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Phys III-I
Renal Physiology
117
Other
Not Applicable
03/31/2004

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Term
Kidneys sythesize and secrete:
Definition
renin, erythropoietin, 1,25-dihydroxycholecalciferol
Term
glomeruli in outer cortex, short loops of Henle,
Definition
superficial cortical nephrons
Term
glomeruli near corticomedullary border, long Henle loops, larger glomeruli, higher filtration rates, essential for urine concentration
Definition
juxtamedullary nephrons
Term
ultrafiltration occurs across:
Definition
glomerular capillaries
Term
% Body weight is ECF (Na+, Cl-, HCO3-)
Definition
20%
Term
% Body weight is ICF (K+, Mg+, Protein-, Organic Phosphate-)
Definition
40%
Term
Total Water
Definition
60%
Term
Osmolarity of body fluids
Definition
290 mOsm/L
Term
clearance equation
Definition
C= Urine Conc x Urine flow rate/ Plasma Conc
Term
Renal; blood flow %
Definition
25%
Term
incr renal arterial press -> incr fluid to macula densa -> constrxn of afferent arteriole
Definition
tubuloglomerular feedback
Term
incr press -> renal arterioles constrict
Definition
myogenic mechanism
Term
measure renal blood flow
Definition
RBF = Renal Plasma Flow (RPF)/1-hematocrit (frxn of blood vol occupied by plasma)
Term
inulin is filtered, but not reabsorbed or secreted by reanl tubules and its clearance measures...
Definition
GFR(Glomerular Filtration Rate)
Term
Filtration across the glomerular capillaries is...
Definition
GFR
Term
Dilation of afferent arteriole or constriction of the efferent arterioles causes...
Definition
increase in Pgc (glomerular capillary hydrostatic pressure)
Term
constrxn of ureter causes...
Definition
increase in Pbs (Bowman's space hydrostatic pressure) which -> decreases in GFR and net ultrafiltration pressure
Term
increases along length of glomerular capillary b/c water filtration incr protein conc of glomerular capillary blood...
Definition
Pi gc (Glomerular capillary oncotic pressure)
Term
PAH clearance rate
Definition
high
Term
Protein, Na, Gluc, Bicarb clearance rates
Definition
low
Term
glomerular marker w/ clearance equal to GFR
Definition
inulin
Term
GFR x [Plasma]
Definition
filtered load
Term
V x [Urine]
Definition
Excretion Rate
Term
filtered load - excretion rate
Definition
reabsorption rate
Term
excretion rate - filtered load
Definition
secretion rate
Term
if filtered load is greater than excretion rate, then..., but if filtered load is less than excretion rate, then...
Definition
net reabsortion/net secretion
Term
region of glucose curve between threshold and Tm (250-350 mg/dl), represents excretion o fgluc in urine before saturation (Tm) is fully achieved
Definition
splay
Term
Clearance; Cx/C inulin is > 1.0 the substance is filtered/secreted/both...give examples
Definition
both filtered and secreted; organic acids and bases and sometimes K+
Term
In a person whose cardiac ouput is 5 l/min, the RBF is _____/min or _____/day.
Definition
1.25; 1800
Term
Renal Vasoconstrictors (3)
Definition
SNS Catecholamines; Angiotensin II; Endothelin
Term
Renal Vasodilators (5)
Definition
PGE2; PGI2(Non-steroidal antiinflammatory drugs inhibit synth of prostaglandins, interfering with the protective effects of prostaglandins on renal fxn following hemmorrhage); NO; Bradykinin; Dopamine(low dosage only)
Term
Renal Plasma Flow RPF=
Definition
[U] PAH x (Urine flow rate)/
[RA] PAH - [RV] PAH
Term
Effective RPF
Definition
[U] PAH x Urine Volume/[P] PAH = C PAH, this underestimates true RPF by 10%
Term
RBF=
Definition
RPF/1-Hct, where 1-Hct is fraction of blood volume occupied by plasma
Term
Portion of blood filtered into Bowman's space is the ultrafiltrate which contains _____ and all of the ______, but not the _____ and ______.
Definition
water, small solutes; protein, blood cells
Term
GFR = (Kf) x (net ultrafiltration pressure) =
Definition
Kf [(Pgc - Pbs) - Pi gc]
Term
Pi gc or Oncotic pressure in glomerular capillaries is determined by...
Definition
protein concentration of glomerular capillary blood and it increases along the length of the capillary as fluid is filtered out
Term
1mmol CaCl2 dissolved in 1 L of water = _____ mosm/L
Definition
3
Term
Osmolarity: 1 mosm/L =
Definition
19.3 mmHg
Term
Proteins: Plasma ___, Interstitial ____, Cell ____.
Definition
1.2, 0.2, 4.0
Term
To treat patient in which water loss exceeds salt loss (Na is high, Hypersomotic dehydration), use...
