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Clinical Biochemistry > Renal Function And Kidney Disease > Flashcards

Renal Function And Kidney Disease Flashcards

(79 cards)

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1
Q

What is the role of the ureter

A

Transport urine towards bladder

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2
Q

What is the role of the bladder

A

Temporarily store urine

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3
Q

What is the role of the urethra

A

Conducts urine to exterior

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4
Q

What is the function of urinary system (3)

A
  • excretion & elimination
  • homeostatic regulation
  • endocrine function
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5
Q

What is excretion and elimination

A
  • removal of organic waste products from body fluids
    Eg, urea, creatinine, uric acid
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6
Q

What is regulated by the urinary system

A

water - salt balance

Acid - base balance

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7
Q

What is the function of the endocrine

A

Release hormones into bloodstream

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8
Q

how much urine is excreted daily

A

1.5l

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9
Q

how much of cardiac output does the renal blood flow contribute to

A

20%

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10
Q

what is the plasma renal flow

A

the volume of blood plasma passing through the kidneys per minute

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11
Q

how much is the plasma renal flow

A

600mL/Min./1.73 M2

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12
Q

What 2 processes does the kidney reflect

A
  • ultrafiltration
  • reabsorption
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13
Q

what is the role of the kidney (3)

A
  • homeostasis
  • endocrine function
  • excretion of waste, drugs, urea
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14
Q

what is homeostasis

A

maintaining total body contents at a stable and normal level, even during changes in dietary intake or endogenous production rate

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15
Q

what is erythropoietin

A

a glycoprotein hormone, naturally produced by the peritubular cells of the kidney, that stimulates red blood cell production.

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16
Q

what hormone is produced from the endocrine system that is needed for the kidney function

A

erythropoietin

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17
Q

what enzyme is produced from the endocrine system that is needed for the kidney function

A

1-alpha hydroxylase to produce 1,25(OH)2D3

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18
Q

What is paracrine and autocrine function in the endocrine system

A

Paracrine - cell signalling on nearby cells
Autocrine -signalling acts on the signalling cell

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19
Q

Which elements does the paracrine and autocrine function produce

A
  • bradykinin
  • prostaglandin
  • endothelial factors
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20
Q

What does bradykinin do

A

Elevate vascular permeability and to cause vasodilation in some arteries and veins

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21
Q

What does vasodilation mean

A

When blood vessels widen to allow more blood to flow through

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22
Q

What does the prostaglandin do

A

Generate inflammatory response

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23
Q

What are the endothelial factors (vasodilators factors)

A
  • nitric oxide
  • endothelin
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24
Q

How is the kidney involved in the catabolism (breakdown) of insulin

A

When the nephron mass decreases, leads to a decreased insulin catabolism and results in longer circulating half life

