Renal system Flashcards by Aisling Creed

What is the basic function of the renal cortex?

Where filtration and bulk processing happens

kind of the outer bit of kidney

How well did you know this?

Not at all

Perfectly

What body cavity do nephrons drain into?

Calyx
- gives unidirectional flow
- if blocked then have back flow of urine into the kidney

How well did you know this?

Not at all

Perfectly

What is the difference between the long and short loop of henle?

Short: mainly in the cortex
Long: dips past cortex into medulla (means urine can be concentrated)

How well did you know this?

Not at all

Perfectly

Where does the blood flow into the kidney?

Glomelular capillaries in the renal cortex

kidney is highest perfused organ in body (or second)

How well did you know this?

Not at all

Perfectly

Describe the route of blood flow through the kidney starting with artery and ending with vein

Artery-> afferent arteriole -> glomerulus (filtration)-> efferent arteriole -> peritubular capillary -> venule -> vein

artery-arteroile-capillary-arteriole-capillary-vein

How well did you know this?

Not at all

Perfectly

Which has cells that have adapted to a low O2 environment: Medulla or Cortex?

Medulla
pO2 ~ 10mmHg

How well did you know this?

Not at all

Perfectly

Why is high blood flow so important in the kidney?

High blood flow NEEDED for glomerlular filtration rate NOT metobolic purposes

How well did you know this?

Not at all

Perfectly

What exerts colloid oncotic pressure?

net oncotic= 25 mmHg

Proteins in the blood; they PULL fluid towards them

hence why colloid oncotic pressure= pulling pressure

How well did you know this?

Not at all

Perfectly

Are proteins filtered in Bowmans space?

No, hence the colloid oncotic pressure= 0mmHg

How well did you know this?

Not at all

Perfectly

What DECREASES GFR?

glomelular filtration rate

angiotensin II (ANGII)
noradrenalin
endothelium-1 (ET-1)

How well did you know this?

Not at all

Perfectly

What INCREASES GFR?

glomerular filtration rate

Nitric oxide
Prostoglandins

How well did you know this?

Not at all

Perfectly

Protein in your urine is a sign of what?

That your filtration barrier is breaking down

How well did you know this?

Not at all

Perfectly

What are the three filtration layers separating plasma from bowmans space?

capillary endothelium (lets in water but not proteins, neg charge)
basement membrane (collagen matrix- densely negative)
Podocytes (epithelium): fine mesh

How well did you know this?

Not at all

Perfectly

What are normal sodium and potassium levels in renal epithelial cells?

20 mM Na
110 mM K

Have about 140mM Na and 5 mMK in the blood, so this creates driving forces

How well did you know this?

Not at all

Perfectly

What molecule is recorded from urine to calculate GFR?

Inulin: bc its excreted at same rate as its filtered by glomerulus
Creatinine: in plasma and broken down from skeltal muscles over time

How well did you know this?

Not at all

Perfectly

How much Na, K, water, bicarbonate, phosphate, glucose, and amino acids does the PCT reabsorb?

65% of Na, K, water, bicarbonate, phosphate
100% glucose and amino acids

can do this bc it has leaky epithelial cells
The AMOUNT of Na is LARGE but the concentration is the same = as plasma => because PCT has leaky epithelial cells so water moves with the Na
Should be NO amino acids or glucose in someones urine

What transporters are found in the PCT and what are their functions?

NHE3: Na import coupled with H+ export
AQP1: water import
NaPi2: brings in P with Na
SGLT2: brings in glucose with Na (dysfunctional in T2 diabetes)

NHE3 accounts for 1/2 of the sodium that the PCT reabsorbs

Why is the thick ascending limb of the loop of henle sometimes called the ‘diluting segment’?

Because there is NO WATER reabsorption

only cations can go through

water is impermeable bc NO aquaporins = NO transcellular pathway

What transporters are found in the TAL?

thick ascending limb= TAL

NKCC2: imports K+, 2 Cl-, Na
ROMK: exports K+ (to keep NKCC2 running) and generates +10 mV in the lumen which pushes cations into the cell

Doesnt import a LOT of K because if K wasnt recycled then NKCC2 wouldnt work (bc 5mM of K in the blood so not loads)
Means that NKC22 is ELECTROGENIC

Where is the paracellular cation shunt found?
What cations does it let through into the interstital fluid?
What osmotic gradient does it generate?

TAL
Na+, K+, Mg2+, Ca2+
+200 mosmol

this is generated bc of ROMK, the +10 mV in the lumen drives the cations across the apical membrane between cells

Which part of the renal system do thiazide diuretics target?

