Renal Lec 4 Flashcards
4 different types of renal handling
- filtration only
- filtration + partial reabsorption
- filtration + complete reabsorption
- filtration + secretion
harmful/not useful substance undergo what type of renal handling
-filtration + secretion
useful substances undergo what type of renal handling
-filtration + complete reabsorption
inulin, creatine (type of renal handling)
-filtration only
electrolytes (type of renal handling)
-filtration + partial reabsorption
glucose, amino acids (type of renal handling)
-filtration + complete reabsorption
organic acids (PAH-para-aminohippuric acid) and bases
-filtration + secretion
urea (mostly excreted or reabsorbed?)
slightly excreted and reabsorbed)
water, sodium (mostly excreted or reabsorbed?)
mostly reabsorbed
glucose (mostly excreted or reabsorbed?)
all reabsorbed
is neurohormonal input involved in glucose reabsorption
no
is neurohormonal input involved in water,sodium reabsorption
yes
reabsorption from tubular lumen through tubular epithelial cell into peritubular capillaries is mediated by (2 methods- major/minor)
- mediated transport (transepithelial) - major
- diffusion across tight junction (paracellular) - minor
reabsorption of Na+
- passive diffusion across luminal/apical side into tubular epithelial cells
- active transport on basolateral membrane by Na+/K+ ATPase into interstitial fluid (to peritubular capillaries)
Na+ movement depends on
type of channel/ transport protein
cotransport in PCT (proximal tubule)
filtrate is similar to (Na+ conc.)
interstitial fluid
filtrate —-> interstitial fluid (Na+ reabsorption mechanism)
mediated transport
interstitial fluid —-> blood plasma (Na+ reabsorption mechanism)
diffusion and bulk transport
high or low Na+ conc in tubule lumen and interstitial fluid
high
high or low Na+ conc in tubule epithelial cell
low
at normal plasma glucose concentration, amount of filtered glucose reabsorbed
all of it
in proximal tubule, glucose is reabsorbed by
- secondary active transport on luminal side by SGLT (sodium linked co-transport)
- facilitated diffusion on basolateral side by GLUT (diffusion)
renal threshold
the concentration level up to which a substance (as glucose) in the blood is prevented from passing through the kidneys into the urine.
glucosuria
glucose in urine
glucose conc in tubule lumen
low
glucose conc in tubule epithelial cell
high
glucose conc in tubinterstial fluid
low
transport maximum
the point at which increase in concentration of a substance does not result in an increase in movement of a substance across a cell membrane
renal threshold glucose
300 mg/100ml
transport maximum glucose
375 mg/min
diabetes mellitus (pathophysiological reason)
capacity to reabsorb glucose is normal, but filtered load is
greatly increased and is beyond the threshold level to
reabsorb glucose by the tubules
renal glucosuria (pathophysiological reason)
• genetic mutation of the Na+/glucose cotransporter, that
normally mediates active reabsorption of glucose in the
proximal tubules
renal glucosuria (other names)
- benign glucosuria
- familial renal glucosuria
reabsorption of urea by diffusion
-water is reabsorbed in proximal tubule and concentration urea increases inside tubule lumen so urea diffuses down the concentration gradient into interstial fluid
urea reabsorption depends on
water reabsorption
substances secreted
- mostly H+ and K+
* choline, creatinine and penicillin
tubular secretion is coupled to
reabsorption of Na+
tubular secretion requires
active transport
renal clearance is a way of
quantifying kidney function in removing substances from plasma
renal clearance is a measure of
the volume of plasma from which a substance is completely removed by kidney/unit time
unit for clearance
ml/min or L/h
clearance values are specific to
each substances
Clearance of S (equation)
S= Us *V/Ps Us= conc of S in urine V= volume of urine passed (ml/min) Ps= conc. of S in plasma
inulin is
a polysaccharide not found in body but in plants + vegetables
inulin is (type of renal handling?)
readily filtered but not reabsorbed, secreted, or metabolized by tubule
clearance of inulin equals the
glomerular filtration rate
clearance of inulin (equation)
Cin= Uin *V/Pin
creatinine is a product of
muscle metabolism
creatinine is (type of renal handling?)
filtered not reabsorbed, but undergo slight secretion
clearance of creatinine slightly overestimates
GFR but can be used to determine GFR clinically
clearance of X > GFR + example
secretion occurred
ex. PAH
clearance of X < GFR + example
reabsorption occurred
ex. glucose
Ion transport in nephron summary (Na+, Cl-, K+)
• Na+ is actively reabsorbed
• Cl- is transported passively when Na+ is pumped out of the
cell
• K+ is secreted into the tubules mainly by cells of the distal
tubule and collecting ducts (CD)
proximal convoluted tubule reabsorbs
most of the water and non-waste plasma solutes
PCT is a major site of
solute secretion expect K+
loop of henle creates
osmotic gradient + reabsorbs large amounts of ions and less amounts of water
distal convoluted tubule is the site for
major homeostatic mechanisms of fine control of water and solute to produce urine (hormonal control)
proximal tubules (percent of renal handling?)
80% reabsorptive + secretory activates
loop of henle (renal handling)
little of water, large amount of ions reabsorbed
distal tubules (percent of renal handling?)
12% –15% reabsorption occurs here