Definition
D5 1/4 Saline
Term
Normal Glucose
Definition
70-110 mg/dl
Term
Normal Na
Definition
137-144 mmol/l
Term
Normal K
Definition
3.5-5.0 mmol/l
Term
Normal Cl-
Definition
100-108 mmol/l
Term
Normal CO2
Definition
24-32 mmol/l
Term
Normal anion gap
Definition
5-15
Term
Normal BUN
Definition
8-22 mg/dl
Term
Normal creatinine
Definition
0.5-1.4 mg/dl
Term
Normal Ca
Definition
8.9-10.4 mg/dl
Term
Normal phosphorus
Definition
2.5-4.5 mg/dl
Term
Normal total protein
Definition
6.0-8.0 gm/dl
Term
Normal albumin
Definition
3.5-5.0 g/dl
Term
Normal RBF
Definition
1200 ml/min or 20% of cardiac output
Term
Normal RPF
Definition
650 ml/min
Term
Normal GFR
Definition
125 ml/min
Term
short nephrons aka...
Definition
cortical nephrons
Term
long nephrons aka...
Definition
juxtamedullary nephrons
Term
Condition with injury and inflammation to glomerulus and red cell in urine
Definition
acute glomerulonephritis
Term
creatinine clearance is used as a glomerular marker to measure _______ which it slightly overestimates because it is secreted at a low level.
Definition
GFR
Term
Filtration fraction = _______ and its normal value is ___ % and thus increases in filtration fraction produce an increase in _______ concentration.
Definition
GFR/RPF; 20; protein
Term
Indomethacin blocks the synthesis of vasodilator ______, thus reducing_____ and ______.
Definition
Prostaglandins; blood flow; GFR
Term
Proximal tubule-resorption by Na/K ATPase of...
Definition
Na (glucose, aa, phosphate, lactate, H+ by secondary active transport moved against conc gradient by taking a ride on the favorable Na gradient)
Term
Proximal Tubule-substantial proportion of filtered _______ are reabsorbed by endocytosis
Definition
proteins
Term
Proximal tubule-Non-specific anion carrier secretes ...(11)
Definition
urate, fatty acids, steroid hormones, bile salts, hippurates, chlorothiazides, sulfonylureas, bumetanide, penicillin, furosemide, salicylates
Term
Proximal tubule-non-specific cation carrier secretes ... (3)
Definition
creatinine, catechols, morphine
Term
Late proximal tubule- _____ moves passively carrying with it _____ (3)
Definition
Cl- ; Na, Ca, Mg, etc
Term
Henle's Loop-Thin descending limb is _____ to water and relatively ______ to ions.
Definition
permeable; impermeable
Term
Henle's Loop-Thin ascending limb is _____ to water but ____ is reabsorbed passively
Definition
impermeable; Na
Term
Henle's Loop-Thick ascending limb is only segment which actively reabsorbs _____ and the entire ascending limb is relatively _______ to water.
Definition
solute; impermeable
Term
Late distal tubule and collecting duct-alpha intercalated cell does ______.
Definition
K+ reabsorption
Term
Late distal tubule and collecting duct-principal cell does______.
Definition
K+ secretion
Term
Glucose reabsorption depends on _______ ________ which have a Tm based on the ________.
Definition
saturable carriers; number of transporters
Term
Na transport is/is not saturable in proximal tubule b/c the Tm for Na is _______ than the load of sodium and the main limitation for Na reabsorption in prox tubule is _______.
Definition
is not; much higher; back leak of Na back into the tubular fluid.
Term
If filtration rises momentarily, then tubular hydrostatic pressure _____, peritubular capillary hydrostatic pressure ______ and peritubular oncotic pressure _____.
Definition
rises, falls, rises and all three of these favor reabsorption in proximal tubule
Term
With volume expansion there is a small rise in GFR but larger rise in fluid escaping filtration and thus peritubular capillary hydrostatic pressure ______ and peritubullary capillary pressure ______. Both factors impede reabsorption, tubular flow increas
Definition
rises; falls
Term
Water reabsortion is _____ and it occurs by two methods: _____ and ______.
Definition
passive; tight jxns; aquaporins
Term
Glomerulotubular balance-if filtration were to increase, then the icreased hydrostatic pressure in the tubule would increase/decrease prox tubule reabsorption. Thus about ___ % of fluid is reabsorbed in the proximal tubuleeven when filtered load varies.
Definition
increase; 65%
Term
Reabsorption and secretion require...
Definition
transporters in the membranes of the epithelial cells
Term
Gluc reabsorption requires _______ across the luminal mb and _______ across the peritubular mb.
Definition
Na-gluc coport; facilitated gluc transport
Term
Splay is explained by ______ of the Na-gluc coporter and the ______ of nephrons.
Definition
low affinity; heterogeneity (of Tm)
Term
Urea reabsorption is by ______ _______ mechanism
Definition
simple diffusion
Term
renal clearance is defined as...
