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Renal Physiology Flashcards

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1
Q

Normal pH of Kidneys

A

7.4 by regulating H+ and HCO3-

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2
Q

Positive Balance

A

Intake exceeds output

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3
Q

Negative Balance

A

Output exceeds input

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4
Q

Weight of both kidneys

A

300 grams of <0.5% body weight

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5
Q

How many nephrons in adult Kidney?

A

1.2 million… can life active life with only 25% of these

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6
Q

Superficial Nephrons

A

short loop of Henle
efferent arteriole gives rise to peritubular capillaries
no thin ascending limb

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7
Q

Juxtamedullary Nephrons

A

long loop of Henle
Thin ascending limb
Efferent arteriole gives rise to peritubular capillaries AND ascending vasa recta

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8
Q

Proximal Tubule

A

Brush border on apical side, highly invaginated basolateral membrane filled with mitochandria

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9
Q

Straight portion of Proximal Tubule (pars recta)

A

much less well endowed with basolateral infoldings and mitochandria

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10
Q

Thin descending and thin ascending loop of Henle

A

poorly developed apical and basolateral membranes and few mitochandria

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11
Q

Thick ascending Limb of Henle and Distal Tubule

A

Extensive basolateral infoldings with mitochondria

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12
Q

Collecting Duct

A

Principle cells and Intercalated cells

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13
Q

Principle cells

A

Moderately invaginated basolateral membrane with few mitochondria.
Important for Na and Cl reabsorption

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14
Q

Intercalated Cells

A

Have high density of mitochondria
One population secretes H+
The other secretes HCO3-

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15
Q

Renal Blood flow

A

25% of cardiac output

5L/min and 25%= 1250ml/min-1ml/min=1249ml/min

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16
Q

Urinary Flow Rate (V)

A

1 ml/min

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17
Q

Renal Plasma Flow

A

Renal Blood Flow (RBF) x (1-hematocrit)

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18
Q

Water

A

180L/day filtered

42L in human

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19
Q

Sodium

A

25,000 mEq/day filtered

3,000 mEq in human

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20
Q

3rd space

A

Part of ECW including peritonea, synovial, pleural, cerebral spinal fluids, saliva.
Increase in 3rd space with ascites

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21
Q

Plasma

A

92& water
7% protein
1% small solutes

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22
Q

ECW

ICW

A

Na, Cl, HCO3-

K, organic phosphate and protein

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23
Q

Volume (equation)

A

Volume= amount/concentration

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24
Q

Osmolality

A

The concentration of discrete osmotically active particles in solution
Function of # particles regardless of mass, charge, size

