- Filters plasma to produce glomerular filtrate - Filters through nephron to form urine - Efficiency of filtration is GFR Volume of blood filtered per min

KIDNEY Flashcards by Deleted Deleted

Functions of the kidney

-Basic renal processes (Glomerular filtration, tubular reabsorption and secretion)
-Urine formation
-Fluid and electrolyte balance (K, Na)
-Acid-base balance regulation
-Waste product (urea), drugs, toxins excretion
-Secretion of hormones (ADH, renin)

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Anatomy of kidney

Paired, bean shaped located retroperitoneally on either side of spinal column
Two regions
- cortex (outer)
- medulla (inner)
Bilateral ureters - thick walled canals, connecting kidney to bladder
Nephrons - functional units of kidneys (1mil)

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Five parts of nephron

Glomerulus
Proximal convoluted tubule
Loop of Henle
Distal convoluted tubule
Collecting duct

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Glomerulus

Part of nephron
A capillary tuff surrounded by expanded end of the renal tubule

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Glomerulus functions

Filters plasma to produce glomerular filtrate
Filters through nephron to form urine
Efficiency of filtration is GFR
Volume of blood filtered per min

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How is GFR measured?

Creatine

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Creatine tissue source

muscle mostly 2% of creatine results in creatinine

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Diagnostic significance:

Not reabsorbed by tubules
This is why it can be used to
monitor GFR
Kidney function.
Monitoring progressive
kidney disease.

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Proximal & distal convoluted tubule

Part of the nephron
Located in the cortex

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Loop of Henle

Part of the nephron
comprising descending and
ascending limbs.

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Loop of Henle functions

Recovery of water and ions.
Regulates osmolality.
Loop diuretics: Furosemide
Loop diuretic that increases excretion of Na +
and C

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Proximal convoluted tubule functions

Re)absorption:
* ~67% of Na + , K +
* 100% of organic solutes
* 50% of urea
* ~80% of Phosphate

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Distal convoluted tubule functions

Adjusts for electrolyte and acid–base
homeostasis.
Only 10% of filtrate volume remains.
Further reabsorption is under hormonal
control.
By what hormone?

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Collecting Duct

Part of the nephron
Formed by two or more distal convoluted tubules as they pass through cortex and medulla.

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Collecting duct functions

Final site for concentrating or diluting urine
Controls reabsorption of water, Na + , Cl - , and urea

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Hormones produced by the kidney

Renin
Erythropoietin
1,25-dihydroxy vitamin D3
Prostaglandins

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Renin function

catalyzes synthesis of angiotensin
causes vasoconstriction

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Erythropoietin function

acts on erythroid progenitor cells in bone marrow, increasing number of red blood cells.

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cause of increasing number of red blood cells

low oxygen levels (high elevation) or tumor

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1,25-dihydroxy vitamin D3 function

determines phosphate and calcium balance/bone calcification

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Organs involved in determining phosphate and calcium balance/bone calcification

intestine, kidney, and bone

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Prostaglandins function

increase renal blood flow, sodium and water excretion, and renin release.

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Prostaglandins function

increase renal blood flow, sodium and water excretion, and renin release.

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What does an increase renal blood flow, sodium and water excretion, and renin release do?

Oppose renal vasoconstriction (vasodilation) - increases renal blood flow

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Hormonal control of renal function (H2O)

- Increased plasma osmolality or decreased intervascular volume stimulates secretion of ADH from posterior pituitary - ADH increases permeability of distal convoluted tubules and collecting ducts to water, causing increased water absorption.

Hormonal control of renal function (Electrolyte)

- Na+ : controlled primarily by renin–angiotensin– aldosterone hormonal system; excreted from kidneys * Cl- passively reabsorbed as a counter-ion - Potassium: reabsorbed and excreted by distal convoluted tubule and collecting ducts; excretion controlled by aldosterone

Inhibit ADH

Caffeine

Other functions of the kidney

Urea Creatine Uric acid Acid-base balance

Other functions of the kidney (Urea)

Filtered by glomerulus and reabsorbed in collecting ducts

Other functions of the kidney (Creatine)

Filtered by glomerulus

Where does creatine come from?

ATP

Other functions of the kidney (Uric acid)

Readily filtered by glomerulus Uric acid - waste product - bad (insoluble)

Build up of uric acid

liver damage - could cause gout due to hyperuricemia

Monitoring renal function

GFR Beta 2 microglobulin Albuminuria

GFR biomarker

Creatine is a bio marker for?

Beta 2 -microglobulin

- Used to assess tubular function in renal transplant patients. - Blood and urine β 2 -m tests may be ordered to distinguish between glomerular and tubular defects.

Why is Beta 2 -microglobulin used to assess tubular function in renal transplant patients?

Elevated levels indicate organ rejection.

Elevated levels of Beta 2-microglobulin indicate?

organ rejection

Elevated levels of Beta 2-microglobulin indicate?

organ rejection

What is used to monitor diabetes mellitus? How do most diabetics die?

Albuminuria Liver damage - cannot filter stuff

How many mg of albumin to diagnose albuminuria?

For a 24-hour urine collection, 30 to 300 mg of albumin

Glomerular Disease

Acute glomerulonephritis Chronic glomerulonephritis

What prevents big things from getting into the tubules - kidneys?

Glomerulus

Acute glomerulonephritis

Glomerular Disease - Large, inflamed glomeruli with a decreased capillary lumen - increased blood pressure - Rapid onset of hematuria and proteinuria

Albuminuria solutions

Dialysis Kidney transplant

Diabetic Kidney Disease

15% of Americans are estimated to have

Why do 9/10 likely don’t know they have diabetic kidney disease?

Unknown symptom (peeing a lot)

How is DKD diagnosed?

Albumin protein

Dialysis is required if patients progress to from

Diabetic Kidney Disease to ESRD

Amphibolic - Allows transition from a fed state to a fasting state -GH plateaus in young adult life

Growth Hormone

Genetic disease resulting in excess GH

Acromegaly

How is acromegaly diagnosed?

Oral glucose test

Produces oxytocin & vasopressin

Posterior Pituitary

Regulates free water excretion and balance. Deficiency can lead to diabetes.

Vasopressin

Signs of diabetes

Polyuria and polydipsia

Produces two hormones: Thyroid and Calcitonin

Thyroid Gland

The thyroid hormone synthesizes this

Iodine - oxidized and bound with tyrosyl resides on thyroglobulin

Two active forms of thyroid hormone

T3 - 75-80% comes from T4 T4

Three major binding protein

TBG TBPA Albumin

Hyperthyroidism High free T4 and/or T3 Undetectable TSH

Grave's Disease

Hypothyroidism High TSH with low T4

Hashimoto

Produces steroid hormones and neuropeptides

Adrenal Gland

All adrenal steroids are derived from

Cholesterol

Only free cholesterol can enter steroidogenic pathway in response to

ACTH from pituitary

KIDNEY Flashcards

(64 cards)