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27 Cards in this Set
- Front
- Back
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Reabsorption takes place in :
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loop of henle, convoluted tubules, collecting ducts.
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Active Secretion:
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acid and base pumps in the proximal tubules and P-glycoprotein
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Excretion
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Urine flows from the kidneys to the ureters, bladder, out the urethra.
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quantitive measures
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GFR and crcl
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glomerular filtration depends on the SNGFR (single nephron glomerular filtration rate)
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Renal Flow (20% of blood flow)
Hydrostatic pressure (pushs out of the capillaries into the glomerulus, facilitating filtration) |
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Tubular function:
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Proximal tubules
Loop of Henle Distal Convoluted Tubule Collecting tubules |
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Proximal Tubule:
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ADH causes water reabsorption
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Loop of Henle (LOH)
responsible for concentrating urine |
Water, Na, Cl reabsorption in thin ascending limb.
EXTENSIVE Na, Cl, Ca (PTH) reabsorption in thick ascending limb. |
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Distal Convoluted Tubule (DCT): responsible for diluting urine.
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Na, Cl, Ca are reabsorbed here.
H+ ion and K are secreted in DCT. |
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Collecting tubule:
fine tune the composition of urine |
ADH: causes water reabsorption.
ANP and aldosterone: Na reabsorption Aldosterone: K and H+ ion secretion; some HCO3 reabsorption |
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Kidney functions:
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1. Excretory
2. Regulatory 3. Metabolic 4. Hormonal 5. Endocrine function |
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Endocrine Function:
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Erythopoietin (EPO)
PGs and Kinins |
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Erythropoetin (EPO):
Uses: produced when: |
ESRD, CANCER, AIDs
Produced in: anemia, ischemia, decrease atmosphere levels of Oxygen Must be adequate iron, B12, folate. |
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aldosterone:
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Collecting duct:
Increase reabsorption of Na and water. Secreation of K and H+ |
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Decrease in renal blood flow
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- AT II
- Catecholamin |
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PTH
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STIMULATES VITAMIN D.
NEED VITAMIN D3 IN RENAL DZ. |
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Where does carbonic anhydrase inhibitor work?
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- proximal convoluted tubule
- (Diamox - Acetazolamide) - MOA: prevent conversion of CO2 and water into carbonic acid in the tubular lumen. |
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Most commonly used for Carbonic Anhydrase inhibitor:
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- glaucoma
- metabolic alkalosis. |
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Loop diuretics used:
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- hyponatremia
- renal failure - hypercalcemia - HTN - Peripheal and pulmonary edema. |
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Loope of Henle MOA:
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BLOCK sodium - potassium - 2 chloride symport
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Loop diuretics:
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Lasix: absorption decreased with gut edema. )50% oral
Bumex: 100% oral Demadex Edecrine (ethacrynic acid): more ototoxicity. |
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Thiazide diuretics:
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distal convuled tubules
Na-Cl symport Hypo natremia : block the diluting portion of the nephron. |
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Thiazide diuretics used in:
generally ineffective in pt CrCL < 30-50 mL/min |
HTN, CHF, ascites.
Increase risk of torsades due to K. |
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Potassium-Sparing Diuretics:
contraindicated K > 5.5 or Cr > 2. |
Collecting Duct
- Dyrenium & Midamor: not effective diuretics. - Inspra and Aldactone: aldosterone antagonists: causes Na loss and K retention. |
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Causes of diuretic resistance:
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1. excessive Na
2. reduced renal blood flow. 3. inadequate doses or absorption. |
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Diuretic Resistance:
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Acute: due to diuretic induced volume loss; replete excess volume loss to overcome
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Chronic diuretic resistance:
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- hypertrophy of the distal nephron allows more than quantities of Na to be reabsorbed in the distale tubule. (tx: metolazone)
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