Kidney Functions and Hormones Overview
35 Questions
1 Views

Choose a study mode

Play Quiz
Study Flashcards
Spaced Repetition
Chat to Lesson

Podcast

Play an AI-generated podcast conversation about this lesson

Questions and Answers

If a patient's kidneys are failing to regulate electrolytes properly, which of the following is the most likely direct consequence?

  • Decreased metabolism of nucleic acids.
  • Reduced excretion of metabolic waste.
  • Unstable blood pressure and nerve function. (correct)
  • Increased production of proteins.
  • Which primary function of the kidney is most directly related to the process of removing urea from the body?

  • Excretion of metabolic waste. (correct)
  • Regulation of blood volume.
  • Maintenance of electrolyte balance.
  • Regulation of blood pH.
  • A patient is experiencing metabolic acidosis. Which kidney function is most relevant in restoring the body's pH balance?

  • Acid-base balance. (correct)
  • Regulation of water balance.
  • Excretion of protein metabolites.
  • Control of electrolyte concentrations.
  • In a desert environment, which kidney function is most crucial for survival?

    <p>Maximizing water reabsorption. (B)</p> Signup and view all the answers

    A build-up of uric acid (a product of nucleic acid metabolism) in the body is most directly linked to a deficiency in which kidney function?

    <p>Excretion of metabolic waste. (A)</p> Signup and view all the answers

    What is the origin of creatinine?

    <p>Breakdown of phosphocreatine (D)</p> Signup and view all the answers

    How is creatinine removed from the body?

    <p>Through urine (A)</p> Signup and view all the answers

    What is the chemical nature of creatinine, as described in the text?

    <p>A cyclic anhydride (D)</p> Signup and view all the answers

    If a patient's urine test reveals a significant elevation in creatinine levels, which of the following is a plausible explanation?

    <p>The patient's kidney function is impaired, leading to reduced creatinine excretion. (B)</p> Signup and view all the answers

    What is the relationship between creatine, phosphocreatine, and creatinine?

    <p>Phosphocreatine is converted to creatine, and creatine is converted to creatinine. (D)</p> Signup and view all the answers

    What does 'V' represent in the creatinine clearance calculation formula?

    <p>Volume of urine excreted per minute. (A)</p> Signup and view all the answers

    If a patient has a urine creatinine concentration (U) of 120 mg/dL, a plasma creatinine concentration (P) of 1.5 mg/dL, and a urine volume (V) of 1 mL/min, what is their creatinine clearance before adjusting for body surface area?

    <p>80 ml/min (C)</p> Signup and view all the answers

    Why is body surface area (A) used in the Cockcroft-Gault creatinine clearance calculation?

    <p>To adjust creatinine clearance to the average body size. (D)</p> Signup and view all the answers

    A researcher is studying kidney function in mice but doesn't have data on body surface area. Which parameters from the creatinine clearance formula are still required to estimate kidney function?

    <p>Urine creatinine concentration (U), plasma creatinine concentration (P), and urine volume (V). (C)</p> Signup and view all the answers

    Why does plasma urea concentration typically increase more rapidly than creatinine levels when the Glomerular Filtration Rate (GFR) declines due to renal dysfunction?

    <p>Urea is more readily reabsorbed in the renal tubules compared to creatinine, especially when GFR decreases. (A)</p> Signup and view all the answers

    Which factor has the least influence on serum creatinine levels?

    <p>Dietary sodium intake (D)</p> Signup and view all the answers

    A patient's creatinine clearance is calculated to be 130 ml/min using the standard formula. Which of the following is the MOST likely explanation?

    <p>The patient has normal or above-normal kidney function. (D)</p> Signup and view all the answers

    How do drugs like cimetidine and trimethoprim affect serum creatinine levels?

    <p>They inhibit creatinine secretion in the renal tubules, leading to an increase in serum creatinine. (A)</p> Signup and view all the answers

    If a patient with normal renal function begins a rigorous exercise program to build muscle mass, what corresponding change is most likely to be observed in their serum creatinine levels?

    <p>A moderate increase due to greater creatinine production from muscle metabolism. (B)</p> Signup and view all the answers

    An elderly female patient with decreased muscle mass has a serum creatinine level within the normal reference range. What does this indicate about her renal function?

    <p>The serum creatinine level may overestimate her actual GFR due to reduced creatinine production. (C)</p> Signup and view all the answers

    What is the primary consequence of damaged glomeruli in the kidneys?

    <p>Elevated levels of plasma proteins in the urine. (D)</p> Signup and view all the answers

    Why does albumin appear more readily in the urine compared to globulins when glomeruli are damaged?

    <p>Albumin molecules are smaller than globulin molecules. (C)</p> Signup and view all the answers

    The presence of which protein in the urine suggests a pathological condition?

