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Renal Physiology

AB
Plasma clearance isthe volume of plasma that is cleared of a specific substance each minute
Proteins and glucose havezero renal clearance
The site of the is major RBF pressure drop isthe afferent arteriole
The renal blood flow (RBF) at rest, equivalent to1 L/min
Autoregulation dampens systemic blood pressure changes byaltering the afferent arterioles diameters
Autoregulation occursbetween 70 and 210 mmHg
Autoregulation of RBFis by myogenic and tubuloglomerular feedback mechanisms
Tubuloglomerular feedback occurs betweenmacula densa (MD) cells and cells of the afferent arteriole
When fluid delivery and NaCl transport at MD increasethere are increases in cell Na and Ca
Renin is produced atthe granular cells of afferent arterioles
Angiotensin II acts on the adrenal cortex inducingthe release of aldosterone
GBM sieving functionallows free passage of neutral molecules up 18 micron radius
In kidney disease, proteinuria may be dueto loss of negative charge selectivity or to increasing numbers of large size pores of the basement membrane
The thin segment of the loop of Henle is specialized forpassive transport
Active transport movesproteins, amino acids, glucose, fructose, and sodium, potassium, calcium, bicarbonate and chloride ions
Passive transport moveswater, chloride and sodium ions, urea, and lipid-soluble compounds
Sodium is actively transported acrossthe proximal tubule
Cortical Loop of Henle is responsible forthe reabsorption of solute
Medullary Loop of Henle is responsible forthe concentrating urine
Distal tubule is responsible forthe pH regulation by secreting H+ into the urine
ADH increases water reabsorption and concentrates urine in theCollecting ducts
ADH release is stimulated byincreased blood osmolality or a decrease in blood pressure
The atrial natriuretic factorinhibits ADH production
The ascending limb of the loop of Henleis impermeable to water
The medulla is composed ofrenal pyramids, separated by renal columns
Nephrons arecortical 80% and juxta-medullary 20%
The glomerular Bowman's capsule,proximal and distal convoluted tubules are located inthe cortex
The loop of Henle is located inthe medulla
Podocytes are cells that compose theinner layer of the Bowman's capsule.
The glomerular ultrafiltrate, formed under the force ofblood pressure
The glomerular filtration rate (GFR) isthe volume of filtrate produced by both kidneys
GFR ranges from115 to 125 ml/min.
The GFR can be regulated byconstriction or dilation of the afferent arterioles
Sympathetic innervation to the kidney causes .constriction of the afferent arterioles
About 65% of the filtered salt and water is reabsorbed acrossthe proximal convoluted tubules
The renal reabsorption of water occurs as a result ofthe countercurrent multiplier system
Sodium is actively extruded from theascending limb of Henle
In the ascending limb of Henle filtrate becomeshypotonic
The hypertonicity of the medulla is multiplied by apositive feedback mechanism
The collecting duct ispermeable to water but not to salt
The permeability of the collecting ducts to water is stimulated byantidiuretic hormone
Inulin is use to measurethe glomerular filtration rate
PAH clearance is a measure ofthe total renal blood flow.
In normal function all of the filtered glucose through the kidney isreabsorbed
Aldosterone stimulates sodium reabsorption and potassium secretion in thedistal convoluted tubule.
Aldosterone secretion is stimulated directly by a rise inblood potassium
Decreased renal blood flow stimulates the secretion of therenin
Renin is produced by thejuxtaglomerular apparatus.
Renin catalyzes the formation ofangiotensin I
Angiotensin II stimulates the adrenal cortex to secretealdosterone
Aldosterone stimulates the secretion ofH+, and potassium in exchange with Na+
Loop diureticsinhibit active Na+ transport in the ascending limb and early distal tubule
Osmotic diuretics are extra solutes thatincrease the osmotic pressure of the filtrate
The potassium-sparing diuretics act on the distal tubule toinhibit the reabsorption of Na+ and secretion of K+.
Renal dialysis is used to treatrenal insufficiency


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