Renal physiology Flashcards
3 processes involved in urine formation:
- glomerular filtration
- selective reabsorption
- selective tubular secretion
What is a renal corpuscle?
Bowman’s capsule together with its contained glomerulus
what are podocytes?
specialized epithelial cells that make up the visceral lining of Bowman’s capsule, wrap around capillaries of the glomerulus
they form “filtration slits”
name the 2 predominant osmolytes in initial filtrate
sodium (Na+)
&
chloride (Cl-)
what is arginine vasopressin
another name for ADH (antidiuretic hormone)
regulates the tonicity of body fluids.
osmolality and osmolarity difference
Osmolarity: the number of solute particles per 1 L of solvent
Osmolality: is the number of solute particles in 1 kg of solvent
For dilute solutions, the difference between osmolarity and osmolality is insignificant.
osmolarity considers volume (L)
osmolality considers mass (kg)
ADH mechanism of action
Osmoreceptors detect increased plasma osmolarity ->
stimulates peripheral vasoconstriction +
the insertion of aquaporins into the luminal cells of the collecting ducts
what is diabetes insipidus
disorder of fluid imbalance
characterized by the lack of aquaporin channels in the distal collecting ducts from a lack of ADH (can also be from a lack of renal response to existing ADH)
water reabsorption prevented
osmolarity of the blood increases
osmoreceptors in the hypothalamus detect this change and stimulate thirst.
= polydipsia and polyuria cycle.
what is aldosterone
the major mineralcorticosteroid hormone from the adrenal cortex
major regulator of blood pressure because its essential for sodium conservation
promotes reabsorption of Na+
also promotes secretion of potassium
primary increase in bicarbonate ions indicates what type of state?
metabolic alkalosis
primary deficit in carbon dioxide indicates what type of state?
respiratory alkalosis
primary decrease in bicarbonate ions indicates what type of state?
metabolic acidosis
primary excess of carbon dioxide indicates what type of state?
respiratory acidosis
What is uric acid?
a waste metabolite from nucleic acid/purine/DNA/RNA catabolism
What is the juxtaglomerular apparatus?
function?
a specialized structure formed by the
distal convoluted tubule and the
glomerular afferent arteriole.
located near the vascular pole of the glomerulus
main function is to regulate:
blood pressure and the
glomerular filtration rate
Renin function
induces RAAS cascade resulting in the secretion of aldosterone in adrenal cortex layer of zona glomerulosa
more specifically it cleaves angiotensinogen into angiotensin I
calcitriol stimulates
stimulates intestinal calcium absorption,
increases reabsorption of calcium by the kidneys,
and possibly increases the release of calcium from skeletal stores.
thus increases blood calcium levels
aldosterone function
supports active reabsorption of sodium with associated passive reabsorption of water
and active secretion of potassium/ K+
primary mineralcorticoid is
aldosterone
Mineralcorticoid function
regulate water, Na, K and Cl balance and blood pressure
ADH secretion is controlled via?
regulated by osmolarity-sensitive cells in the hypothalamus, and pressure sensitive cells in
the circulatory system (sense volume of fluids)
A reduction in blood volume and blood pressure of 5-10% or more induces secretion of ADH.
Antidiuretic hormone (ADH), vasopressin main function
increases water reabsorption in distal tubules and the collecting ducts by regulating the density of aquaporins
Kidneys produce what hormones
erythropoietin
renin-angiotensin
vitamiin-D3-hormone/calcitriol
Plasma osmolarity of the body is monitored by
osmoreceptors in the hypothalamus, which
detect the concentration of electrolytes in the extracellular fluid.
polypeptide hormone ADH/vasopressin is produced and released where
The hypothalamus produces it,
then its transported to and released from the posterior pituitary
Where is aldosterone produced?
the outer layer of the adrenal cortex, the zona glomerulosa
what results in diabetes insipidus
Chronic underproduction of ADH or a mutation in the ADH receptor
how does aldosterone aid in maintaining proper water balance
by enhancing Na+ reabsorption and K+ secretion in Distal renal tubules.
Increases the number of Na+-K+-ATPase molecules.
The reabsorption of Na+ also results in the osmotic reabsorption of water, which alters blood volume and blood pressure.
Aldosterone release is stimulated by (3-5)
hypovolemia or decreased blood pressure
hyponatremia
hyperkalemia
Production stimulated by angiotensin II.
when is RAAS activated
When blood pressure drops. Detected by baroreceptors.
Where is renin produced and released
Produced by mesangial cells in walls of afferent arterioles of cells of the juxtaglomerular apparatus in response to decrease in perfusion pressure.
