%

1%

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34
Q

• Concentration of your substance in the blood above w/c the kidneys begins to remove it into the urine.

• REMEMBER: If a substance’s concentration exceeds the _______for tubular reabsorption, it will appear in the urine

A

renal threshold

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35
Q

renal threshold of glucose

A

160-180 mg/dL

36
Q

Active transport

A

Glucose, amino acids, salts
Chloride
Sodium

37
Q

Tubular reabsorption

Glucose, amino acids, salts

A

Proximal convoluted tubule

38
Q

Tubular reabsorption

Chloride

A

Ascending LOH

39
Q

Tubular reabsorption

Sodium

A

Proximal and distal convoluted tubules

40
Q

Tubular reabsorption

Water

A

Proximal convoluted tubule
Descending loop of Henle
Collecting duct

41
Q

Tubular reabsorption

Urea

A

Proximal convoluted tubule
Ascending loop of Henle

42
Q

Tubular reabsorption

Sodium

A

Ascending loop of Henle

43
Q

Passive transport

A

Water
Urea
Sodium

44
Q

Overproduction of aldosterone = increased sodium level

A

Conn Syndrome

45
Q

Opposite of Conn’s Syndrome -›

Not producing enough aldosterone = lower Na level

A

Addison’s Disease

46
Q

• Increased ADH = more water reabsorbed

A

SIADH (Syndrome of Inappropriate Antidiuretic Hormone Secretion)

47
Q

Decreased ADH = lesser water reabsorbed

A

Diabetes Insipidus

48
Q

Aldosterone
ADH

Targets?

A

DCT
Collecting Ducts

49
Q

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

A

Tubular Secretion

50
Q

Tubular cells secrete products of their own cellular metabolism to the filtrate in the tubular lumen

A

Tubular secretion

51
Q

TUBULAR SECRETION

Movement of substances from the _______ to ______

A

peritubular capillary plasma to the tubular lumen

52
Q

TUBULAR SECRETION

Two maior functions:

A
  1. Eliminating waste products not filtered by the glomerulus
  2. Regulating the acid-base balance in the body through the secretion of hydrogen ions.
53
Q

Tubular secretion

Regulating the acid-base balance in the body through the secretion of_____

A

hydrogen ions

54
Q

Tubular secretion

Eliminating waste products _____by the glomerulus

A

not filtered

55
Q

RENAL FUNCTION TESTS

A

• Glomerular Filtration Tests (GFTs)
• Tubular Reabsorption Tests
• Tubular Secretion Tests
• Renal Blood Flow Tests

56
Q

WHY PERFORM RENAL FUNCTION TESTS?

• These rely on the measurement of the waste products in the blood (usually______ and _____) which accumulate when the kidneys begin to fail.

• Alarming once the substances that are not usually present in urine was detected

A

urea and creatinine

57
Q

There should be ______ of the nephrons still functioning (advanced renal failure) before the concentration of these products begin to accumulate in the blood.

58
Q

Clearance Test is for???

A

GLOMERULAR FILTRATION TESTS

59
Q

• standard test used to measure the filtering capacity of the glomeruli

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

A

Clearance Test

60
Q

GLOMERULAR FILTRATION TESTS

Clearance Test

Common tests

A

Urea clearance test
Creatinine clearance test
Inulin clearance
Cystatin C

61
Q

GLOMERULAR FILTRATION TESTS

Clearance Test

Uncommon tests

A

• Beta-2 Microglobulin
• Beta Trace Protein
• Tryptophan glycoconjugate
• Neutrophil Gelatinase Associated Lipocalin (NGAL)

62
Q

To ensure accuracy of the test, the substance to be analyzed must:

  1. Be neither______ and_____
  2. Be_____ in the urine during a possible 24-hour collection period
  3. Have a consistent_____ level
  4. Be______ to the_____
  5. Be available for________ (can be tested)
A

reabsorbed nor secreted

stable

plasma

available, body

chemical analvsis

63
Q

• Regarded as the gold standard for clearance test (glomerular filtration test)

Cannot be reabsorbed & secreted
Requires intravenous infusion

A

Inulin Clearance

64
Q

Clearance test

• Available in the body = inhibitor of your cysteine proteinase
• _____ is completely reabsorbed.
• Produced by all of our nucleated cells
• Not affected by age, sex, or muscle mass
• Readily filtered by the glomerulus = very small size & is positively charged.

A

Cystatin C

65
Q

is present in the urine, which gives us an early identification of a possible kidnev failure.

A

Cystatin C

66
Q

• Protein being expressed by vour neutrophils & epithelial cells in PCT
• Acute Kidney Injury makes the concentration of NGAL rises wlin 2-6 hours

A verv useful early predictor of vour acute kidnev iniurv.

A

Neutrophil Gelatinase Associated Lipocalin (NGAL)

67
Q

Concentration tests are for???

A

TUBULAR REABSORPTION TESTS

68
Q

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

A

Concentration Test

69
Q

Concentration Test (4)

A

• Osmolality and osmolarity
• Free water clearance
• Fishberg Test
• Mosenthal Test

70
Q

Measures the amount of solute free water excreted in the kidney.

A

Free water clearance

71
Q

24-hour water deprivation.

Afterward, measurement of the specific gravity of the urine.

A

Fishberg Test

72
Q

• In relation to checking the specific gravity
• Day vs. night time of checking of specific gravity
• Comparing the volume and specific gravity of your urine sample in the morning and in the evening to evaluate the concentrating ability of kidney/tubules.

A

Mosenthal Test

73
Q

To measure the exact amount of blood flowing through the kidney, it is necessary to use a substance that is:
• Completely removed from the blood (peritubular capillaries) rather than being removed when the blood reaches the glomerulus

A

TUBULAR SECRETION AND RENAL BLOOD FLOW TESTS

74
Q

TUBULAR SECRETION AND RENAL BLOOD FLOW TESTS (3)

A

• PAH (P-aminohippuric) Test)
• Titratable Acidity
• Urinary Ammonia

75
Q

Nontoxic substance (exogenous substance).

Loosely bound to plasma proteins

Not readily present in the body = it is taken up.

A

PAH (P-aminohippuric) Test

76
Q

Measures the amount of acid present in a solution

• Ability of your kidney to produce acidic urine.

A

Titratable Acidity

77
Q

• Total Acidity - Titratable Acidity
• Both tests can be run simultaneously.
• Collect a 2-hr interval of sample (before and after) the intake of oral ammonium chloride.

A

Urinary Ammonia

78
Q

How many percent of sodium, chloride, and water is reabsorbed in the tubules?

79
Q

How many percent of glucose is reabsorbed in the tubules?

80
Q

How many percent of amino acids, vitamins , proteins is reabsorbed in the tubules?

A

Almost all

81
Q

How much urea, uric acid, ion are reabsorbed in the tubules?

A

Variable amounts

82
Q

How many percent of uric acid is reabsorbed in the tubules?

83
Q

How many glomerular filtrate leaves the body?

84
Q

Conn Syndrome

A

Increase ALDOSTERONE and SODIUM

85
Q

Addison disease

A

decrease ALDOSTERONE and SODIUM

86
Q

Syndrome Inappropriate Antidiuretic Hormone Secretion

A

Increase ADH and WATER

87
Q

Diabetes Insipidus

A

Decrease ADH and WATER

CC LEC (38 decks)

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