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25
Which has higher osmolality, interstitium or plasma?
Plasma bc of higher protein concentration
26
Generalized Edema
Both ICFV and ECFV expand Osmolality falls Gain of isoosmotic/isotonic NaCl Add Pure water Decreased excretion by kidneys of Na and Cl
27
Severe Diarrhea
Only ECFV expands No change in osmolality Loss of isosmotic/isotonic NaCl Add isotonic NaCl
28
Hot Desert/Sweating
ICFV shrinks, ECFV expands Loss of Pure water or hypotonic NaCl Add Pure NaCl
29
GFR (equation)
Ccr= Ucr x V --------- Pcr
30
Plasma Ultra Filtrate Systemic Glomerular
Systemic- declines bc hydrostatic pressure falls | Glom- declines bc oncontic pressure rises
31
Filtration Fraction
GFR/RBF= 0.2 (20% filtered)
32
Any change in Efferent Arteriole Resistance results in what?
A change in the Fractional Filtration (FF)
33
Where is Renin made?
Juxtaglomerular Apparatus
34
Juxtaglomerular Apparatus
1. Macula Densa Cells (thick ascending) 2. Renin producing Granular Cells (afferent arteriole) 3. Extraglomerular Mesangial Cells
35
Factors that Inc/Dec Renin secretion
``` Nerve stimulation (NE/E) (cAMP) Renal vascular baroreceptors (Ca) Prostaglandins (cAMP) Macula Densa Mechanism (dec distal Na) ANGIOTENSIN II = inhibits renin secretion (feedback) ```
36
Prostaglandins
Increase bc of vasoconstrictors and cause vasodilation of the afferent and efferent arterioles
37
Nitric Oxide
Vasodilator Sensitive to arganine analogs NO increases with shear stress, bradykines, ACh, ATP
38
Trancellular Reabsorption
Across the apical membrane the cytoplasm and the basolateral membrane
39
Paracellular Reabsorption
Between renal tubular cells across the tight junction and thru the lateral intercellular space
40
If glucose exceeds the renal threshold above which TM is exceeded
Glucosuria | Uncontrolled Diabete
41
If glucosuria is observed even when plasma glucose is below renal threshold
GFR is extremely high --> Pregnancy Transporters are impaired--> Genetic mutation or proximal tubule damage
42
Which electrolyte is similar to glucose?
Phosphate
43
What is urea reabsorption dependent on?
Flow
44
Describe the mechanism of urea
The flow rate decreases as water is reabsorbed from lumen in to interstitial. Consequently, urea becomes more concentrated in tubular lumen and then gets reabsorbed down its chemical gradient in to the interstitium
45
Amount Reabsorbed (equation)
GFR x Pgluc x Ugluc x V= amt reabsorbed
46
Amount Secreted (equation)
Ux x V - GFR x Px
47
PAH
Para-aminohippurate TMpah= 80mg/ml 90% is not bound to proteins aka freely filtered Undergoes secretion in proximal tubule by secondary transport
48
Sodium Reabsorption in Early Proximal Tubule
``` Na-H antiporter Na-glucose symporter--> electrogenic Na-amino acid symporter Na-lactate symporter 3Na-phosphate antiporter ```
49
Sodium Reabsorption in Late Proximal Tubule
``` Na-H antiporter Cl-anion antiporter Passive diffusion of Cl through paracellular--> results in positive potential difference therefore drives passive Na reabsorption 50% of NaCl reabsorption here 2Na-glucose symporter ```
50
How much water, Na and Cl does the proximal tubule reabsorb?
67% 2/3 trancellular 1/3 paracellular Reabsorbs all of glucose, amino acids, HCO3, lactate
51
Is the proximal tubule hyperosmotic or isosmotic?
slightly hyper osmotic but wesay that it's isosmotic bc water is highly permeable here
52
An increase in oncotic pressure or decrease in hydrostatic pressure in PTC will promote what?
Water reabsorption
53
What stimulates sodium reabsorption in proximal tubule?
Angiotensin II and catecholamines
54
What inhibits sodium reabsorption in proximal tubule?
Nitric oxide | Atrial natriuretic factor
55
Ouabain
Na-K ATPase inhibitor
56
Acetozolamide (diamox)
Carbonic anhydrase inhibitor
57
Mannitol
Osmotic diuretic
58
Sodium Reabsorption in Loop of Henle
25% sodium reabsorbed | 15% water (only thin descending)
59
Thick ascending limb of Henle
Na-K-2Cl symporter
60
Furosemide (lasix)
inhibits the Na-K-2Cl symporter | aka unreabsorbed solutes
61
Proximal Tubule and Thick ascending limb of Henle Diuretics
67% and 20% of filtered potassium is usually reabsorbed so profound potassium wasting with these drugs
62
Early Distal Tubule
Na-Cl symporter in apical membrane Thiazide diuretics block this Impermeable to water
63
Late Distal Tubule and Collecting Duct
Reabsorb NaCl and Water Na channel in apical membrane Ameloride and Triamterene- Inhibit this channel Potassium sparing diuretics
64
What is the major factor that stimulates Na reabsorption in the distal tubule and collecting duct?
Aldosterone | Secreted by adrenal cortex (in response to angII or increase plasma K)
65
Within minutes of stimulation...
Aldosterone increases reabsorption Increases protease activity Inserts more Na/K-ATPase in basolateral membrane
66
Within several hours...
Increase gene expression of Na-K-ATPase and Na-Cl symporter
67
Spironolactone
Potassium sparing diuretic | Binds to mineralocorticoid receptor
68
Atrial natriuretic and Brain Natriuretic Peptides inhibit what?
NaCl and water reabsorption by medullary collecting duct

Renal Physiology (1 decks)

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