Topic 8 Part C Controlling Reabsorption Flashcards
Glomerulartubular Balance allows an increase in what?
Allows an increase in reabsorption rate when there is an increase in tubular load (increased tubular inflow)
If GFR went from 125 mls/minute to 150 mls/minute rate of reabsorption in proximal tubule would go from 81 mls/minute [65% of GFR] to 97.5 mls/minute [65% of GFR] SAME PERCENT !!!!
Glomerulartubular Balance works to maintain Na and Volume homeostasis how?
Prevents large changes in fluid flow to distal tubules even though there have been significant changes in MAP
Peritubular Capillary & Interstitial Forces there is a relationship between what three things?
Relationship of hydrostatic and oncotic pressures AND filtration coefficient
Normal–net force for reabsorption
Peritubular Capillary & Interstitial
Normal–net force for reabsorption of 10 mmHg
IN (πc 32 + Pif 6 = 38) –OUT (Pc 13 + if π15 = 28) = 38-28
Peritubular Capillary & Interstitial Normal Reabsorption Rate? (ml/min)
Normal reabsorption rate of 124 mls/minute
Large filtration coefficient equation?
Reabsorption rate / net force
Affected by transfer surface area & hydraulic conductivity (permeability)
ex: 24 mls/min / 10 mmHg = 12.4 mls/min/mmHg
Factors Affecting Peritubular Capillary Reabsorption
Peritubular hydrostatic pressure (PHP) Peritubular oncotic pressure (POP) Filtration Coefficient (FC)
Increased PHP - (Peritubular hydrostatic pressure) does what to reabsorption?
DECREASES Reabsorption
Increased Arterial Pressure does what to PHP and Reabsorption?
INCREASE PHP and DECREASES Reabsorption
Increases Resistance of afferent & efferent arteriole does what to PHP and Reabsorption?
Decreases PHP and Increases Reabsorption
Increased Peritubular oncotic pressure (POP) does what to reabsorption?
INCREASES reabsorption
Increase Plasma protein concentration, does what to plasma oncotic pressure, POP, and reabsorption?
INCREASES plasma oncotic pressure, INCREASES POP, and INCREASES reabsorption
Filtration fraction equation
(GFR/RPF)
Increases Filtration Fraction
INCREASES protein concentration (more fluid is actually filtered)
INCREASES POP
INCREASES reabsorption
Renal interstitial hydrostatic and colloid osmotic pressures are affected by changes in what?
reabsorptive forces of peritubular capillaries
DECREASED capillary reabsorption does what to interstitial solute and water?
PRODUCES INCREASE in interstitial solute AND interstitial water
DECREASED capillary reabsorption does what to interstitial hydrostatic and oncotic pressure?
PRODUCES INCREASE in interstitial hydrostatic pressure AND in interstitial oncotic pressure
DECREASED capillary reabsorption does what to the net movement of solute and water from the renal tubules to renal interstitial space?
PRODUCES DECREASE in net movement (i.e. reabsorption) of solute & water from renal tubules to renal interstitial spaces
Decreased Peritubular reabsorption does what to solute & water accumulation in interstitial space
INCREASES solute & water accumulation in interstitial space
Decreased Peritubular reabsorption does what to backflow of solute and water from interstitial space into tubular lumen?
INCREASES backflow of solute and water from interstitial space into tubular lumen
Forces that increase peritubular capillary reabsorption also increase movement of solute and water from where?
solute and water (reabsorption) from the tubular lumen to the renal interstitial spaces [Reverse also true]
Increased Capillary surface area does what to FC & reabsorption?
Increases FC & reabsorption
Increased Capillary permeability area does what to FC and reabsorption?
Increases FC and reabsorption
Filtration Coefficient will be affected by what?
Coefficient remains constant under most physiologic conditions. Will be affected by renal disease
When arterial pressure is increased what happens to angiotensin II release? and does what?
Angiotensin II release is decreased
Less stimulation of sodium reabsorption by angiotensin II
Less stimulation of aldosterone production which means less stimulation of sodium reabsorption
Angiotensin II works where? (4)
Proximal tubule; Thick ascending loop of Henle / distal tubule; Collecting duct
Antidiuretic Hormone works where? (3)
Distal tubule; Collecting tubule & duct
Atrial natriuretic peptide works where? (3)
Distal tubule; Collecting tubule & duct
Parathyroid Hormone works where? (3)
Proximal tubule; Thick ascending loop of Henle; Distal tubule
Aldosterone works where? (2)
Collecting tubule & duct
Aldosterone increases what 3 things?
⬆️ NaCl reabsorption, ⬆️ H2O reabsorption
⬆️ K+ secretion
Angiotensin II increases what 3 things?
⬆️ NaCl reabsorption, ⬆️ H2O reabsorption
⬆️ K+ secretion
Antidiuretic Hormone increases what?
⬆️ H2O reabsorption
Atrial natriuretic peptide
⬇️ NaCl reabsorption
Parathyroid Hormone
⬇️ PO4—reabsorption
⬆️ Ca++ reabsorption
Aldosterone is secreted by what?
Secreted by zona glomerulosa cell in adrenal cortex
Aldosterone principal site of action is where?
Principal cells of cortical collecting tubule
Aldosterone stimulates increased what?
Stimulates increased Na-K ATPase activity (basolateral locations)
Increases permeability of luminal side membrane to sodium
Aldosterone increased release is stimulated by what 2 things?
