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15 Cards in this Set
- Front
- Back
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Function of kidney |
-Blood volume reg. (RAAS) -Electrolyte reg. -Excretion of waste products: urea, uric acid, drugs, creatinine -Produces Erythropoietin -Gluconeogenesis |
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Kidney Structure |
-14 Lobes -Lobe has renal pyramids w/ overlaying cortex -Cortex contains glomeruli -Pyramids contain loop of henle/collecting ducts -Can function w/ 1 kidney w/o impairment |
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Nephron |
1. Bowman Capsule includes glomerulus 2. PCT-proximal convoluted tubule 3. Loop of Henle. -Thin descending -Thick ascending 4. Juxtaglomerular apparatus 5. DCT distal convolued tubles 6. Cortical collecting tubule |
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Kidney Filtration |
-Filtration is passive. (H2O and small molecules (<5-10kDa) diffuse into proximal tubule -Secretion is active: Eliminates certain compounds -Reabsorption of water and solutes |
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Glomerulus |
-Blood enters Afferent, leaves Efferent -Filter 120-140ml/min (180L daily) -All but 1-2ml reabsorbed -GFR= volume of plasma filtered per unit of time |
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Renal function TEst |
-GFR -Essential for drug dose adjustment in renal impairment -Based on specific clearance (inulin or creatinine) -GFR = Analyte in urine x volume of urine/ analyte in plasma -Low GFR = increase Plasma urea, creatinine cystatin C -Other tests: color, pH, RBC, WBC, casts, glucose, crystals |
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Proximal convoluted tubule |
-Reabsorbs 85% NaHCO3, 66% NaCl, 60% water, 100% AA and Glucose (Na dependent glucose transporter) -Secretes acids/basis, diuretics -Apical: NHE3 (Na+/H+) exchange Basolateral: ATPase (Na+/K+), Na+HCO3- contransport -lumenal/intracellular Carbonic Anhydrase allows PCT cells to get CO2 back |
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Carbonic Anhydrase inhibitors |
-Inhibit CA in PCT -increases HCO3 secretion -Short acting -Helpful w/ Edema, glaucoma, gout, altitude sickness -Toxic: Hyperchloremic metabolic acidosis, kidney stones, Long term use need to admin more HCO3 |
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Thin Descending Limb (Loop of Henle) |
Passive water absorption -Prevented by Mannitol |
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Thick Ascending Limb (Loop of Henle) |
-NOT WATER PERMEABLE -Absorbs Mg and Ca via electrochemical gradient -Hypertonic innerstitium (countercurrent multiplier effect) -Apical: 15-25% of NaCl via NKCC2 -Diffusion of K+ to lumen creates positive gradient -Basolateral: ATPase (Na+/K+) -Target of Loops/Loss of Divalent Cations |
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Countercurrent Multiplier effect |
Cross currents improves efficiency of transport across gradients |
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Osmotic Diuretics - Mannitol |
-Prevents reabsorption of Water in PCT and thin descending limb -Acts as impermeant solute to retain water in tubular fluid -Increase extracellular volume of H2O -Poorly absorbed -IV -Toxic: edema, severe dehydration, hyponatremia |
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Loop Diuretics- Furosemide |
-Not limited by HCO3 -Most potent diuretic -Target NKCC2 in the Thick ascending Limb -Increase Mg2+ and Ca2+ loss -Pulmonary/periph edema -Acute renal failure -Toxic: hypokalemic metabolic alkalosis, loss of Mg2+, ototoxic |
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Distal Convoluted Tubule |
- NOT water permeable -Absorbs NaCl via NCC cotransporter -Apical: NCC (target of thiazide diuretics) -Basolateral: Absorbs Ca2+, Na+/Ca2+ exchange (regulated by PTH), ATPase (Na+/K+) |
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Thiazides-HCTZ |
-Target NCC1 in DCT -Increase Ca2+ reansorption Used: hypertension/heart fail/Kidney stones/Diabetes
Toxic: hypokalemic metabolic alkalosis/hyperglycemia/hyperlipidemia/ hyponatremia |
