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Renal 2
Dr. Baer's 2nd lecture
32
Physiology
Undergraduate 2
02/26/2012

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Term
The two types of nephrons with main difference.
Definition
Cortical - Makes dilute urine
Juxtamedullary - Makes concentrated urine
Term
The four renal processes.
Definition
Filtration, reabsorption, secretion, and excretion.
Term
Filtration occurs here.
Definition
Glomerulus/Bowman's capsule.
Term
Podocytes.
Definition
Capsule epithelium cells that surround capillaries. They curl around the capillary. Controls how much fluid comes out of capillaries.
Term
Amount of plasma filtered.
Amount of cardiac output directed to kidneys.
Definition
Filtered: ~20%
Amount of C.O: ~25%
Term
Amount of fluid filtered.
Urinary output.
**Don't need to memorize, but couldn't hurt to know**
Definition
Filtered: 125 mL/min. or 180L/day
Output: 1.5L/day so most is reabsorbed.
Term
Glomerular Filtration Rate (GFR)
Definition
Volume of plasma filtered over time by glomerulus.
Term
Changes in GFR often change...
Definition
Urine output.
Term
Low GFR generally indicates...
Definition
Renal failure. (This is BAD!)
Term
A force which PROMOTES filtration is.
Definition
BLOOD PRESSURE: 55mmHg in capillaries. This is high.
Term
A force which OPPOSES filtration is.
Definition
OSMOTIC PRESSURE: (especially oncotic pressure) 30 mmHg
TUBULE PRESSURE: (from fluid in capsule) 15 mmHg
Term
GFR autoregulation.
Definition
Maintenance of constant GFR over a wide range of b.p. This requires altering renal VASCULAR RESISTANCE.
Term
Myogenic Intrinsic Control.
Definition
If theres more pressure in the tube BEFORE the glomerulus the tube gets smaller letting less in so it can handle it.
Term
Effect of increase in blood pressure on glomerular apparatus.
Definition
Opens stretch sensitive ion channels in AFFERENT arteriole so more calcium comes in and the blood vessels constrict, lowering blood flow.
Term
Tubuloglomerular feedback is sensed by.
Definition
Macula densa - cells in the distal tubule by the glomerulus.
Term
Tubuloglomerular feedback response.
Definition
Paracrine hormone is released to constrict the afferent arteriole.
Term
Extrinsic sympathetic innervation's mechanism of action.
Definition
Reduces GFR, can occur during hemorrhage, afferent arteriole vasoconstriction, decreased glomerulus permeability.
Term
Mesangial cells.
Definition
Surrounds glomerular capillaries, reduces glomerular permeability, stimulated by sympathetic nerves or angiotensin II.
Term
Roll of podocytes in permeability.
Definition
Podocytes will contract and flatten out. This decreases the space between them meaning less filtration area.
Term
Ccr
Definition
Clearance of Creatinine
Term
Clearance
Definition
Filtered volume from which a solute has been removed. This is the amount of filtered substance that is not reabsorbed, metabolized, or secreted.
Term
Characteristics of test substance for filtration.
Definition
Need a solute that is not reabsorbed, metabolized, or secreted.
Term
50 mg/mL of solute in 100 mL of afferent blood.

40mg/mL of solute in 100 mL of efferent blood.

Clearance is?
Definition
20mL. 80mL of fluid is needed to keep the amount of solutes at the same concentration as the afferent blood.
Term
Used experimentally to find GFR. Reason why it sucks.
Definition
INULIN clearance. Must be constantly infused into the patient.
Term
Creatinine.
Definition
A muscle metabolism byproduct. Has a fairly constant plasma level.
Term
Formula for Mass filtered = Mass excreted.
Definition
Filtration rate x Plasma conc = Urine conc x Urine Volume
Term
GFR = (formula)
Definition
[U x V(rate)]/P in mL/min.
Term
Volume cleared.
Definition
Filtered fluid volume that returns to the plasma without the solute.
Term
Characteristics of test substance for plasma flow.
Definition
Must be both filtered AND secreted but not absorbed. TOTAL CLEARANCE must occur (remove all solute).
Term
Typically used to measure Renal Plasma Flow.
Definition
p-aminohippuric acid (HAP) is totally cleared so it is used to measure RPF.
Term
RPF = (formula)
Definition
(Upah x V)/Ppah

Upah is urine concentration of PAH
Ppah is plasma concentration of PAH
V is the rate of flow of urine over 24h
Term
Renal Blood Flow (RBF) = (formula)
Definition
RBF = RPF/(1-Hct)

Where: Hct is hematocrit, the percent of RBC's in blood.
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