Renal 3 Flashcards

1
Q

Of the 180L/day filtered what is excreted

A

less than 1% (1.5L)

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2
Q

what does regulated reabsorption allow kidneys to do

A

selectively return ions and water to plasma and maintain homeostasis

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3
Q

Why filter 180L if only excreting 1%

A
  • rapid way to remove unwanted materials
  • rapid regulation of fluid and ions
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4
Q

what can be active and passive

A

reabsorption

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5
Q

filtrate in lumen and ECF initially have what similar

A

solute, they are isosmotic

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6
Q

reabsorption involves what two types of transport

A

transepithilial (transcellular)
paracellular

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7
Q

transepithelial transport

A

substances cross the apical and basolateral membranes of tubule cells to enter ECF (require protein transporters)

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8
Q

paracellular transport

A

substances pass through the cell to cell junctions between two adjacent tubule cells

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9
Q

what creates the electrochemical gradient that drives reabsorption

A

reabsorption of sodium set up by Na-K ATPase

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10
Q

what does sodium do

A

starts process of active transport that drives all reabsorption within proximal tubule

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11
Q

what kind of transport is basolateral Na always

A

active transport via NA-K ATPase

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12
Q

how does Na cause secondary active transport (symport with Na+)

A

Na moving down its electrochemical gradient pulls glucose, amino acids, ions into the cell against their concentration gradient

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13
Q

What are two other reabsorption mechanisms

A

passive reabsorption, endocytosis

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14
Q

passive reabsorption (e.g. urea)

A

initially urea=urea
when Na and anions move, H20 drawn via osmotic gradient and urea now has concentration gradieint to move via paracellular transport

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15
Q

endocytosis

A

megalin binds to small plasma proteins and peptides to be digested by lyosomes in cell

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16
Q

what do the majority of substances transported in the nephron use

A

membrane proteins

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17
Q

what is saturation of these membrane proteins

A

max rate of transport that occurs when all available carrier are occupied

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18
Q

what is the transport rate at saturation

A

transport maximum

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19
Q

what happens when excess glucose is filtered

A

more glucose then transporter so glucose excreted

20
Q

renal threshold

A

plasma concentration of a solute when it first appears in the urine

21
Q

amount excreted =

A

Amount filtered - amount absorbed + amount secreted

22
Q

what is glucose appearing in urine called

A

glucosuria or glycosuria

23
Q

what causes the peritubular capillary pressures to favor reabsorpition

A

colloid osmotic gradient from protein witihin peritubular capillaries draws fluid and dissolved solutes to be reabsorbed

24
Q

what does the hydrostatic pressure drop to after fluid is removed and resistance encountered

A

10mmHg

25
Q

why does the oncotic pressure remain 30mmHg as blood travels to peritubular

A

plasma proteins are not filtered

26
Q

what is the net pressure that drives fluid and solutes from interstitial space back into capillaries

A

20mmHg
30-10

27
Q

what is secretion

A

transfer of molecules from ECF into lumen of nephron

28
Q

what does secretion depend on like reabsorption

A

membrane transport proteins

29
Q

what kind of process is secretion

A

active requiring movement of substances against concentration gradients

30
Q

purpose of secretion

A

homeostatic regulation of K+ and H+ (in distal)
organic compound removal (medications, in proximal)

31
Q

what does secretion enhance

A

excretion of a substance

32
Q

when will excretion of a substance be very high

A

if filtered, not reabsorbed, and then secreted

33
Q

how are organic solutes secreted

A

multi step (tertiary) active transport (proximal tubule)

34
Q

what is tertiary active transport

A

indirect active ATP process is 3 steps removed from movement of the molecule of interest

35
Q

oat transporters

A

organic anion trasnporters

36
Q

where do OAT transporters use energy from for tertiary indirect active transport

A

transporting dicarboxylates down their concentration gradient to move organic anions against their concentration gradient

37
Q

what is a-ketoglutarate

A

by-product of citric acid cycle

38
Q

what is direct active transport (tertiary process)

A

Na-K-ATPase keeps Na in cell low

39
Q

what is secondary indirect active transport (tertiary process)

A

Na-dicarboxylate cotransporter concentrates a dicarboxylate in cell using energy from Na gradient

40
Q

prior to 1930s what was leading cause of death

A

infection

41
Q

why was all penicilin ingested be excreted within 3-4 hours

A

readily filtered and secreted using tertiary process

42
Q

what would penicillin be given with

A

probenecid which was preferentially secreted by OAT transporter and prevented penicillin secretion

43
Q

what does excretion tell us

A

only what body is eliminating, not renal function

44
Q

what is GFR an indicator of

A

overall kidney function

45
Q

what is renal handling/clearance info necessary for

A

new drugs

46
Q

how do we look directly at filtration, reabsorption, and secretion at level of individual nephron

A

experimentally
indirect methods using analysis of urine and blood

47
Q
A