Renal II: Sodium Handling, Water Handling, and ARF Flashcards
_____ is required to increase ECF volume
Na ingestion
______ cause release of ADH via hypothalamic signaling
Decreased ECF, Increased osmolarity
______: buildup of nitrogenous wastes in the blood
azotemia
ADH is released from _______
posterior pituitary gland
ADH release is a __________ system with an emergency ________.
osmolarity; low-volume override
ADH release is mediated by ______ baroreceptors
left atrial
ANP blocks _____ at the renal tubles
ADH, Aldosterone
ANP decreases release of _____.
ADH, Renin
ANP mediates ______ of _____ arterioles in the kidney
dilation; afferent and efferent
Cl(x) =
Ux * V / Px
Cockcroft and Gault equation =
Clx = A(140-Age)Weight / (72*Scr)
Exceptions: conditions under which FeNa is decreased in absence of pre-renal azotemia
Pigment exposure, radiocontrast exposure, non-oliguric ATN
FeNa = ____ in post-renal azotemia
> 1%
FeNa = ____ in pre-renal azotemia
FeNa=
(Una/Pna) / (Ucr/Pcr)
Gold standard for calculating GFR because it is not secreted or reabsorbed in the tubules.
Inulin
High specific gravity urine is characteristic of ______ azotemia
pre-renal
In the Cockcroft and Gault equation, A =
1 for men; 0.85 for women
Increase in ECF volume leads to release of _____ from cardiac myocytes
pro-ANP
Loss of ECF Na leads to ______ aldosterone
increased
Loss of ECF Na leads to ______ angiotensin II
increased
Most common cause of abrupt fall in GFR in hospitalized patients
Pre-renal azotemia
Some creatinine is ______, so generally it _____estimates GFR
secreted; over-
Some urea is ______, so generally it _____estimates GFR
absorbed; under-
Ucr/Pcr ratio is _____ in pre-renal azotemia and ____ in post-renal azotemia
> 20;
Urine Na concentration in post-renal azotemia
> 40mEq/L
Urine Na concentration in pre-renal azotemia
What effect on renal arterioles? ACEIs, ARBs
Decrease resistance of efferent arterioles
What effect on renal arterioles? Angiotensin II
Increase resistance of efferent arterioles
What effect on renal arterioles? NO, prostaglandins, high protein diet
Decrease resistance of afferent arterioles
What effect on renal arterioles? NSAIDs, endothelin, adenosine, norepinephrine, thromboxanes
Increase resistance of afferent arterioles
What type of azotemia? acute glomerulonephritis, hemolytic uremic syndrome
Intrinsice disease
What type of azotemia? acute interstitial nephritis (Allergic Interstitial Nephritis), infection
Intrinsic disease
What type of azotemia? Acute tubular necrosis (ATN)
Intrinsic disease
What type of azotemia? Benign prostatic hyperplasia
Post-renal
What type of azotemia? bladder carcinoma, urinary infections, neuropathy
Post-renal
What type of azotemia? CHF, MI, valvular disease, pericardial tamponade
Pre-renal
What type of azotemia? cholesterol emboli, renal vein thrombosis
Intrinsic disease
What type of azotemia? Cirrhosis, sepsis, medication, autonomic neuropathy
Pre-renal
What type of azotemia? renal losses, GI losses, Third space losses, hemorrhage
Pre-renal
What type of azotemia? retroperitoneal fibrosis, compression by a tumor
Post-renal
