Renal Transport Cont. Flashcards
Factors that stimulate Na+ Reabsorption?
- Na + deficiency
- Hyponatremia
Factors that stimulate Na+ Secretion?
- Hypernatremia
- Prostaglandins
- ANP
If there is a problem with Na+ concentration, the problem is usually involved with?
Water
Factors that stimulate K+ Secretion?
- K+ Excess
- Aldosterone
Factors that stimulate K+ Reabsorption?
- K + deficiency
- Hypokalemia
What 2 things cause ADH to be released?
- Hyperosmolarity
2. Volume Depletion
ADH is more sensitive to small changes in?
Osmolality!
What are the 3 mechanisms of ADH?
- Increase water permeability
- Increase Urea permeability
- Increase activity of NKCC2
Where does ADH increase water permeability?
Principal cells in the distal tubule
How does ADH increase water permeability at principal cells in the distal tubule?
Inserts AQPs into apical membrane
Which AQP does ADH insert on to the apical membrane of principal cells in the distal tubule?
AQP - 2
Since ADH can insert AQP - 2 on to principal cells, what will this cause?
Water will be REABSORBED
Under the action of ADH, water is reabsorbed. What is left behind in the tubule?
UREA
Where in the nephron is the [urea] really HIGH?
Inner Medullary Collecting Duct
What happens when the [urea] is really high in the inner medullary collecting duct?
It will diffuse out passively
Describe how Urea is recycled under the actions of ADH
ADH causes more water to be reabsorbed at the distal tubule
- This leaves Urea behind in the distal tubule with concentrations increasing
- Once at the inner medullary collecting duct, urea will passively diffuse out of the tubule
- Urea will then eventually diffuse back into the tubule upstream
ADH also increases the activity of the NKCC2 at the thick ascending limb. What does this cause?
More reabsorption of Na, K, 2Cl. Further, due to back leak of K+ this indirectly causes more reabsorption of Mg and Ca!
Where is the Kidney Interstitium and what does it contain?
Between tubules and vessels
- contains Interstitial fluid, ECM and cells
As you move from the Kidney’s cortex, to outer medulla, to inner medulla, what increases?
Interstitium Osmolality!
The kidney interstitium osmolality increases as you move towards?
Inner medulla
What 2 mechanisms control urine concentration?
- Counter Current Multiplier
2. Counter Current Exchanger
With the Counter Current Multiplier, what leaves the Ascending limb and enters the kidney interstitium?
NaCl
With the Counter Current Multiplier, as NaCl enters the interstitium, what does this cause to happen to the interstitium?
It becomes hyperosmotic
With the Counter Current Multiplier, as NaCl enters the interstitium, what will leave the Descending limb?
Water
With the Counter Current Multiplier, as water enters the interstitum, what does this cause to happen to the hyperosmotic interstitium (due to NaCl from ascending limb)?
Equalizes the osmolality
With the Counter Current Multiplier, as more fluid enters the descending limb, what will this create?
A gradient
The length of the loop of Henle determines?
SIZE OF GRADIENT
What determines the size of the gradient?
Length of the loop of Henle
After the Counter Current Multiplier, then what occurs?
Counter Current Exchanger
With the Counter Current Exchanger, water has entered the interstitial fluid from the Descending limb. Where does it get reabsorbed?
Vasa Recta
The medullary osmolality is due to what 2 molecules?
NaCl
Urea
This vessel minimizes solute washout from interstitium
Vasa Recta
What is Osmolar Clearance?
Total clearance of ALL solutes from the blood
What is the equation for Osmolar Clearance?
U * V/(P) – same as renal clearance but for all solutes
What is Free Water Clearance?
The rate at which the body excretes SOLUTE - FREE WATER
What is the equation for Free Water Clearance?
V - Cosm
If Free Water Clearance is (+), what does that mean?
FREE WATER WAS EXCRETED
If Free Water Clearance is (-), what does that mean?
More solutes than free water were excreted
What is the Obligatory Urine Volume (OUV)?
Minimum amount of urine required to secrete waste products
What is the equation for Obligatory Urine Volume?
Minimum solute excretion per day/Maximum urine concentrating ability
Continuously reabsorb solutes and NOT water
excreting lots of water
Diurersis
- High volume and dilute urine
Requires high ADH and high Osmolality of interstitial fluid (water reabsorption)
Antidiuresis
Excretion of large amounts of Na+
Natriuresis