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19 Cards in this Set
- Front
- Back
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# of glomeruli
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600,000-1.2 million
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filtration surface area of the kidney
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125-250 cm^2
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Not all the glomerular capillaries are filtering in the same capacity. There are changes that occur that will determine how many capillaries are filtering. What determines how many glomerular capillaries are filling?
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colloid osmotic pressure increasing
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Which is a nonselective process?
a. filter b. ultrafilter |
a. filter is a non-selective process for ions like Na, K, Cl, etc.
ultrafilter is a selective process (ie. in the case of specific molecules like urea, creatinine, glucose, etc) POINT: the glomerulus is BOTH a filter and ultrafilter |
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how will the kidney of a volume depleted patient respond in a natural setting?
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systemic hypoperfusion will lead to systemic release of both AGII (efferent >afferent constriction) and norepi (efferent=afferent constriction)
this will lead to net renal vasoconstriction which decreases RPF, maintains GFR and shunts blood away from kidney and toward coronary/cerebral circultion afterwards, prostaglandins come and decrease arteriolar tone in order to prevent excessive renal ischemia |
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severely hypoperfused patient (who's in shock) is now going into acute renal failure. he is on NSAIDs for his rheumatoid arthritis. what went wrong? what should you do?
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hypoperfused pt will naturally have increase vasoconstrictor concentration (norepi and AG II) in body. with so much vasoconstriction, you need to have prostaglandins to decrease arteriolar tone in order to prevent excessive renal ischemia.
NSAID usage inhibited PG production adn lead to acute renal failure. take patient off the NSAIDs!! |
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what does the macula densa do in response to decrease renal perfusion (decreased GFR)?
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2 things:
1) tubuloglomerular feedback: increase dilation of AFFERENT glomerular arteriole 2) EFFERENT arteriole constriction via increased release of renin (to increase AG II production) BOTH OF THESE EVENTS WILL INCREASE GFR ONCE AGAIN |
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single nephron glomerular filtration rate (SNGFR) is a ACTIVE/PASSIVE process of ultrafiltration of plasma across the semi-permeable capillary wall.
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passive
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normal GFR is _____ ml/min
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120
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what is the "intact nephron hypothesis"
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Dz kills certain number of glomeruli; remaining nephrons will compensate to keep filtration constant but they will hypertrophy in response
How bad this dz is is determined by how many nephrons you have per kidney (variable across different people). The critical point is when you only have 50% of the baseline glomeruli left bc of the dz, then you are in trouble. As glomerulus begins to adapt by filtering more, it becomes a hyperfiltering glomeruls. |
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severely hypoperfused patient (who's in shock) is now going into acute renal failure. he is on NSAIDs for his rheumatoid arthritis. what went wrong? what should you do?
|
hypoperfused pt will naturally have increase vasoconstrictor concentration (norepi and AG II) in body. with so much vasoconstriction, you need to have prostaglandins to decrease arteriolar tone in order to prevent excessive renal ischemia.
NSAID usage inhibited PG production adn lead to acute renal failure. take patient off the NSAIDs!! |
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what does the macula densa do in response to decrease renal perfusion (decreased GFR)?
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2 things:
1) tubuloglomerular feedback: increase dilation of AFFERENT glomerular arteriole 2) EFFERENT arteriole constriction via increased release of renin (to increase AG II production) BOTH OF THESE EVENTS WILL INCREASE GFR ONCE AGAIN |
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single nephron glomerular filtration rate (SNGFR) is a ACTIVE/PASSIVE process of ultrafiltration of plasma across the semi-permeable capillary wall.
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passive
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normal GFR is _____ ml/min
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120
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what is the "intact nephron hypothesis"
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Dz kills certain number of glomeruli; remaining nephrons will compensate to keep filtration constant but they will hypertrophy in response
How bad this dz is is determined by how many nephrons you have per kidney (variable across different people). The critical point is when you only have 50% of the baseline glomeruli left bc of the dz, then you are in trouble. As glomerulus begins to adapt by filtering more, it becomes a hyperfiltering glomeruls. |
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changes in plasma volume, BP, RBF, and GFR in a pregnant woman
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increased plasma vol, dec BP, inc RBF, inc GFR (by 50% in the 1st trimester)
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how much does GFR decrease after 35-40 years of age?
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10 mL/decade (as GFR decreases with age, you're more susceptible to problems)
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what is the definition of chronic kidney disease?
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structural or functional abnormalities of the kidneys for greater/equal to 3 months, as manifested by:
-proteinuria OR low GFR (below 60 mL/min) |
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kidney failure is the last stage of CKD and is defined as less than ___ ml/min in GFR or being on dialysis.
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15 ml/min
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