Increased extracellular potassium concentration
Increased angiotensin II levels (i.e. sodium / volume depletion or low arterial pressure)
Aldosterone Absence caused/s what?
Absence (adrenal malfunction or destruction) (Addison’s disease)
(decreases BP)
Aldosterone Excess caused/s what?
Excess (adrenal tumors) (Conn’s syndrome)
increased BP
Aldosterone is a very important regulator of what 2 things?
Na reabsorption
K secretion
Most powerful sodium-retaining hormone
Angiotensin II
Angiotensin II increased production is caused by what?
Low blood pressure and/or low ECF volume
Angiotensin II actions? (3)
Stimulates aldosterone secretion (sodium reabsorption)
Constricts efferent arterioles (sodium and water reabsorption)
Direct stimulation of sodium reabsorption in proximal tubules, LOH, distal tubules, and collecting tubules
Angiotensin II constriction of efferent arterioles does what?
Helps ensure that normal exertion rates of metabolic wastes are maintained by helping to maintain normal rates of GFR
Able to retain sodium & water without retaining metabolic waste
Angiotensin II’s Direct stimulation of sodium reabsorption in proximal tubules, LOH, distal tubules, and collecting tubules is caused by what 3 mechanisms?
Stimulate increased Na-K ATPase activity of tubular epithelial cells (basolateral membrane)
Stimulate Na-H exchange in proximal tubule (luminal membrane)
Stimulate Na-Bicarb co-transport (basolateral membrane)- which increases H+ secretion
ADH (Vasopressin) made where?
Made in the hypothalamus
Two types of magnocellular (large) neurons produce
(stored and released from post pituitarty gland)
Neurons located in supraoptic and paraventricular nuclei produce what %’s of ADH?
83% in supraoptic
17% in paraventricular nuclei
Stimulation of what causes release of AHD?
Stimulation of the supraoptic and paraventricular nuclei (increased osmolarity) sends impulses down the magnocellular neurons which stimulates release of ADH from storage vesicles located in the nerve endings
ADH stimulates formation of what?
water channels across luminal membrane
ADH - HOW does it work in the tubular cell?
binds with what?, which increases formation of what? then what things come together? and they do what?
Binds with specific V2 receptors which increases formation of cyclic AMP and activation of protein kinases
Protein kinase activation results in movement of aquaporin-2 (intracellular protein) to luminal side of cell
Aquaporin-2 molecules come together and fuse with cell membrane to form water channels which increases membrane permeability to water (water reabsorption)
Chronic increases in ADH causes what?
an increase in formation of aquaporin-2 molecules
DECREASED [ADH] results in movement of the
aquaporin-2 where?
molecules back into the cytoplasm which reduces the number of water channels and DECREASING water permeability
Atrial Natriuretic Peptide Secreted by what?
cardiac atrial cells when atria distended by plasma volume expansion
Atrial Natriuretic Peptide Actions? (2)
Direct inhibition of sodium & water reabsorption (especially collecting ducts)
Inhibits renin secretion (thus inhibits angiotensin II formation)
Atrial Natriuretic Peptide is an Important response to help prevent sodium and water retention during what?
heart failure
Most important hormone for regulating calcium
Parathyroid Hormone
Parathyroid Hormone three actions?
Increases calcium reabsorption (distal tubules)
Inhibits phosphate reabsorption (proximal tubule)
Increases magnesium reabsorption (loop of Henle)
SNS severe stimulation results in what effect to GFR ?
Severe stimulation results in constriction of renal arterioles which DECREASE GFR
SNS low levels of stimulation activate what on renal tubular epithelial cells? and what does it stimulate?
activate alpha-receptors on renal tubular epithelial cells (proximal tubule, thick ascending limb of loop of Henle, maybe distal tubule)
Receptor activation stimulates sodium reabsorption which sodium and water excretion
SNS stimulates release of what which adds to tubular reabsorption of Na?
Stimulates release of renin (angiotensin II)
Renal Clearance
Volume of plasma that is completely cleared (i.e. all of specified solute) by kidneys per unit time
Not realistic as no volume of blood completely cleared
Renal Clearance PROVIDES:
Way to quantify excretory function of kidneys Way to quantify renal blood flow Way to quantify glomerular filtration Way to quantify tubular reabsorption Way to quantify tubular secretion
Renal Clearance equation?
C(ml/min) = U x V/P Clearance = Urinary excretion rate / Plasma concentration GFR = U x V/P
If solute freely filtered and neither reabsorbed or secreted, then excretion rate is equal to what?
is the filtration rate
Inulin clearance used as measure of what?
GFR
What substance is usually used clinically to measure GFR?
Creatinine usually used clinically although small amount is reabsorbed
Rough estimate of changes in GFR is to look at changes in creatinine concentration
–A four fold increase in creatinine concentration means the GFR is one-fourth normal
If a substance is completely cleared then clearance rate should equal what flow?
renal plasma flow
PAH clearance provides reasonable estimation of renal plasma flow bc what % is cleared?
90% cleared
Actual renal plasma flow can be calculated by what calculation with the PAH
PAH clearance rate by the PAH extraction rate
PAH Clearance / 0.9
Absorption - equation
Filtered load–Excretion rate
Secretion - equation
Excretion rate–Filtered load
Clearance Rate If equal to inulin clearance
Substance only filtered, not reabsorbed, not secreted
Clearance Rate - If less than inulin clearance
Substance must be reabsorbed
Clearance Rate - If greater than inulin clearance
Substance must be secreated