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The Kidney and Renal Function Flashcards

1
Q

Kidney Disease can be:

A
  • chronic
  • acute and present with life threatening
    emergencies
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2
Q

Functions of the urinary tract (2):

A

1) Excretion: removal of organic waste
products
2) Elimination: discharge of waste products
into the environment

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3
Q

Homeostatic functions of the kidney (2):

A
  • regulation of water and electrolyte balance
  • regulation of acid base balance
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4
Q

Excretory functions of the kidney (2):

A
  • excretion of drugs and their metabolites
  • excretion of endogenous waste products
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5
Q

Regulatory functions of the kidney (1):

A
  • production of hormones: erythropoietin,
    renin, prostaglandins, active vit D
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6
Q

Erythropoeitin function

A

stimulates bone marrow to create RBCs

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7
Q

Manifestations of kidney disease:

A
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8
Q

The Kidneys

A
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9
Q

Two major layers of the kidney:

A

1) Cortex
2) Medulla

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10
Q

Cortex of kidney (2):

A
  • outer region
  • contains glomerulus and convoluted
    tubules
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11
Q

Medulla of Kidney (3):

A
  • inner region of kidney
  • arranged into pyramid like structures
  • consists of the bulk of nephron structure
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12
Q

What is the functional unit of the kidney?

A
  • nephron
  • responsible for urine formation/
    composition
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13
Q

Early stages of chronic kidney disease you can lose upto

A

50% of nephrons

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14
Q

Five distinct sections of nephron:

A
  • Glomerulus
  • Proximal Convoluted Tubule
  • Loop of Henle
  • Distal Convolute Tubule
  • Collecting Duct
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15
Q

Nephron

A
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16
Q

Nephron functions

A
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17
Q

Renal Blood Flow (normally)

A

1-1.25L/min

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18
Q

Glomerular Filtration Rate (normally)

A

100-125ml/min (150-200L/day)

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19
Q

Total no. nephrons: 2.5 million:
Cortical:
Juxtaglomerular:

A

Cortical: 2.1 million
Juxtaglomerular: 0.4 million

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20
Q

Tubular fluid enters the collecting duct

A
  • deep in the inner medulla of kidney
  • tubular fluid exits at the tip of the renal
    pyramid
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21
Q

A site of drug-induced nephrotoxicity is

A

the renal papilla

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22
Q

Cortical nephrons:

A
  • 70-80% of all nephrons in a kidney
  • located in the cortex
  • short loop of Henle into the medulla
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23
Q

Juxtaglomerular Nephrons:

A
  • 20-30%
  • situated closer to the medulla
  • loop of henle extends deep into renal
    pyramids
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24
Q

Modification of urine occurs in which part of the nephron

A
  • the distal collecting tubule
  • the collecting duct
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25
Q

The nephron

A
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26
Q

Juxtaglomerular Apparatues:
- is?
- produces?
- location?
- function
- components (3) c

A
  • specialised region associated with the
    nephron, but separate from it
  • produces and secretes renin
  • located between the thick ascending limb
    and afferent arteriole
  • measures and identifies changes in blood
    pressure and regulation of renin secretion

Components (3):
- Macula densa
- Juxtaglomerular cells
- Extragomerular mesangial cells

28
Q

The Renal Corpuscle

29
Q

Clinical Importance of Nephrons:

A
  • Diseases of the nephron affect the
    glomeruli or tubules
30
Q

Glomerular Disease(3):

A
  • Diabetic nephropathy
  • Glomerulonephritis
  • IgA Nephropathy
31
Q

Renal Tubular Diseases (3):

A
  • acute tubular necrosis
  • Glomerulonephritis
  • IgA Nephropathy
32
Q

Blood Suppky to the nephron

33
Q

What % of cardiac output does the kidneys receive and 90% of this supplies

A
  • 20-25% of cardiac output
  • 90% of this supplies the renal cortex
    maintaining highly active tubular cells
34
Q

Order of vessels for nephron blood supply ***

A
  • main renal artery
  • segmental
  • interlobar
  • arcuate
  • interlobular
  • afferent arteriole into golmerulus
  • efferent arteriole
  • peri-tubular capillaries
  • vasa recta
  • renal vein
35
Q

Blood Supply to the Nephrons

36
Q

Cortical nephrons major role

A

regulatory and excretory function

37
Q

Juxtaglomerular nephrons major role

A

in concentrating or diluting urine

38
Q

Juxtaglomerular nephrons have a long loop of henle that penetrates deep into the medulla.

true or False?

39
Q

Cortical nephrons have a glomerulus and bowmans capsule.

True or False?

40
Q

Juxtaglomerular nephrons have a glomerulus and bowmans capsule.

True or False?

41
Q

Cortical nephrons have vasa recta.

True or False?

A

False
Juxtaglomerular nephrons have large vasa recta

42
Q

Sympathetic nerve supply to the kidney:

A

Sympathetic: coeliac ganglion and
sympathetic chain
- supplies arteries
- reduces blood supply to kidney during
stress, increases renin secretion =
associated with hypertension

43
Q

Parasympathetic nerve supply to the kidney:

A
  • efferent from vagus nerve (hilum)
  • controls tone of efferent arterioles
  • may modify GFR and renal blood flow
44
Q

The Glomerulus

45
Q

1 capillary forms how many glomerular loops

46
Q

Interstitium of glomerulus

A

site of erythropoeitin and prostaglandin production

47
Q

What component of the juxtaglomerular apparatus releases renin?

A

Macula Densa

48
Q

Glycocalyx

A

layer of negatively charged proteoglycansand glycosaminoglycans

coats the luminal surface of endothelial cells and the opening of fenestra

49
Q

Permeability in glomerular capillaries is higher than other capillaries.

True or False?

50
Q

Glomerular Filtration Barrier

51
Q

Glomerular Filtration is dependent on (2):

A
  • blood pressure
  • renal blood flow
52
Q

Glomerular filtrate has to pass through:

A
  • pores in glomerular capillary endothelium
  • the basement membrane of bowman’s
    capsule (contractile mesangial cells)
  • epithelial cells of bowmans capsules
    (PODOCYTES) via filtration slits into
    capsular space
53
Q

mesangial cells in the center of the glomerulus affect on GFR

A
  • phagocytic clearing Ag/Ab complexes and
    contract due to angiontensin II and ADH
    reducing GFR by reducing filtration surface
    area
54
Q

Where does secretion occur through glomerular filtration

55
Q

ultrafiltration definition

A

solution moves by pressure gradient

56
Q

GFR changes when systemic BP changes.

True or False?

A

False
GFR generally remains constant even when systemic BP changes
involves autoregulation of renal blood flow

57
Q

Three major functions of the nephron:

A
  • filtration: blood to produce a filtrate
  • reabsorption: H2O, ions, organic nutrients
  • secretion: waste products into tubular fluid
58
Q

Transcellular transport

A
  • passive or active
  • can be secondary to active transport
59
Q

Paracellular transport

A

movement driven by concentration, osmotic or electrical gradients

60
Q

Paracellular re-absorption occurs through

A

tight junctions

61
Q

Processes of the nephron

62
Q

Tubular re-absorption

A
  • 99% filtered water, electrolytes and
    nutrients re-absorbed into blood
  • some solutes re-absorbed either active,
    passive, secondary
63
Q

tubular Secretion:

A
  • some endogenous substances and drugs
    not filtered at glomerulus due to
    size/protein binding
  • specialised pumps in PCT transport
    compound in plasma to nephron
  • for organic acids or drugs
  • for organic bases or drugs

NME (52 decks)

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