The sodium transporter in the distal convoluted tube

Thiazide diuretics used to treat high BP

What are the two cell types found in collecting duct?

Principal cell: main cell type, Na/K
Intercalated cell: intercalates between principal cells; alpha (acid) and beta (base)

also has cilila (for sensing flow)

one collecting duct for every 10 nephrons

What transporters are found in the collecting duct?

NONE there are only CHANNELS found in the collecting duct:
ENac: imports Na
ROMK: exports K
ENac and ROMK create a -40mV in the lumen

What does aldosterone act on?

Retains sodium, loses potassium
* Acts on mineralcortocoid receptors in the principal cell in the collecting duct
* Essentially behaves like a TF and generates loads of ROMK, ENac, and NaK-ATPase — inc capacity for transport

retain Na and LOSE K

Describe the angiotensin-aldosterone system (RAAS)

*DECREASED blood volume* makes kidney make **Renin**, which leads to secretion of **Angiotensin** which... - stimulates brain to find more salt - stimulates **aldosterone** which tells kidney to absorb more salt - stimulates **vasopressin** which tells kidney to absorb more water - stimulates arteries to vasoconstrict all to *INCREASE blood volume *

What effect does vassopressin have on the principal cells in the collecting duct?

It puts AQP-2 in the luminal membrane so cells go from being impermeable to very permeable to water

What is countercurrent flow in the loop of Henle?

**Concentrates one arm (ascending) by diluting the other (descending)** - The deeper you go into the medulla, the more concentrated = medulla is HYPERTONIC - The longer the loop- the greater the multiplication - Must maintain a +200 mosmol gradient between medulla interstitial and ascending thick limb - descending is PERMEABLE to water while ascending is IMPERMEABLE to water - law of mass action, just separating Na and water

What are the differences between interstital, plasma, and intracellular K+ concentration in the kidney? Why is this important?

Intracellular: 110-140 mM (high) Interstital/plasma: 3.5-5 mM (low) importrant for MEMBRANE POTENTIAL!!!

How does body maintain K balance when eating food?

Uptake of K into cells by insulin and B-adrenergic Kidney can modify itself over time to become used to high or low K intake ## Footnote when you have kidney disease you cant excrete K very well, because cannot rapidly excrete it => hyperkalemia

How much K is reabsorbed in the PT? How? | proximal tubule

750 mmol/day, 70% of K reabsorbed Leaky epithelium, so absorbed paracellularly Driven by the transeptihelial potential difference

What are the two routes in the collecting duct principle cell for K secretion?

1. ROMK: main route, stimulated by aldosterone and high K intake 2. BK: stimulated by high K intake and high flow (central cillium)

Which type of intercalated cell provides a route for K reabsorption? Alpha or beta?

Alpha : couples H+ export with K+ import Beta has bicarbonate/Cl transporter | H-K-ATPase is important in reabsorbing K during low K diet

What is the aldosterone paradox? What is the solution?

- Paradox: Aldosterone can trigger K loss without triggering Na retention - Soln: Na retention occurs in the DCT which has 0 K channels (bc angiotensin II is high) - Soln: K loss occurs in PC which has loads of K channels so wld be minimizing Na reabsorption | PC= principle cell ## Footnote Eg, can eat a banana which would trigger aldosterone so K is lost through urine WITHOUT aldosterone triggering Na retention which would lead to increased BP Can eat a banana without BP going up

What is the difference between a weak and strong acid?

Weak: less dissociated, higher pKa, higher pH of soln Strong: more dissociated, low pKa, low pH of soln

What are sources of non-volatile acid?

1. Incomplete carb metabolism (lactic acid) 2. Protein metabolism (H2SO4 eg cys, HCL eg arg/lys)

During diarhea, why do you become acidotic?

Because you are losing a lot of bicarbonate Losing base = retaining acid

What are the three ways the kidney eliminates acid?

1. Excretion of H+ (as NH4, H3PO4, creatine, other buffers) 2. Reabsorption of bicarbonate 3. Bicarbonate regeneration (via NH4 formation) ## Footnote no bicarbonate should be seen in urine, BUT if you have too much base the beta intercalated cell can secrete it with its cotransporter Pendrin Very little free H+ secreted because the max urine can be is pH 4.5, so would j be way too slow for the amt of acid in the body

Where is ammonia made?

Made in the proximal tubule, pKa of becoming ammonium is 9.0 (super ideal), exists in urine as ammonium

What stimulates aldosterone production?

1. Low blood volume triggers aldosterone so Na is retained 2. High plasma potassium triggers aldosterone so K is lost