Term
| Name the three endocrine functions of the kidney |
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Definition
1. erythropoeitin
2. Renin
3. VItamin D3 |
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Term
| If the body lacks enough vitamin D3 then where else will it get Ca from |
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Definition
| From the bones. The parathyroid will release parathyroid hormone to stimulate bone breakdown for Ca |
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Term
| is renin a hormone or enzyme |
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Definition
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Term
| kidney's receive __ % of the CO |
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Definition
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Term
| Plasma is ___ % of whole blood |
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Definition
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Term
| What is the cardiac output of PLASMA alone? How much of that gets to the kidneys/min |
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Definition
| 3L/min of plasma in CO. Out of which 600mL of plasma is circulated/min to kidneys |
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Term
| renal perfusion pressure= |
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Definition
| Inflow-outflow / resistance |
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Term
| how many glomerulus are there in body |
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Definition
| 1 million per kidney and 2 million total. |
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Term
| Out of the plasma entering the glomerulus how much of it is filtered into bowman's capsule |
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Definition
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Term
| how many liters / day is filtered by the kidneys |
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Definition
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Term
| what cells in kideny can sense flucutations in the levels of Na and Cl |
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Definition
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Term
| most powerful native vasoconstrictor is |
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Definition
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Term
| Nitric oxide binds to guanalyte cyclase to make |
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Definition
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Term
| smooth muscle contraction is activated by what receptor |
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Definition
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Term
| Phospholipase C is activated as a result of what vasoacitve things |
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Definition
1. Vaso
2. angiotensin 2
3. endothelin |
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Term
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Definition
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Term
| where is Nitric oxide made |
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Definition
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Term
| Angiotensin II is what kind of molecule |
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Definition
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Term
| GFR is maintained at 120 mL/min as long as MAP is wihtin the autoregulation boundaries of __ to ___. |
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Definition
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Term
| If your MAP goes outside the normal autoregulation boundaries for renal GFR then the GFR will either increase or decrease on a linear or non-linear plane |
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Definition
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Term
| Vasopressin not only works on vasoconstriction but also affects what organ system negatively |
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Definition
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Term
| ADH binds to ____ receptors on the distal and collecting tubules which results in placement of ____ to the wall and allows water to be reabsorbed |
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Definition
| ADAH binds to V2 receptors in distal and collecting tubule and causes placement of aqualporins to wall which allow water to be reabsorbed back into the highly osmotic blood due to the large Na,Cl, and K reabsorption previously during the ascending limb. |
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Term
| ADH release responds to two hemodynamic changes |
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Definition
1. Changes in osmolarity of blood. If high osmolarity then ADH released to increase NA/Cl absorption via V2 channels in distal and collecting tubules
2. ADH as a vasoconstrictor on V1 channels on vessel endothelium. If osmalrity of blood normal, but body very hypotensive then baroreceptors will trigger ADH release |
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Term
| The gradient for ADH to respond to is |
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Definition
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Term
| Are both urine output and GFR autoregulated? |
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Definition
| NO. Only GFR is autoregulated. Urine output depends on multiple circumstances. |
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Term
| how many Liters a day are filtered by your body |
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Definition
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Term
| What is the equation for fractional excretion of Na and how do you use this equation to differentiate between pre-renal and intra-renal causes of acute kidney injury. |
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Definition
Fe-na is the fractional excretion of sodium.
FeNa= (UNaxSCr)
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(SNaxUCr)
It measures the efficiency of the kidneys to balance excretion/reabsorption of Na appropriately. To do this it compared the Na balance to fixed predictable standard of filtration/reabsoprtion which is Cr. The kidney's cannot reabsorb Cr therefore you can establish a baseline for how much Na should be filtered along with Cr and compare the amount of Na reabsorbed to what is excreted and as long as Cr clearance is normal, then you determine whether the Na clearance and reabsorption was normal. |
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Term
Describe how you would interept and intervene for the following FeNa results
1. <1%
2. >3% |
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Definition
1. <1% means that a large percentage of Na is being reabsorbed and this indicates that the body's kidney's are working and attempting to conserve Na to allow for the counter current multiplier to get more H20 reabsorbed as well to maintain perfusion
2. FeNa > 3% means the kidney's have a problem. The patient has hemodynamic issues but despite this they are not appropriately conserving Na-H20 for the crisis. |
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