32 :D Flashcards

1
Q

What is filtration and what is its selectivity and what does it create?

A

Movement of plasma from the glomerular capillaries (blood) into the glomerular capsule

Most substances in plasma are freely- filtered
- Not very selective at the glomerulus
- Creates a plasma-like filtrate of the blood

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2
Q

What determines glomerular filtration?

A
  • Filtration barrier
  • Renal blood flow
  • Driving forces
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3
Q
A
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4
Q

What’s filtered and what’s not filtered?

A
  • small substances (low molecular mass) are freely
  • large substances (high molecular mass) are NOT filtered
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5
Q

Albanian can’t pass through

A

Yep

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6
Q

Glomerular filtration: Renal blood flow
- how much CO do they get?
- why?

A

Renal blood flow (RBF) ≈ 1/5th or 20% of CO per min
RBF ≈ 11 0 0 -1200mL blood/min

high flow for filtration, rather than metabolism

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7
Q

Two types of driving forces

A

Hydrostatic pressures
- Pressure due to the volume of fluid
- “Pushes” fluid away

Colloid osmotic pressures
- Osmotic pressure due to protein
- “Pulls” fluid towards

  • Positive pressures favour filtration
  • Negative pressures oppose filtration
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8
Q

4 pressures / driving forces

A

Glomerular hydrostatic pressure (GHP)
= blood pressure (+ 50 mmHg)

Blood colloid osmotic pressure (BCOP)
= albumin (- 25 mmHg)

Capsular hydrostatic pressure (CsHP)
= pressure of filtrate already present (- 15 mmHg)

Capsular colloid osmotic pressure (CsCOP)
= no protein in capsular space (+ 0 mmHg)
(If u have a kidney disorder there many be proteins try a pull more fluid from blood)

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9
Q

Together the 4 pressures determine the:

A

Net filtration pressure

(+50) + (-25) + (-15) + (0) = 10 mmHg

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10
Q

How much of the kidneys plasma (blood) flow is filtered?

A

Filtration Fraction

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11
Q

Renal Blood Flow, Renal Plasma Flow and Filtration Fraction

A
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12
Q

Filtration Fraction =

A

Glomerular filtration rate (GFR)
———————————————
Renal plasma flow (RPF)

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13
Q

Filtration Fraction calculation =

A

GFR = 125 mL/min
RPF = 625 mL/min

Filtration Fraction =
125 mL/min
—————— = 1/5th or 20%
625 mL/min

≈ 20% of the RPF is filtered
≈ 80% remains in the glomerular capillaries -> the efferent arteriole -> peritubular capillaries

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14
Q

How much plasma is filtered per minute?

A

Glomerular Filtration Rate (GFR)

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15
Q

Glomerular filtration rate - KNOW THESE NUMBERS

A

Normally:
- 180 L/day
- 125 mL/minute

But produces only 1.5L of urine perday (we reabsortion 99%)
- Tightly regulated
- Variation from person to person
- Declines slowly from age 30

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16
Q

How much of a substance is filtered per minute?

A

Renal Filtered Load

17
Q

What is the renal filtered load?

A

amount of a particular substance (solute) filtered per unit of time (per minute/hour/day)

18
Q

How to calculate the filtered load

A

GFR x solute plasma conc.

19
Q

How to calculate the filtered load - glucose example

A

e.g. glucose

GFR (125 ml/min) = 0.125 L/min
Plasma glucose conc = 5 mmol/L

Renal filtered load
= 0.125 L/min x 5 mmol/L
= 0.625 mmol/min

20
Q

How much plasma is cleared of a substance per minute?

A

Renal Clearance

21
Q

What is renal clearance - LEARN

A

Clearance is the volume (mL) of plasma that is cleared of a substance by the kidneys per unit time (per minute)

22
Q

Renal Clearance can be used to:

A
  • Quantify how a substance is handled by the kidneys
  • Estimate glomerular filtration rate (GFR)
23
Q

Renal clearncae - creatin and insulin example - how do u calculate it

A
  • 99% of the plasma which was filtered was reabsorbed
  • clearance of creatine = volume of plasma filtered per minute = GFR
24
Q

Renal clearance - PAH - how to calculate it?

A
  • clearance of PAH = volume of plasma flowing through the kidneys per minute = RPF
25
Q

Renal clearance - glucose - how to calculate it?

A

Clearance of glucose - NO plasma is cleared of glucose

26
Q

Renal clearance - sodium - how do you calculate it?

A
  • clearance of sodium = very small volume of plasma per minute
27
Q

Actual calculation for clearance - dont memorise ist understand

A

The equation describes the clearance (via the kidneys) for all substances that can be detected in plasma and urine!

28
Q

Estimating GFR using Renal Clearance
- requirements

A

To be used to measure GFR a substance must:
- Be freely filtered
- NOT be reabsorbed from the tubule
- NOT be secreted into the tubule

29
Q

Estimating GFR using Renal Clearance
- two main substances that meet the requirements

A

Inulin (not to be confused with insulin!!)
• Polysaccharide, not metabolised by body
• Not found in body, must be injected

Creatinine
• Waste product produced by muscles
• Already in the body, so most commonly used clinically

30
Q

Food with high inulin

A
31
Q

Estimating GFR using Renal Clearance
- creatine example

A
32
Q

Relationship between GFR and plasma creatinine

A

Plasma creatinine conc is an important mark to apply drugs!!
indicator of kidney function:

  • If both kidneys are working (GFR = 125 mL/min) plasma creatinine is low
  • Even if only one kidney is still working (GFR = 60 mL/min), plasma creatinine is fairly normal
  • When GFR < 25 mL/min plasma creatinine conc increases as the kidneys ability to clear waste products from the blood is reduced
33
Q
A
34
Q

GFR, RPF and Renal Clearance

A
35
Q

GFR
?

A

The amount of plasma filtered per unit time by the kidneys