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25
How can the kidney produce glucose
Via gluconeogenesis during fasting
26
What will changes in kidney function result in
Change in plasma concentration
27
How is the kidney involved in blood pressure regulation
- control renin, angiotensin, aldosterone system - homeostasis in sodium and water - production of vasodilators substances
28
Why do sodium and water levels need to be maintained
Maintain normal extracellular fluid volume
29
What is renal threshold
Concentration in blood beyond which it is excreted in urine
30
What is the renal threshold of glucose
180mg/dL
31
What is tubular maximum
Maximum capacity of kidneys to absorb a particular substance
32
What is the tubular maximum for glucose
350mg/min
33
What is neutral balance
Dietary intake plus endogenous production equals excretion rate of kidney
34
What is a positive balance
Intake plus endogenous production > renal excretion
35
What does a positive balance lead to
Increased total body content
36
What is a negative balance
Intake plus endogenous production < renal excretion
37
What does a negative balance lead to
Leading to decreased total body content
38
What are the key parts of the kidney
Renal cortex Renal medulla Renal pelvis Renal pyramids Ureter
39
What are nephrons
They are the functional units of the kidney They do filtration and reabsorption
40
Where is the nephron located
Between the cortex and medulla
41
What 2 parts does the nephron contain
Glomerulus and renal tubule
42
What is the main function of the glomerulus
Bundle of blood vessels responsible to filtrate the blood
43
What is the renal tubule
Responsible for absorption or excretion of substances
44
What does the renal tubule consist of
Bowman’s capsule, proximal tubule, loop of Henley, distal tubule and collecting duct
45
What are the 2 types of nephrons
Cortical nephrons and juxtamedullary nephron
46
What percentage of nephrons is cortical
85%
47
What is the role of the juxtamedullary nephrons
Long loops that go deep into the medulla, important in production of concentrated urine
48
How many times a day does the kidney filter body’s entire plasma volume
60x
49
How much oxygen does the kidney consume
20-25%
50
What are the three phase processes involved in the formation of urine
- glomerulus filtration - selective and passive reabsorption - secretion
51
Where does the glomerular filtration take place
Through the semipermeable walls of the glomerular capillaries
52
What is the driving hydrostatic pressure provided by
Arterial pressure
53
What happens during reabsorption
• In the proximal and distal tubule, the primary urine becomes highly concentrated as the result of the removal of water • At the same time, many other low molecular weight constituents are reabsorbed by active transport – glucose, AA and organic and inorganic ions
54
What happens during secretion
Released into urine in the kidney by active transport
55
What is the role of erythropoietin
Controls the differentiation of the bone marrow stem cells. Ensures bone marrow cells are converted to erythrocytes, so concentration in blood increases
56
What is the role of renin
an enzyme which converts the plasma protein angiotensinogen to angiotensin I
57
What is Angiotensin converting enzyme (ACE)
formed in the lungs converts angiotensin I to angiotensin II which causes vasoconstriction and an increase in blood pressure
58
What is the role of Angiotensin II
stimulates the aldosterone production (water and sodium retention which together increase blood volume)
59
What is calcitriol
steroid-related hormone involved in calcium and phosphorus homeostasis
60
How is renal disease investigated
Personal history and physical examination Blood laboratory findings Urinalysis Assessment of renal function Imaging Renal Biopsy
61
What are plasma labatory findings
• urea, creatinine, Na, K • Ca, phosphate, parathormone • pH, HCO3- • CRP, FW, leucocytosis • FBC: anaemia • D dimers • haptoglobin, myoglobin • immunology: autoantibodies – ANCA, antiGBM, ANA, antidsDNA, complement
62
When assessing kidney function what should the urine be
Sterile • Clear • Amber colour • Characteristic odour • Slightly acidic pH (0.5 and 0.6) • A specific concentration range • Specific gravity (1.010 and 1.030)
63
What amount of urine produced is considered Anuria (dehydration)
<100ml/24hours
64
What amount of urine produced is considered oliguria
<400L/24 hours
65
What amount of urine produced is considered healthy
500ml/24 hours
66
What amount of urine produced is considered polyuria (diuretics, heart failure)
<3L/24 hours
67
What can red urine suggest
- blood - beetroot ingestion - haemoglobin - myoglobin
68
What can orange urine suggest
Rifampicin
69
What can brown urine suggest
Blood, hyperbilirubinemia, nitrofurantoin
70
What can a urinary test strip (dipstick) show
- specific gravity, pH, blood, albumin, nitrates, glucose, ketones
71
What can you check with urinary microscopy
Bacteriuria, casts, crystals, phase-contrast
72
What are the normal values of erythrocytes and leukocytes
> 10 erythrocytes/ul > 20 leucocytes/ul
73
What can glucose indicate in the dipstick testing
Diabetes mellitus
74
What can urobilinogen (reduced form of bilirubin) indicate in the dipstick testing
Liver function
75
What can haemoglobin indicate in the dipstick testing
Multiple intravascular haemolysis
76
What can pH indicate in the dipstick testing
Renal tubular acidosis
77
What is proteinuria
Renal disease
78
What is the normal range of protein in urine
> 150 mg of protein /day in adults and > 140 mg/day in children
79
What is the protein range in someone with proteinuria
300mg/day

Clinical Biochemistry (5 decks)

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