What do Natriuretic Peptides do ?
Long-Term Sodium-Water, Blood Volume, and Arterial Pressure Regulation by Vasodilation and Renal Natriuresis & Diuresis.
How do Natriuretic Peptides affect the CV System?
↓Preload & ↓CVP
How do Natriuretic Peptides affect the Kidneys?
Inhibits Renin Release
Inhibits Aldosterone Secretion
Inhibits ADH Secretion
What stimulates Atrial Natriuretic Peptide release?
Atrial Stretch or ↑ECF
Where in the Kidney does ANP act to Decrease Sodium Reabsorption?
Where is Brain Natriuretic Peptide synthesized?
What happens w/ the Chronic use of Diuretics?
Where in the Kidneys do Loop Diuretics, like Bumex & Lasix work?
Thick Ascending Limb of Loop of Henle
Where in the Kidney do Thiazides work?
Distal Convoluted Tubule
Where do Potassium-Sparing Diuretics work?
Distal Tubule & Collecting Duct
Where in the Kidney does Mannitol & Diamox work?
How do Osmotic Diuretics like Mannitol & Urea work?
Gets filtered & stuck in the Tubules and draws in fluid with them
How do Loop Diuretics like Lasix, Bumex, and Ethacrynic Acid work?
Inhibits the Na-2Cl-K pump in the TAL and stops the Countercurrent System
Thiazides are most commonly used & stops Sodium Reabsorption in the DCT. How do they affect Potassium Levels?
Can cause Hypokalemia & Alkalosis b/c increased Sodium in the DCT stimulates Aldosterone sodium pump to exchange Potassium & H+ for Sodium
How do Carbonic Anhydrase Inhbitors, like Diamox, work?
↓Na Reabsorption in PCT by decreasing the Bicarb Reabsorption that is coupled to the Sodium, which can cause Acidosis
What is the main use for Diamox?
How do Aldosterone Antagonist like Spironolactone work?
Spares Potassium via a decrease in Na Reabsorption & K+ Secretion by competing for aldosterone binding sites in the DCT.
Which class of Diuretics are Amiloride & Triamterene?
Sodium Channel Blockers
How do Na Channel Blockers work?
Decrease Na Reabsorption by decreasing Na/K-ATPase in the Collecting Tubule, which also spares Potassium
What is the difference b/t Acute Kidney Injury vs. Chronic Kidney Disease?
AKI: Acute decline or complete loss of kidney function that eventually recovers back to normal
CKD: Irreversible decrease in Functional Nephrons
What are the leading causes of ESRD?
#1 - Diabetes
#2 - HTN
When would you start to see symptoms of CKD?
When there are < 70% of Functional Nephrons
How is Chronic Kidney Disease defined?
Kidney Damage or Decreased Kidney Function lasting 3 months or more
How much of a decrease in functioning nephrons would result in abnormal electrolytes & body fluid volumes?
A decrease below 20-25% of normal
What causes CKD?
Renal Vasculature Injury
What are some causes of Renal Vasculature Injury?
What are some causes of Glomerulonephritis?
What is Nephrotic Syndrome?
Loss of Negative Charge in Basement Membrane from Proteinuria
What is Pyelonephritis?
E. Coli Infection, affecting the Renal Medulla & Impairs Ability to concentrate Urine
What are the effects of Uremia?
↑K, Phosphates & Phenol
↑CO for more O2 Carrying Capacity