kidney pathophysiology FS Flashcards
(45 cards)
Name 5 renal disorders
postinfectious glomerulonephritis
Polycystic kidney disease
membranous nephropathy
lupus glomerulonephritis
IgA nephropathy
proteinuria
Renal Artery stenosis
Describe the diseased glomerular capillary
Sub epithelial deposits as in membranous nephropathy
Large sub epithelial deposits in acute post infectious glomeruleronephritis (Large, irregular subepithelial deposits or “humps”)
Sub-endothelial deposits in diffuse proliferative lupus glomerulonephritis
Mesangial deposits seen in IgA nephropathy
Damage of epithelial foot processes in proteinuria
Autoimmune antibody binding basement membrane(as in Goodpasture syndrome) does not produce visible deposits, but a smooth linear pattern is seen on immunofluorescence)
what is the mesangium composed of
mesangial cells surrounded by extracellular matric in direct contact with endothelium
where does ultrafiltration occur
across the glomerular wall and through the channels in the mesangial matric into the urinary space
what is the cause of decrease in glomerular filtration rate
renal dsease
diabetes
hypertension
what is the cause of decrease in GFR and increase bowmans capusule hydrostatic pressure
urinary tract obstruction
what is the cause of increase in glomerular capillary hydrostatic pressure and decrease in glomerular filtration rate?
renal blood flow
increased plasma proteins
what is the cause of decrease systemic arterial pressure and decrease in bowmans capusle hydrostatic pressure
decrease in arterial pressure
what is the cause of decrease efferent arteoilar resistance and decrease bowmans capsule hydrostatic pressure?
angitensin II decrease
what is the cause for increase in afferent arteriolar resistance and a decrease in glomeular capillary hydrostatoc pressure
sympathetic activity, vasoconstrictor hormones like nerepinphrine
give two things GFR is determined by
balance of hydrostatic qand colloid osmotic forces across the capillary membrane (net filrtation pressure)
Capillary filtration coefficient (Kf), which is the permeability multiplied by the filtering surface area of the capillaries
give the equation to find GFR
Kf x net filtration pressure
due to high hydrostatic pressure and Kf, glomerular capillaries have a filtration rate more than other capillaries
how are kidneys classified?
acute problems, can stop a kidney function can recover (acute renal failure)
name 4 cause of prerenal acute renal failure
intravascular volume depletion
cardiac failure
primary renal hemodynamic abnormalities
peripheral vasodilation and resultant hypotension
what are symptoms of intravascular volume depletion
hemorrage
diarrhea
vomit
burns
symptoms of cardiac failure
valvular damage
myocardial infarction
symptoms of renal hemodynamic abnormalities
embolism
thrombosis of renal artery vein
renal artery stenosis
blockade of prostglandin synthesis
symptoms of peripeheral vasodilation and hypotension
anesthesia
anyaphylatic shock
sepsis
severe infection
In Europe, the most commonly prescribed NSAIDs are:
diclofenac
ibuprofen
naproxen
celecoxib
mefenamic acid
etoricoxib
indomethacin
aspirin (in doses greater than 600mg
What are NSAIDs
Non steroidal anti inflammatory drugs
they block prostaglanding synthesis
they inhibit COX-2 enzymes in the kidney
What is the function of prostoglandin in the kidney?
PGI2,PGE2, thromboxane A2(TXA2), and PGF2αare made there
PGs affect vascular tone (increase RBF) and NaCl transport
PGI2&PGE2stimulates renin and aldosterone release
In the macula densa what happens when increase flow and na+ delivery occurs
ATP is released
decrease GFR maintains normal filtered load
decreases renin secretion allows more NA+ secretion
In the macula densa what happens when decrease flow and na+ delivery occurs
NO and prostoglandins produced
increase GFR maintains normal filtered load
increases renein secretion and conserves NA+
What can prostoglandin oppose
oppose ADH
helps in water excretion
