1 Renal Function Flashcards
(103 cards)
1
Q
System of the body whose primary goal is to excrete unwanted substances
A
Urinary system
2
Q
Main function of urinary system
A
Excretion of unwanted substances
3
Q
4 Main Components of Urinary System
A
Kidney
Ureter
Bladder
Urethra
4
Q
Main component: filter
A
Kidney
5
Q
Connects kidney and bladder
A
Ureter
6
Q
Storage of urine
A
Bladder
7
Q
functional unit of the kidney
A
Nephron
8
Q
How many nephrons are present in EACH kidney
A
1-1.5 million
9
Q
Types of Nephron
A
Cortical
Juxtamedullary
10
Q
Types of nephron is based on
A
Location
11
Q
Percentage of cortical nephron
A
85%
12
Q
85% of nephron is known as
A
Cortical nephron
13
Q
Type of nephron that removes waste and reabsorbs nutrients
A
Cortical nephron
14
Q
Location of cortical nephron
A
Cortex
15
Q
15% of nephrons are
A
Juxtamedullary
16
Q
Juxtamedullary takes up ___% of nephrons
A
15%
17
Q
Type of nephron where concentration of urine occurs
A
Juxtamedullary
18
Q
Urinary filtrate flow (10)
A
- Bowman capsule
- Proximal convoluted tubule
- Descending loop of Henle
- Ascending loop of Henle
- Distal convoluted tubule
- Collecting duct
- Renal calyces
- Ureter
- Bladder
- Urethra
19
Q
Renal blood flow
A
- Renal artery
- Afferent arteriole
- Glomerulus
- Efferent arteriole
- Peritubular capillaries
- Vasa recta
- Renal vein
20
Q
Sites for water and salt exchange
A
Loop of henle
21
Q
RENAL FUNCTIONS (4)
A
- Renal Blood Flow
- Glomerular Filtration
- Tubular Reabsorption
- Tubular Secretion
22
Q
Human Kidney receives __% of the blood
A
25%
23
Q
Human Kidney receives 25% of the blood from ____
A
Renal artery
24
Q
Blood enters the nephron via
A
Afferent arterioles
25
average body surface
1.73 m^2
26
Total Renal Blood Flow
1200 mL/min
27
Total Renal Plasma Flow
600-700 mL/min
28
Coil of 8 capillary lobes
Glomerulus
29
Nonselective filter of plasma substances
Glomerulus
30
Factors influencing filtration process
Cellular Structure of the Glomerulus
Hydrostatic pressure
Oncotic Pressure
Feedback mechanism of RAAS
31
RAAS
Renin-angiotensin-aldosterone system
32
Based on cellular structure, Plasma filtrate must pass….
1. Capillary wall membrane
2. Basement membrane (basal lamina)
3. Visceral epithelium of the Bowman’s Capsule
33
____ increase capillary permeability but do not allow passage of large molecules and blood cells
Pores
34
thin membranes covering the filtration slits
Podocytes
35
Foot processes
Podocytes
36
Principle: repels molecules with negative charge
Shield of negativity
37
Results from the smaller size of the efferent arterioles and the glomerular capillaries
Glomerular pressure
38
Regulates the blood flow to and within the glomerulus
Renin-Angiotensin-Aldosterone System (RAAS)
39
RAAS Respond to changes in
blood pressure and plasma sodium content
40
Respond to changes in the blood pressure and plasma sodium content
Renin-Angiotensin-Aldosterone System (RAAS)
41
Angiotensinogen are found where and it produces what
Plasma, produces angiotensin I
42
Angiotensin converting enzymes are found where
Lungs
43
Function of aldosterone
Sodium retaining
44
Sodium retaining hormone
Aldosterone
45
causes the kidneys to release less water (water reabsorption), decreasing the amount of urine produced.
Anti diuretic hormone
46
Substances are removed from the glomerular filtrate and returned to the blood
Tubular reabsorption
47
Two types of transport mechanism for tubular reabsorption
Active and passive transport
48
It is when the plasma concentration exceeds the renal threshold
Maximal reabsorptive capacity
49
Plasma concentration where the active transport stops
Renal threshold
50
Renal threshold for glucose
160-180 mg/dL
51
Active or passive? Location of reabsorption?
Glucose
Active, PCT
52
Active or passive? Location of reabsorption?