Definition
volume of plasma which is completely cleared of the substance per unit time (units are ml/min) and the formula is = (Ux)(V)/(Px)
Term
Renin-Angiotensin System: Low BP, Low Fluid Volume, High Beta-1 Symp --> Incr _____ levels
Definition
Renin
Term
Plasma K+ levels go ___ w/ diuretics, diarrhea, and diaphoresis
Definition
down
Term
Plasma K+ levels go ___ w/ insulin, epi, or aldosterone.
Definition
down
Term
Aldosterone promotes the reabsorption of ___ in the ___ .
Definition
Na; distal nephron
Term
Aldosterone promotes the excretion of ___ which is related to the ___ retaining action.
Definition
K+; Na+
Term
Aldosterone's mechanism of action is to act by synth of the ___ in the ___ cells which stimulates lumenal ___ permeability.
Definition
Na/K ATPase; principal; Na
Term
Aldosterone is stimulated by elevated plasma ___ or ___ and inhibited by ___ which is released as a result of stretch in the ___.
Definition
K+, angiotensin; ANP; cardiac atria
Term
The natriuretic factors include: (7)
Definition
ANP, urodilatin, Brain natriuretic peptide, dopamine, bradykinin, prostaglandins, nitric oxide
Term
___% of filtered K+ is reabsorbed before ___ which is where K+ ___ takes place.
Definition
distal nephron; secretion
Term
Parathyroid Hormone (PTH) stimulates ___ excretion.
Definition
Phosphate
Term
Volume depletion incr Na reabsorption, phosphate follows and phosphate ___ rises/falls.
Definition
excretion; falls
Term
While there is a finite capacity to reabsorb K+, its reabsorptive Tmax can be regulated up/down if dietary phosphate is low.
Definition
up
Term
all urine production in excess of osmolar clearance is ___ clearance.
Definition
free water
Term
In prox nephron, urine osmolarity is ___ and ___ is reabsorbed.
Definition
300; water
Term
In ascending loop of Henle, urine osmolarity incr/decr to ___ while ___ is reabsorbed.
Definition
decr; 80; solute
Term
In distal nephron and collecting duct, ___ is reabsorbed and urine osmolarity finally becomes ___.
Definition
water; 1200
Term
In medullary vasa recta countercurrent exchange descending portion, solute moves ___ the capillary lumen while H2Omoves ___. In the ascending portion, H2O moves ___ while solute moves ___.
Definition
into, out; into, out.
Term
ADH regulates ___ (not ___ excretion). Its primary mission is to ___ "free" water.
Definition
water; fluid; retain
Term
Urea permeability is affected by ___ which causes it to be ___ in the medulla.
Definition
ADH; trapped
Term
ADH renders the ___ nephron highly ___ to water.
Definition
distal; permeable
Term
In diabetes insipidus w/ polyuria, the plasma vol ___ while the plasma Na ___.
Definition
decr; incr
Term
With Syndrome of Inappropriate ADH secretion, there is incr/decr ADH which leads to plasma vol___, plasma Na___.(psychogenic drinking would have the same darrow-yannet)
Definition
incr, decr
Term
water deprivation or adipsia leads to plasma vol ___ w/ plasma Na ___.
Definition
decr; incr
Term
Addison's disease is high/low aldosterone leading to ___ plasma vol, ___ Na, and ___ K. Hyperaldosteronism is the opposite of this.
Definition
low; decr; decr; incr
Term
Adding CO2 to the system tends to ___ the pH
Definition
decr
Term
If we remove bicarb from the system, the pH will ___.
Definition
decr
Term
reabsorption of filtered HCO3- occurs in the cells of the ___. Here there is H+ ___ and if the H+ combines w/ ___ it will be retained. If combined with ___ it will be excreted.
Definition
prox tubule; secretion; bicarb; PO4
Term
Net acid excretion = ___ excretion + ___ - ___ excretion
Definition
NH4; titratable acid; bicarb
Term
Base excess is a value which describes how many mEq of___ must be given to a patient to return the ___ to normal.
Definition
H+; pH
Term
In metabolic acidosis, bicarb must ___ and so, in most cases, anion gap incr/decr. Anion gap = __ - [___ + ___]
Definition
Na - [HCO3 + Cl]
Term
Increased anion gap due to metabolic acidosis caused by ...
Definition
DM, lactic acidosis, salicyclate poisoning, chronic renal failure, alcohol, ethylene glycol
Term
Normal anion gap due to metabolic acidosis caused by ...
Definition
diarrhea, carbonic anhydrase inhibitors, renal tubular acidosis, ammonium chloride
Term
metbolic alkalosis that responds to NaCl(saline treatment) includes ___ and ___ in which the volume depletion initiates a compensatory incr in Na reabsorption which is coupled to ___ reabsorption and H+ ion secretion.
Definition
diuretics; vomiting; bicarb;
Term
other types of metabolic alkalosis include ___ and ___.
Definition
bicarb ingestion; hyperaldosteronism
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