Renal Q and A

Question 1

What 3 effects does DM have on the glomerulus?

Answer 1

o Mesangial expansion is directly induced by hyperglycaemia
o Thickening of the glomerular basement membrane occurs
o Glomerular sclerosis is caused by intraglomerular hypertension (induced by dilatation of the afferent renal artery or from ischaemic injury induced by hyaline narrowing of the vessels supplying the glomeruli.

Question 2

Role of SGLUT2 in diabetic glomerulonephritis (4)

Answer 2

o Increased glucose and NaCl reabsorption in the PCT and reduces distal delivery of solute, particularly NaCl, to the macula densa.
o The resulting decrease in tubuloglomerular feedback may dilate the afferent arteriole and increase glomerular perfusion.
o Concurrently high local production of angiotensin 2 at the efferent arteriole induces vasoconstriction.
o The overall effect is high intraglomerular pressure and glomerular hyperfiltration