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MSS - Renal Exam 1 > Elements of Renal Function > Flashcards

Elements of Renal Function Flashcards

1
Q

kidney function?

A

regulate ECF concentration
regulate plasma electrolyte concentration
regulate acid base balance
regulate extracellular fluid volume, arterial blood presure
eliminate metabolic waste

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2
Q

hormones in kidney?

A

erythropoietin
vitamin D
renin

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3
Q

synthesized in kidney?

A

ammonia
prostaglandins
kinins
glucose

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4
Q

kidney is important?

A

integrated with many other body systems

renal failure: anemia, osteoporisis, disregulation of calcium and phosphate

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5
Q

kidneys a blood pressure

A

also regulated

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6
Q

renal blood supply

A

20% cardiac output

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7
Q

renal BP?

A

glomerular capillaries - 60 mmHg

-pretty high

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8
Q

pressure in peritubular capillaries

A

lower (13 mmHg)

permits fluid reabsorption

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9
Q

pressure in capillary beds?

A

can be regulated by resistance changes in afferent and efferent arterioles

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10
Q

two types of nephrons?

A 
superficial
juxtamedullary (much longer loops of henle)
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11
Q

cortical nephron?

A

short loop of henle

-surrounded by peritubular capillaries

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12
Q

juxtamedullary nephron

A

long loop of henle

-long efferent arterioles divided into specialized peritubular capillaries (vasa recta)

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13
Q

renal microcirculation?

A

afferent arteriole
glomerular capillaries
efferent arteriole
peritubular capillaries

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14
Q

vasa recta

A

runs alongside loos of henle in juxtamedullary nephron

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15
Q

venous drainage?

A

interlobular vein
arcuate vein
interlobar vein
renal vein

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16
Q

first capillary network?

A

glomerular capillaries

  • high hydrostatic pressure
  • large fluid volume filtered in bowmans capsule
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17
Q

second capillary network?

A

peritubular capillarires

  • low hydrostatic pressure
  • law amounts of water and solute are reabsorbed
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18
Q

renal blood flow

A

very high flow

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19
Q

renal flow during exercise?

A

decreased flow

-blood is shunted to skeletal muscle

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20
Q

flow rates in regions of kidney?

A

cortex highest
slower as get more central (outer to inner medulla)

slow rate in medulla allows concentration of urine

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21
Q

innervation of kidney?

A

sympathetics on smooth muscle on arterioles and granular cells in afferent arterioles

22
Q

granular cells

A

on juxtaglomerular apparatus

-sympathetic stimulation of renin release

23
Q

sympathetic stimulation?

A

powerful constriction of afferent and efferent arterioles
-afferent > efferent

decreases renal blood flow
diverts renal fraction to vital organs

also stimulates renin release

24
Q

renin

A

stimulates Na+ reabsorption in proximal tubule, thick ascending loop of henle, distal convoluted duct, collecting duct

25
glomerular filtration
filtration of plasma from glomerular capillaries into bowmans capsule
26
tubular reabsorption
transferral of substances from tubular lumen to peritubular capillaries
27
tubular secretion
transferral of substances from peritubular capillaries to tubular lumen
28
excretion
voiding of substances in urine
29
urinary excretion = ?
amount filtered - reabsorbed + secreted
30
tubular reabsorption = ?
glomerular filtration - urinary excretion if excretion rate > filtration rate, tubular secretion must have occurred
31
glomerular filtration rate
volume of plasma filtered into combined nephron of both kidneys per unit time
32
filtration rate
GFR x plasma concentration of substance
33
urinary excrection rate?
flow rate x concentration of substance in urine
34
reabsorption or secretion of substance?
difference between glomerular filtration and urinary excretion (assuming substance is not produced or metabolized by kidneys)
35
excretion < filtration
net reabsorption occured
36
excretion > filtration
net secretion occured
37
clearance
volume of plasma from which a substance is completely removed by kidney in given time period describes how effectively the kidneys remove a substance from the bloodstream and excrete it in the urine different substances have different clearance GFR measure depends on clearance
38
clearance of substance = ?
concentration in urine x urine volume / concentration of substance in plasma Cx = Ux x V / Px ***
39
GFR estimate?
can be done using clearance -if compound freely filtered, but NOT secreted, reabsorbed, produced, nor degraded by the kidneys
40
inulin
freely filtered, not reabsorbed, secreted, or metabolized inulin clearance equal to GFR problems - need to inject it
41
creatinine?
another estimate of GFR -freely filtered, but not perfect creatinine secretion in proximal tubule overestimates Ux; substances in blood cause overestimation of Px two sources of error nearly cancel eachother out
42
P-creatinine and GFR?
plasma creatinine inversely proportional not perfect, difference in lean muscle compensatory increased proximal tubule secretion
43
uses of creatinine?
long term function
44
BUN/creatinine
creatinine from muscle BUN from liver (waste product) urea reabsorbed by tubules can be regulated creatinine reabsorbed remains the same
45
BUN/Cr >20/1
prerenal problem - BUN reabsorption is increased - due to hypovolemia creatinine doesn't change with hypovolemia
46
BUN/Cr 10-20/1
normal range or postrenal | -can be postrenal disease (obstruction)
47
BUN/Cr <10/1
intrarenal | -renal damage causes reduced reabsorption of BUN and a lower BUN/Cr ratio
48
cystatin C
another marker of GFR - produced by all nucleated cells - freely filtered - not dependent on muscle mass or gender it goes up, GFR goes down used to determine estimage GFR (eGFR)
49
para-amino hippuric acid (PAH)
freely filtered and avidly secreted -completely cleared from plasma of peritubular capillaries gives estimate of blood flow
50
filtration fraction
renal plasma flow through the tubule FF = GFR/RPF RPF = renal plasma flow
51
increased FF
oncotic pressure of efferent arteriole increases | -facilitates reabsorption

MSS - Renal Exam 1 (8 decks)

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