Unit 4: Renal Physiology Pt3--Kidneys Flashcards
(49 cards)
What is the measure of renal function?
Glomerular Filtration rate (GFR)
What is the GFR equal to the clearance of?
- inulin
- serum creatinine
- blood urea nitrogen (BUN)
What is the normal GFR?
What must it be at to be considered Kidney (renal) Failure?
greater than 90 ml/min
GFR less than 15 ml/min
What does Renal Clearance describe?
rate at which substance are removed from the plasma
volume of plasma completely cleared of a substance by the kidneys per unit of time
What is the equation for Clearance of the kidney?
Clearance = (urine conc. of substance X) / (plasma conc. of substance X) x urine flow rate
What can urine flow rate vary from?
0 to 600 mL/min
if at 0 it means NOT cleared
What is the renal clearance proportional to? What is it inversely proportional to?
proportional–> to urine conc of susbtance X ( increase urine conc. of substance X; will increase clearance)
inversely proportional to –> plasma conc. of substance X
What three pieces of information do we need in order to calculate renal clearance?
- urine conc. of substance X (mg/mL)
- plasma conc. of substance X (mg/mL)
- urine flow rate (mL/min)
What does the clearance of inulin equal to? How is this possible?
equal to GFR rate
it is a fructose polymer and is FREELY filtered–> is not reabsorbed or secreted
What has the highest clearances through the kidneys? What is it equal to?
PAH (para-aminohippuric acid)
organic acid that is BOTH filtered and secreted
clearance of PAH = effective renal plasma flow
What can be used to estimate GFR in clinical practice? Why is it only an estimate?
Creatinine –> not perfect substance, b/c some creatinine is secreted by proximal tubule
10% error– which is cancelled by method that overestimates plasma creatine by 10%
What is the equation for Clearance Ratios?
= Clearance of X / Clearance of inulin
What does it mean if the Clearance ratio equals 1?
the clearance of x = clearance of inulin
therefore = GFR
What does it mean if the Clearance Ratio is greater than 1? What is an example of this?
the clearance of x > clearance of inulin
therefore substance x is BOTH filtered and secreted
Ex: PAH
What does it mean if the Clearance Ratio is less than 1? What are examples?
the clearance of x < clearance of inulin
Two Possibilities:
- Substance x is not filtered (Ex: albumen)
- Substance x is filtered and subsequently reabsorbed (Ex: glucose)
What fraction of resting CO do the kidneys receive?
1/4 of resting CO
= 125 ml/min
(180 L/day)
What are the four ways Regulation of Renal Blood Flow (RBF) occurs?
- SNS and circulating catecholamines
- Angiotensin II
- Prostaglandins (PGE2 and PG12)
- Dopamine
What are the afferent and efferent arterioles innervated by? Which one has more alpha1 receptors? What will stimulation do?
both innervated by SNS
Afferent Arterioles have more alpha1 receptors–> SNS stimulation will decrease GFR and RBF
What effect does stimulation of SNS have on kidneys?
decrease GFR and RBF
stimulate release or renin from juxtaglomerular cells
What type of cells is renin released from?
juxtaglomerular cells
What is a potent vasoconstrictor of BOTH Afferent Arterioles and Efferent Arterioles in the kidney?
Angiotensin II
Are Afferent Arterioles or Efferent Arterioles more sensitive to Angiotensin II? What effect will low and high levels of Angiotensin II have?
Efferent arterioles are more sensitive
Low Levels–> increase GFR by constricting Efferent Arterioles
High Levels–> decrease GFR by constricting BOTH Afferent and Efferent Arterioles
overall will decrease RBF
What is produced locally that will vasodilate both Afferent and Efferent Arterioles?
Prostaglandins
What activates Prostaglandins? Why?
activated by hemorrhage (will vasodilate AA and EE)–> to attenuate(reduce effect of) constrictor effects of angiotensin II and SNS to prevent renal failure