Renal disease

Question 1

what are the functions of the kidney?

Answer 1

excretion of end products of metabolism - urea and creatinine and removal of foreign chemicals

regulation of electrolyte balance, acid base balance, body water volume and osmolality balance

Question 2

what are the 3 layers of the glomerular capsule membrane?

Answer 2

endothelium, basement membrane and epithelium

Question 3

what is the function of the 3 layers of the glomerular capsule membrane?

Answer 3

act as a barrier to the filtration of large molecules such as proteins

Question 4

what is glomerular filtration rate?

Answer 4

the amount of filtrate formed per minute

Question 5

what is filtrate?

Answer 5

primary urine

Question 6

how does filtration occur?

Answer 6

gradient pressure
blood colloid pressure
capsular pressure
glomerular hydrostatic pressure

Question 7

what is reabsorption?

Answer 7

second step in urine formation

takes place by passive and active transport mechanism from all parts of the renal tubule

major portion of water, electrolytes and normally all nutrients are reabsorbed from the PCT in the loop of Henle

Question 8

what are other responsibilities of the kidneys?

Answer 8

blood pressure control (renin production)

erythropoetin production

activation of vitamin D

Question 9

outline the changes to the renal system in pregnancy

Answer 9

plasma volume increases by 40-50%

cardiac output increases by 30%

reduced vascular resistance, altered BP regulation

renal blood flor increases by 80%

50% increase in filtering capacity (Glomerular filtration rate) by 18weeks until 36weeks then steady return to pre pregnant state

kidneys increase in length by 1cm

dilation of renal pelvis and ureter on right side

increase in urinary protein excretion up to 0.3g/24hrs

increased risk of UTI from urinary stasis.

increase in non diabetic glycosuria due to increase in filtered load and inability to reabsorb back through the tubules at the same rate

change in acid base balance

increase in erythropoietin production 40% to increase red cell mass§

Question 10

what is nephrotic syndrome?

Answer 10

occurs in severe PET

> 3-3.5g protein in 24hr collection
low serum albumin- alters osmotic pressure, allows fluid to escape into the tissues
loss of anti thrombin = hypercoaguability
increase in concentration within the blood
oedema=reduces mobility

high risk for DVT, need anti coagulant therapy