Test 2: Wk6: 1 Renal transport mechanisms and clearance - Mangiarua Flashcards

1
Q

3 basic renal processes

A

1 glomerular filtration
2 tubular secretion
3 tubular reabsorbtion

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2
Q

Glomerular filtration

A

bulk-flow of essentially protein-free plasma from the

glomerular capillaries into Bowman’s capsule.

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3
Q

Glomerular filtration is what type of transport

A

passive; no active

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4
Q

Tubular secretion

A

transfer of materials from the peritubular-capillary plasma to the
tubular lumen

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5
Q

Tubular secretion transport

A

Both active and passive transport

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6
Q

Tubular secretion selectivity

A

high

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7
Q

tubular secretion occurs where

A

throughout the length of the nephron

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8
Q

Tubular reabsorption

A

transfer of materials from the lumen of the tubule to the

peritubular-capillary plasma.

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9
Q

Tubular reabsorption selectivity

A

high

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10
Q

Tubular reabsorption transport

A

Both active and passive transport

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11
Q

tubular reabsorption occurs where

A

throughout the length of the nephron

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12
Q

— charged macromolecules are
restricted far more than —molecules, while — charged molecules
are restricted less.

A

negative, neutral, positive

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13
Q

As molecular weight (and therefore size) —, filterability —, so
that proteins with a molecular weight above — d are hardly filtered at all.

A

increase, declines, 70,000

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14
Q

best index of kidney function

A

GFR

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15
Q

GFR 60-89

A

mild kidney dz

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16
Q

GFR 30-59

A

Moderate chronic renal insufficiency

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17
Q

GFR 15-29

A

Severe chronic renal insufficiency

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18
Q

GFR <15

A

End Stage Renal Failure

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19
Q

Renal Clearance

A

volume of plasma from which all of a substance has been removed and excreted into urine per unit time

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20
Q

What is used for Measurement of GFR

A

inulin

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21
Q

— is freely filtered at the glomerulus and not reabsorbed or secreted into tubule

A

inulin

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22
Q

GFR =

A

urine flow x inulin conc. urine / inulin conc. plasma

GFR = V x Uin / Pin

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23
Q

In order to determine the rate at which plasma is filtered into Bowman’s space, a chemical which meets the following criteria is used (6)

A

1) Not bound to plasma proteins.
2) Not electrically charged.
3) Freely filtered.
4) Not lost by reabsorption from tubular fluid to peritubular fluid.
5) Not gained by secretion from peritubular fluid into tubular fluid.
6) All that is filtered is excreted.

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24
Q

Clearance of Inulin

A

GFR = Uin x V / Pin = Cin

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25
Q

Inulin clearance refers to the

A

Inulin clearance refers to the milliliters of plasma from which all inulin has been removed by the kidney each minute

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26
Q

Inulin clearance is independent of

A

plasma inulin conc. and urine flow

27
Q

Creatinine

A

endogenous substance that estimates GFR

28
Q

Clearance of Creatinine

A

GFR = Ccr = Ucr x V / Pcr

29
Q

Creatinine — GFR

A

slightly overestimates

30
Q

— concentration is used to follow pts over long period of chronic renal dz

A

Creatinine

31
Q

Renal Clearance Ca =

A

Ca = Va x V / Pa

32
Q

Ca > Cin

A

cleared by filtration and secretion

33
Q

Cb < Cin

A

some of b is reabsorbed

34
Q

Diffusion:

A
  • requires an electrochemical gradient,

* “downhill” transport

35
Q

Facilitated diffusion:

A

requires an electrochemical gradient + carriers; exhibits
specificity, saturability, and competition,
• “downhill” transport.

36
Q

Primary active transport

A

requires carriers; exhibits specificity, saturability, and
competition,
• “uphill” transport. Requires energy; splitting of ATP.

37
Q

Secondary active transport

A

• requires carriers; exhibits specificity, saturability, and
competition,
• one substance “downhill” transport, the other “uphill”
transport,
• cotransport (or symport),
• countertransport (or antiport).

38
Q

diffusion between cells

A

paracellular

39
Q

“across” the cell

A

transcellular

40
Q

— used for measurement of effective renal plasma flow

A

PAH

41
Q

PAH is filtered —

A

at glomerulus

42
Q

PAH undergoes no significant

A

tubular reabsorbtion

43
Q

— can be used to estimate RPF (Renal Plasma Flow)

A

Clearance of PAH

44
Q

PAH is a foreign compound so it needs to be

A

infused

45
Q

ERPF

A

Effective Renal Plasma Flow

46
Q

ERPF =

A

ERPF = CPAH = V x UPAH / PPAH

47
Q

the effective renal plasma flow Underestimates true RPF by —%

A

10%

48
Q

The actual renal plasma flow can be obtained by dividing the — by —

A

ERPF by excretion ratio of PAH

49
Q

equation for calculation RPF

A

E = A - V / A

A conc. in renal arterial plasma
V conc. in renal venous plasma

50
Q

Urate filterability

A

free

51
Q

more than 90% if filtered urate is reabsorbed where

A

early in prox tubule

52
Q

urate secretion

A

active tubular secretion in late prox tubule

53
Q

urate is — regulated

A

homeostatically

54
Q

urate undergoes both — and —

A

active reabsorption and active secretion

55
Q

K filterability

A

free

56
Q

67% of K reabsorbed in

A

prox tubule

57
Q

20% of K is reabsorbed in

A

TAL of LOH

58
Q

— is reabsorbed or secreted in the late nephron depending on diet

A

K

59
Q

K is — regulated

A

homeostatically

60
Q

Reabsorption rate =

A

Filtered load – Excretion rate

61
Q

Secretion rate =

A

Excretion rate – Filtered load

62
Q

Filtered load =

A

GFR x [plasma]

63
Q

Excretion rate =

A

V x [urine]