What is renin and what does it do
part of RAAS
an enzyme, circulates in the blood, reacts with a
plasma protein produced by the liver called angiotensinogen and produces angiotensin I
how is angiotensin I made
When angiotensinogen is cleaved by renin, it produces angiotensin I
what is angiotensin II and what does it do
part of RAAS
functions as a hormone, causing the release of aldosterone by the adrenal cortex,
resulting in increased Na+ reabsorption, water retention, and an increase in blood pressure.
Most powerful Na+ retaining hormone.
in addition to affecting aldosterone, what else does angiotensin II stimulate (3)
in addition to being a potent vasoconstrictor,
stimulates an increase in ADH and
increased thirst
what is a natriuretic peptide
circulating peptide hormones of cardiac origin that induce natriuresis, which is the excretion of sodium by the kidneys.
important in the regulation of intravascular blood volume and vascular tone.
what is ANP and where secreted
Atrial natriuretic peptide is secreted by atrial cardiac muscle cells
what is BNP and where secreted
Brain natriuretic peptide is secreted by ventricular cardiac muscle cells
name some natriuretic peptide functions (6)
increase urinary excretion of sodium,
increase GFR,
inhibit Na+ reabsorption in distal tubule and collecting duct,
inhibit secretion of renin, aldosterone and vasopressin,
decrease cardiac output,
inhibit sympathetic activity
What is inulin clearance?
procedure by which the filtering capacity of the glomeruli is determined by measuring the rate at which inulin, the test substance, is cleared from blood plasma.
descending limb of loop of henle permeable to what?
only water
ascending limb of loop of henle permeable to what?
ions: Na+ & Cl- & K+
approximate normal osmolarity of plasma
300 mOsm / L
milliosmoles per liter
explain countercurrent exchange
give example
is the transport of chemical metabolites between fluids moving in opposite directions separated by a permeable barrier such as blood within adjacent blood vessels flowing in opposite directions
such as between the vasa recta and loop of henle
Na+- K+ -ATPase moves how many of what, where, in or out?
3 Na+ out of tubular endothelium cell into peritubular capilllary, and 2 K+ into cell from renal interstitium so “bodyside”
How do some bacteria cause alkaline urine?
Bacterial urease generates ammonia from urea, elevating the pH of urine
furosemide mechanism of action
like other loop diuretics, acts by inhibiting the luminal Na-K-Cl cotransporter in the thick ascending limb of the loop of Henle
binds to the chloride transport channel, thus causing more sodium, chloride, and potassium to remain in the urine along with H2O
name 3 endocrine roles of the kidneys
- EPO synthesis (RBC production)
- Activation of vitamin D
- Control of blood pressure via the secretion of renin for the RAAS cascade
Name 5 metabolic waste products excreted via the kidneys
- Urea – metabolite of amino acids
- Creatinine – product of muscle creatine
- Uric acid – nucleic acids
- Bilirubin etc – haemoglobin breakdown
- Metabolites of hormones
In what part of the kidney is EPO produced?
erythropoietin is produced in the renal cortex by interstitial fibroblast-like cells that surround the renal tubules
In which part of the kidney are the loops of Henle, vasa recta and collecting
ducts located?
renal medulla
What portion of cardiac output do the kidneys receive?
20% (25% in some materials)
typical pressure in glomeruli
55mm Hg- 60 mmHg
typical pressure in the vasa recta
Vasa recta 13 mmHg
how does the parasympathetic NS affect the kidneys? vs
how does the sympathetic NS affect them?
Parasympathetic via CN X causes vasodilation of afferent arterioles,
increased blood flow -> increased urine production.
Sympathetic via renal nerves, noradrenaline & circulating adrenaline cause vasoconstriction of arterioles, reduction of blood flow into the glomerulus.
2 types of nephron
the functional unit of kidney
* Cortical
* Juxtamedullary
2 types of renal cortical interstitial cells
- Fibroblast-like cells – EPO production
- Phagocytic cells
4 roles of a nephron
- Filtration
- Secretion
- Reabsorption
- Excretion
How many times is t he entire plasma volume is filtered in a day
The entire plasma volume is filtered 60 times a day
the 3 layers to the “filtration barrier” of the glomeruli
- Endothelium
- Basement membrane
- Podocytes = visceral epithelium
Name the forces favoring filtration
Hydrostatic pressure of blood
(& ultrafiltrate oncotic pressure)
Name the forces opposing filtration
Hydrostatic pressure in Bowman’s capsule (approx. 15 mmHg)
Plasma oncotic pressure (approx. 30 mmHg)