water and sodium regulation Flashcards

1
Q

how is sodium reabsorbed

A

Sodium reabsorption is an active process occurring in all tubular
segments except the descending limb of the Loop of Henle and the
medullary collecting duct

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

how is water reabsorbed

A

Water reabsorption is by diffusion (i.e., osmosis) and is dependent upon
sodium reabsorption (but not exclusively).
Water moves through aquaporin channels. The presence of these aquaporins varies throughout the tubule segments. They are highly expressed in the proximal nephron. They are absent in the collecting ducts unless Anti-diuretic hormone (ADH) is active.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

key points of sodium reabsorption

A
  • Active transport out of cells into interstitial fluid.
  • Transport achieved by Na+/K+-ATPase pump
  • Keeps intracellular conc. of Na+ low to allow
    ‘downhill’ movement of Na+ from lumen
  • Mechanism of Na+ movement across luminal
    membrane varies between tubule segments,
    whereas always via Na+/K+-ATPase pump for
    basolateral membrane
  • Proximal tubule (a): co-transport / counter-
    transport of organic molecules (glucose, aa)
  • Cortical collecting ducts (b): via Na+ channels
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what is the make up of water distributions

A

2/3 intracellular
1/3 extracellular

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what does ADH do

A

Anti-diuretic hormone (ADH) [aka
vasopressin]) initiates a cascade of
event within the collecting duct cells
that leads to an increased number of
AQP2 channels in luminal membrane,
This allows increased passive diffusion of
water into the cell.
Water exits cell through AQP3 and
AQP4, which are not vasopressin
sensitive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what does ADH combine with

A

ADH uses cAMP systems to cause the
insertion of aquaporins into the
membranes of the principle cells of the
collecting ducts.
So water flows out of the collecting
ducts to be reabsorbed by the body

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what regulates ADH

A

Regulation of ADH release from posterior
pituitary gland.
Most important of the inputs come
from osmoreceptors (primarily) and
baroreceptors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

slide 10

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

slide 10

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

the 3 factors effecting sodium reabsorption

A

1) Aldosterone (most major)
2) Atrial Natriuretic Peptide (ANP)
3) Local effect of blood pressure on the tubules

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

describe the Aldosterone and the
Renin-Angiotensin System

A

The release of the enzyme renin converts the
peptide angiotensinogen to angiotensin I.

Angiotensin I then converted to angiotensin II
byangiotensin-converting enzyme (ACE).

Angiotensin II acts on angiotensin receptors located in several target tissues including the adrenal glands, kidneys, brain, and vasculature

Activation of angiotensin receptors in the adrenal glands stimulates aldosterone release from these glands, which increase Na+ and H2O reabsorption

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

slide 13

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

how does Atrial Natriuretic Peptide (ANP) impact sodium regulation

A

ANP is synthesized and sorted in atrial myocytes
ANP is released in response to stretching of the
atria
This occurs when our circulating blood volume increases

An increase in circulating levels of ANP causes ↑Na+ excretion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

how does Local effect of blood pressure on the tubules effect sodium regulation

A

Baroreceptor regulation of blood pressure simultaneously
regulates total-body sodium
» See figure summarising major mechanisms wherein Na+
loss elicits a decrease in GFR.

This is affected by the volume of surface available,
filtration membrane permeability and NFP (net
filtration pressure), blood pressure / blood flow to
the glomerular capillaries.
» GFR is directly proportional to NFP. Therefore,
increases (or decreases) in systemic blood pressure
causes increases (decreases) in GFR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what do diuretics do

A

Diuretics are substances that promote the loss of Na+ and H2O

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

diuretics as medications

A

Diuretics can be medications use to help the body remove excess sodium and waterand
help control blood pressure

» Osmotic diuretics; carbohydrates that are filtered but not reabsorbed (ex. Mannitol).
» Loop diuretics (lasix, furosemide) are the most powerful diuretics because they inhibit the formation of the medullar gradient by inhibiting Na+ reabsorption.

» Hydrochlorithiazide acts on the distal collecting duct.

» Spironolactone is an aldosterone receptor antagonist. This is known as a K+ sparing diuretic. It acts because the K+ in the urine is from aldosterone-driven active tubular secretion into the late DCT and collecting ducts

17
Q

how do exercise impact renal function

A

Renal blood flow decreases as soon as exercise starts
Linear relaƟonship: ↑ exercise intensity = ↓renal
blood flow

18
Q

describe the renal blood flow during exercise

A

Increase sympathetic nervous system activity during exercise causes vasoconstriction of
the renal arterioles.

↑ exercise intensity = ↑ sympatheƟc nervous system acƟvity = ↓renal blood flow

Increase ADH (or vasopressin) release also reduces renal blood flow

ADH causes renal vasoconstriction

Remember that ADH release activity due to renin-angiotensin-aldosterone system
Despite  renal blood flow, increase work for the kidney during exercise

19
Q

how do the kidneys maintain PH during exercise

A

via loss of excess H+ in the urine
Kidneys removes a small amount (2%) of total lactate produced
during exercise

20
Q

how does the kidney conserve body water during exercise

A

fluid regulatory hormones act to increase
water and Na+ reabsorption in the kidney

21
Q

how does the kidney excrete metabolites during exercise

A

H+
Creatinine (excess created from muscle breakdown)
Other proteins

22
Q

what is rhabdomyolysis

A

A condition where skeletal muscle cell
damage can cause acute renal failure
and sometimes death

23
Q

what increases the chances of rhandomyolysis

A

Rhabdomyolysis is most often observed with novel, strenuous,
overexertion
» heat stress ↑ risk

» dehydration likely ↑ risk

24
Q
A