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SUGER > Renal Physiology > Flashcards

Renal Physiology Flashcards

1
Q

What is the kidney cardiac output?

A

5 L/min

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2
Q

What is the renal blood flow?

A

1 L/min

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3
Q

What is the kidney urine flow?

A

1 ml/min

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4
Q

What is the order of renal blood supply?

A

AA
↓
Renal artery
↓
Segmental artery
↓
Interlobar artery
↓
Arcuate artery
↓
Interlobular artery
↓
Afferent arteriole
↓
(Nephron)
Glomerular Capillary
↓
Efferent arteriole
↓
Peritubular Capillary
↓
Vasa recta
↓
Interlobular veins
↓
Arcuate veins
↓
Interlobar veins
↓
Renal veins
↓
IVC

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5
Q

What is the distal part of the nephron (tubule) responsible for?

A

Secretion and reabsorption

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6
Q

What 5 factors determine the crossing of the filtration barrier?

A
  • Pressure
  • Size of the molecule
  • Charge of the molecule
  • Rate of blood flow
  • Binding to plasma proteins e.g. calcium, hormones such as thyroxine
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7
Q

In the filtration barrier what molecules can pass freely?

A

Small molecules and ions up to 10kDa
e.g. glucose, uric acid, potassium, creatinine

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8
Q

What does the negative charge in glomerular basement membrane cause?

A

Fixed negative charge in glomerular basement membrane repels negatively charged anions

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9
Q

What is the main urinary protein?

A

Albumin

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10
Q

What is the molecular weight of albumin?

A

Around 66kDa

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11
Q

What charge is albumin and what does this mean?

A

Negatively charged, cannot easily pass into the tubule

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12
Q

What can damage to the filtration barrier lead to?

A

Can lead to protein leak and a condition known as nephrotic syndrome

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13
Q

What is the glomerular filtration rate?

A

The filtration volume per unit time (minutes)

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14
Q

What is autoregulation?

A

Renal blood flow, capillary pressure and GFR maintained almost constant over systemic mean arterial pressure range 90-200 mmHg

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15
Q

Where does autoregulation occur?

A

In denervated kidneys & in isolated perfused kidneys ∴ not dependent on nerve supply or on blood-borne substances

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16
Q

What is the mechanism of autoregulation?

A

Pressure within afferent arteriole rises
Stretches vessel wall
Triggers contraction of smooth muscle
Arteriolar constriction

17
Q

What does autoregulation prevent?

A

Prevents an increase in systemic arterial pressure from reaching the capillaries

18
Q

What is the GFR of individual nephron regulated by?

A

By the rate at which filtered fluid reaches the distal tubule

19
Q

What do the cells of macula densa (distal tubule) detect?

A

NaCl arrival

20
Q

What do macular densa cells release?

A

Release prostaglandins in response to reduced NaCl delivery
This acts on granular cells, triggering renin release, activating the renin-angiotensin system

21
Q

What is renal clearance?

A

The volume of plasma from which a substance is completely removed by the kidney per unit time (usually a minute)

22
Q

Where does filtration occur?

A

Occurs at the glomerulus from capillaries into Bowman’s space across a barrier of several layers

23
Q

What is GFR determined by?

A

Net filtration pressure
Permeability of filtration barrier
Surface area available for filtration

24
Q

What is GFR maintained by?

A

Autoregulation and tubuloglomerular feedback

25
Q

What is used to measure GFR clinically?

A

Creatinine

26
Q

What are the 3 components of the filtration barrier?

A

Podocytes
Glomerular basement membrane
Fenestrated capillary endothelium

27
Q

What factors favour glomerular filtration?

A

Glomerular capillary blood pressure

28
Q

What factors oppose glomerular filtration?

A

Fluid pressure in Bowman’s space
Osmotic forces due to protein in plasma

29
Q

How does charge affect glomerular filtration?

A

Fixed negative charge in GBM (glycoproteins) repels negatively charged anions

SUGER (5 decks)

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