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Human Systems Physiology > Renal Lecture 1 > Flashcards

Renal Lecture 1 Flashcards

1
Q

What three things do the kidneys regulate?

A
  1. Body fluid osmolality and volumes
  2. Electrolyte balance
  3. Acid-base balance
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2
Q

What other function does the kidney have?

A

Excretion of metabolic products and foreign substances and production and secretion of hormones.

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3
Q

What inorganic substances do the kidneys regulate?

A

Na+, K+, Cl-, HCO3-, H+, Ca2+ and Pi (inorganic phosphate)

These are electrolytes.

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4
Q

How do kidneys regulate pH and why?

A

The pH is maintained by buffers within the body fluids and coordinates it along with lungs and liver. Since many metabolic functions of the body are sensitive to pH, the pH must be maintained within narrow limits.

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5
Q

What waste products to the kidneys excrete?

A

Urea, uric acid, creatine, end products of hemoglobin metabolism and metabolites of hormones. Thus, also plays a role in hormonal concentrations.

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6
Q

How are the kidneys important endocrine organs?

A

Produce and secrete renin, calctriol and erthropoietin

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7
Q

What does renin do?

A

Activates the renin-angiotensin-aldosterone system, which helps regulate blood pressure and Na+ K+ balance.

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8
Q

What does calcitriol do?

A

It is a metabolite of vitamin D3 and is necessary for the normal absorption of calcium by the GI tract and for its deposition in bone.

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9
Q

What does erythropoietin do?

A

It stimulates RBC formation by the bone marrow.

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10
Q

What is GFR?

A

Glomerular filtration rate

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11
Q

What is ESRD?

A

End-stage renal disease

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12
Q

Point at which ureter, renal artery, and renal vein meet

A

Hilium

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13
Q

Glomerulus

A

a cluster of capillaries around the end of a kidney tubule, where waste products are filtered from the blood.

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14
Q

Peritubular capillary

A

tiny blood vessels that travel alongside nephrons allowing reabsorption and secretion between blood and the inner lumen of the nephron.

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15
Q

Vasa recta

A

are a series of straight capillaries in the medulla, parallel to loop of henle

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16
Q

Renal corpuscle

A

Glomerulus + Bowman’s capsule

17
Q

Bowman’s capsule

A

a capsule-shaped membranous structure surrounding the glomerulus of each nephron in the kidneys of mammals that extracts wastes, excess salts, and water from the blood.

18
Q

What is the first step in urine formation?

A

Ultrafiltration of plasma by glomerulus - plasma is cell-parts and protein free after being filtered

19
Q

Components of the filtration barrier

A

Fenestrated capilary endothelium, basement membrane, slit diaphragm

20
Q

What types of species are best filtered?

A

Small, positively charged species/

21
Q

What happens to filtration if negative charge on glomeral wall is reduced?

A

Filtered based on size (small=better) alone; not charge.

22
Q

Heparin Sulfate

A

HS is the molecular source of the negative charge on the glomerular basement membrane

23
Q

Glomerular capillary starling forces

A

Drive fluid from the lumen of glomerular capillaries across the filtration barrier into Bowman’s space.
Pnet=(glomerular capillary pressure + oncotic pressure of Bowman’s space) - (pressure of Bowman’s space + oncotic pressure of glomerular capillary)

24
Q

Glomerular filtration rate

A

GFR=(Kf) * Pnet
Kf=ultrafiltration coefficient
Can substitute in Starling forces equation for Pnet

25
Q

Constriction of afferent arteriole before glomerulus

A

Decreased Pgc, decreased GFR, decreased RBF (renal blood flow)

26
Q

Constriction of efferent arteriole after glomerulus

A

Increased Pgc, increased GFR, decreased RBF

27
Q

Dilation of efferent arteriole

A

Decreased Pgc, Decreased GFR, Increased RBF

28
Q

Dilation of afferent arteriole

A

Increased Pgc, Increased GFR, Increased RBF

29
Q

Increased GFR can be from…

A 
Vasodilators on afferent arteriole:
-prostaglandins
-kinins
-low dose dopamine
-ANP
-NO
Vasoconstrictors on efferent arteriole
-Angiotensin II (low dose)
30
Q

Decreased GFR can be from…

A 
Vasodilators on efferent arteriole
-Angio II blockade
Vasoconstrictors on afferent arteriole
-Angio II (high dose)
-Noradrenaline (SNS)
-Endothelin
-Adenosina
-Vasopressin
-IPG blockade
31
Q

Describe myogenic response of afferent arterioles

A
  • An increase in BP stretches the smooth muscles of the afferent arteriolar wall
  • Stretch sensitive Ca2+ channels are opened,, leading to Ca2+ influx and muscle contraction
  • Vasoconstriction minimized increase in Pgc
  • A decrease in BP reduces the tonic level of afferent arteriolar smooth muscle contraction
  • Vasodilation will sustain Pgc
32
Q

What cells make up the juxtaglomerular apparatus

A

Macula densa cells and granular cells

33
Q

Describe tubuloglomerular feedback

A

GFR increase -> flow through tubule increase -> flow past macula densa increase and so NaCl content increase -> paracrine from macula densa to afferent arterial -> afferent arteriole constricts -> resistance in afferent arteriole increase -> hydrostatic pressure in glomerulus decrease, GFR decrease

34
Q

Principle of Renal Clearance

A

Amount filtered = amount excreted
(clearance of solute) x (plasma concentration of solute) = (urine concentration of solute) x urine flow rate
or, Cx[Px]=[Ux]V

35
Q

Clearance of inulin

A

Equivalent to glomerular filtration rate (GFR), the volume of plasma filtered in one minute

36
Q

Does inulin get more absorbed or more secreted?

A

Neither! Inulin goes into the afferent arteriole, is filtered through the glomerulus, travels down tubular system and is excreted with urine. Filtered inulin = excreted inulin.

37
Q

Describe the stages of kidney disease in terms of creatine clearance and plasma creatine levels.

A

Normal GFR is high (normal) and plasma creatine level normal (low).
Mild kidney disease GFR drops slightly and plasma creatine level increases slightly.
Moderate kidney disease creatine clearance declines further and plasma creatine begins to grow expoentially.
Severe kidney disease creatine clearance very low and creatine levels spike through the roof.

38
Q

Clearance approach to measure GFR

A

Clearance=[U]*V/[P]

39
Q

Creatine-based estimation of GFR

A

creatine clearance = [140-age]*weight[lbs]/[serum creatine]

Human Systems Physiology (29 decks)

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