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Renal Physiology- Effectors
hormones, etc., affecting renal physiology
21
Medical
Professional
01/27/2012

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Term
sympathetic innervation
Definition
minimal SANS tone @ normal ECFV
decreased ECFV increases SANS activity
increased tone -> NE, dopamine release at nerve terminals, circulating epi release by adrenal medulla
NE, epi @ alpha-1-adrenoreceptors
vasoconstriction -> decreases GFR, RBF
degraded by renalase
Term
angiotensin II
Definition
ang II causes vasoconstriction -> decreases GFR/RBF
constricts both AAs and EAs
deceases Kf
Term
prostaglandins
Definition
PGE1, PGE2, PGI2 released due to decreased EVFC (ie hemorrhage, when vaso constriction would lead to renal ischemia), shear stress, dehydration, ang II
increases RBF, may cause no change or increase in GFR
dampens vasoconstrictive effect of SANS, ang II
inhibited by NSAIDs
Term
nitric oxide
Definition
NO vasodilates both AAs and EAs
decreases TPR, increases RBP/GFR
counters catecholamines, ang II
released in response to shear stress, Ach, histamine, bradykinin, ATP
Term
endothelin
Definition
vasoconstricotr of AAs, EAs
stimulated by shear stress, stretch, ang OO, bradykinin, epi, decreased ECFV
Term
bradykinin
Definition
vasodilator released in response to high PGs, low ACE
stimulates NO, PGs
increases GFR/RBF
ACE degrades, inactivates
Term
adenosine
Definition
usu. vasodilates
vasoconstricts AAs in kidneys
decreases GFR/RBF
tubuloglomerular feedback
Term
ANP
Definition
increases w/ increased ECFV
dilates AAs and constricts EAs
some elevation of GFR and constant RBF
Term
ATP
Definition
either vasoconstrictor of AAs (decreases GFR/RBF) or stimulates NO (increases GFR/RBF)
Term
glucocorticoids
Definition
increase GFR/RBF
Term
histamine
Definition
decreases resistance of AAs and EAs
increases RBF w/ constant GFR
Term
dopamine
Definition
produced by PCT
vasodilator- increases RBF
inhibits renin
Term
vasoconstrictors
Definition
sympathetic tone (epi NE)
ang II
endothelin
adenosine (AAs only; vasodilates outside of kidneys)
ATP (AAs only)
Term
vasodilators
Definition
PGs
NO (can be stimulated by ATP)
bradykinin
ANP (dilates AAs and constricts EAs)
glucocorticoids
histamine
dopamine
Term
PGE2 specific
Definition
diruretic/ natriuretic effects
inhibition of NaCl reabsorption (TAL, LDT, CD)
inhibits ADH cAMP in LDT, CD
increases vasa recta blood flow decreasing interstitial OsM
Term
increased water/ NaCl reabsorption, increased K+ secretion in LDT, CD
Definition
increased ADH
increased plasma [K+]
aldosterone
increased tubular flow
Term
aldosterone effects in LDT/CD?
Definition
1. bind to/upregulate nuclear receptors
2. insertion of apical Na+ channels and basolateral Na+/K+ pumps
3. increased synthesis of TCA Cycle intermediate to power pump
Term
ADH in LDT/CD?
Definition
stimulates insertion of apical water channels (aquaporin 2 channels) via adenylate cyclase -> cAMP -> PKA mxn; aquaporins removed in absence of ADH
Term
amiloride (K-sparing)
Definition
blocks Na+ epithelial channel in LDT/CD (as well as Na+-H+ exchanger)
may cause acidosis, hyperkalemia
Term
loop diuretics (Furosemide/Lasix)
Definition
inhibits Na-K-Cl luminal transporter on TAL, may cause hypokalemia, hypomagnesiumemia, hypocalcemia due to diminished positive luminal voltage
Term
thiazide diuertics (HCTZ)
Definition
inhibit Na+-Cl- symporter in DT
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