Chloride
Active, ALH
53
Substances for active transport
Glucose
Amino acid
Salt
Chloride
Sodium
54
Substances of passive transport
Water
Urea
Sodium
55
Where Renal concentration begins
Descending and Ascending Loop of Henle
56
Water is removed by osmosis in the
Descending Loop of Henle
57
Na and Cl are reabsorbed in the
Ascending Loop of Henle
58
Selective reabsorption process
Countercurrent Mechanism
59
Serves to maintain the osmotic gradient of the medulla
Countercurrent Mechanism
60
Involves the passage of substances from the blood in the peritubular capillaries to the tubular filtrate
Tubular secretion
61
One of its function is for Elimination of waste products not filtered by the Glomerulus
Tubular secretion
62
Tubular secree regulates acid base balance through secretion of ___
Hydrogen ions
63
Types of renal function test
Glomerular filtration test
Tubular reabsorption test
Tubular secretion and renal blood flow test
64
Test under glomerular filtration test
Clearance test
- creatinine
- cystatin C
- Beta 2-microglobulin
65
All Clearance Tests are examples of Glomerular Filtration Test except
Free water clearance
66
Measures the rate in milliliters per minute at which the kidneys are able to remove a filterable substance from the blood
Glomerular filtration test
67
Give some Characteristics of Substance to be tested for Glomerular Filtration Test
A. Should not be reabsorbed or secreted by the tubules
B. Substance must be stable for 24 hours
C. Plasma level should be constant
D. Substance should be available in the body
E. Availability of the tests to analyze the substance
68
Clearance Test in the Past
Urea CT
Inulin CT
69
polymer of fructose
Inulin
70
UREA CLEARANCE TEST require ___ hour sample
2
71
Earliest clearance test
Urea CT
72
Problem of urea clearance test
reabsorbed by the tubule (40%)
73
Disadvantage of Inulin clearance test
Exogenous, infused at constant rate
74
First step After confirming if the specimen is from the correct px
Measure volume
75
Test which Requires 24-hour sample
Creatinine clear test
76
Creatinine Clearance Test requires ___ hour sample
24
77
Endogenous procedure for evaluating glomerular filtration
Creatinine CT
78
Creatinine Clearance Formula
Urine creatinine conc ( mg/dL) x urine volume in ml/minute / plasma creatinine conc
79
Corrected Creatinine Clearance Formula
UV/P x 1.73/A
80
Reference range for Corrected Creatinine Clearance Formula
Male 107 – 139 mL/min
Female 87 – 107 mL/min
81
Used for routinely screening patients as part of a metabolic profile and to monitor patients already diagnosed with renal disease or at risk for renal disease
Estimated Glomerular Filtration Rates
82
Produced by all nucleated cell at constant rate
Cystatin C
83
Cystatin C are produced by
Nucleated cell
84
Filtered readily by the glomerulus and reabsorbed and broken down by the renal tubular cells
Cystatin C
85
Cystatin C is Filtered readily by the glomerulus and reabsorbed and broken down by the
renal tubular cells
86
Recommended: Pediatric patients, Elders, People with Diabetes, Critically-ill
Cystatin C clearance test
87
Dissociates from human leukocyte antigen at constant rate
Beta 2 micro globulin
88
Beta 2 micro globulin Dissociates from ____ at constant rate
human leukocyte antigen
89
Most sensitive indicator of a decrease in GFR
Beta 2 micro globulin
90
Used to determine the ability of the tubules to reabsorb essential salts and water that have been non-selectively filtered by the glomerulus
Concentration test
91
Principle: salts and water are reabsorbed in the tubules
Tubular Reabsorption Test
92
largely determined by the body’s state of hydration
Urine concentration
93
Sample of Tubular Reabsorption Test
Obsolete test
Osmolality
Freezing-Point Osmometers
Vapor Pressure Osmometers Specific Gravity Determination
Free Water Clearance
94
Test which uses reagent strip
Specific Gravity Determination
95
Test under obsolete test
Mosenthal Test
Fishberg Test
96
Measures only the number of particles in a solution
Osmolality
97
Free Water Clearance Formula
Urine Osmolality x volume / plasma Osmolality
98
Free water clearance
Positive result – _____
Negative result – _____
Zero result –______
Positive result – hydration Negative result – dehydration Zero result – no effect
99
Historical test for Tubular Secretion and Renal Blood Flow Test
Phenolsulfonpthalein Excretion Test (PSP)
100
Most commonly associated with the tubular secretion and renal blood flow
P-aminohippuric acid (PAH)
101
Indigo Carmine Test is for
Px with unilateral kidney disease
102
Reference range: Titratable Acidity and Urinary Ammonia
70 mEq/day
103
Oral acid load
Ammonium chloride