    <p>Albumin (D)</p> Signup and view all the answers

    A patient's urine sample shows elevated levels of albumin. Which part of the kidney is most likely affected?

    <p>The glomeruli (A)</p> Signup and view all the answers

    What would be the likely effect of a drug that increases the permeability of the glomerulus?

    <p>Increased levels of plasma proteins in the urine. (A)</p> Signup and view all the answers

    Which of the following is the primary reason for measuring Glomerular Filtration Rate (GFR)?

    <p>To detect the onset of renal insufficiency and aid in diagnosis. (B)</p> Signup and view all the answers

    Why is age a factor in the GFR calculation?

    <p>Kidney function naturally declines with age, leading to a lower GFR. (D)</p> Signup and view all the answers

    In the GFR calculation formula, why is the result multiplied by 0.85 if the patient is female?

    <p>To account for the generally lower muscle mass and creatinine production in females. (C)</p> Signup and view all the answers

    Why is serum creatinine level placed in the denominator of the GFR calculation formula?

    <p>Because higher serum creatinine indicates poorer waste filtration by the kidneys. (C)</p> Signup and view all the answers

    What does the abrupt decline in renal function in Acute Kidney Injury (AKI) primarily result in?

    <p>Low GFR with a reversible acute increase in blood urea nitrogen (BUN) and serum creatinine levels. (D)</p> Signup and view all the answers

    In the context of kidney function, what is the significance of '72' in the GFR calculation formula?

    <p>It is a mathematical constant used for unit standardization. (A)</p> Signup and view all the answers

    Which of the following best describes the relationship between GFR and renal function?

    <p>Higher GFR indicates better renal function. (D)</p> Signup and view all the answers

    Why is it important to adjust drug dosages for drugs excreted by the kidney based on GFR?

    <p>To prevent accumulation of the drug in the body, which could lead to toxicity. (C)</p> Signup and view all the answers

    Besides Inulin, what other substance is used to measure GFR?

    <p>Cystatin C. (D)</p> Signup and view all the answers

    What is the clinical manifestation of a low GFR?

    <p>Elevated blood urea nitrogen (BUN) and serum creatinine levels (B)</p> Signup and view all the answers

    Flashcards

    Regulation of water

    The kidneys maintain the balance of water in the body.

    Electrolyte balance

    Kidneys regulate levels of electrolytes like sodium and potassium.

    Acid-base balance

    The kidneys help maintain the pH level of the blood.

    Excretion of waste

    Kidneys remove waste products from protein and nucleic acid metabolism.

    Signup and view all the flashcards

    Metabolism products

    Kidneys excrete metabolic byproducts like urea and creatinine.

    Signup and view all the flashcards

    Creatinine Clearance Formula

    The formula used to calculate creatinine clearance in ml/min: U/P X V X 1.73/A.

    Signup and view all the flashcards

    U in the formula

    U stands for urine creatinine concentration measured in mg/dl over a 24-hour collection.

    Signup and view all the flashcards

    P in the formula

    P represents plasma creatinine concentration, also in mg/dl, indicating blood levels.

    Signup and view all the flashcards

    Volume (V) in the formula

    V is the volume of urine output measured in milliliters per minute.

    Signup and view all the flashcards

    A in the formula

    A represents the body surface area in square meters (m²), used to adjust creatinine clearance.

    Signup and view all the flashcards

    Creatinine

    A waste product formed from the breakdown of phosphocreatine.

    Signup and view all the flashcards

    Serum Creatinine

    A waste product in the blood, used to assess kidney function.

    Signup and view all the flashcards

    Phosphocreatine

    A high-energy molecule used to store energy in muscles, broken down to produce creatinine.

    Signup and view all the flashcards

    GFR

    Glomerular Filtration Rate, a measure of kidney function.

    Signup and view all the flashcards

    Excretion

    The process of removing waste products from the body, such as creatinine in urine.

    Signup and view all the flashcards

    Plasma Urea Concentration

    A measure of urea in the blood, it rises with kidney dysfunction.

    Signup and view all the flashcards

    Final product

    The last substance formed in a biochemical reaction, like creatinine from phosphocreatine.

    Signup and view all the flashcards

    Factors Affecting Creatinine

    Age, sex, exercise, drugs, and muscle mass can influence creatinine levels.

    Signup and view all the flashcards

    Drugs Influencing Creatinine

    Certain medications like cimetidine and trimethoprim can alter creatinine levels.

    Signup and view all the flashcards

    Cyclic anhydride

    A chemical compound that forms a cyclic structure with a loss of water, like creatinine from creatine.

    Signup and view all the flashcards

    Glomeruli damage

    Damage to glomeruli increases permeability, leading to protein in urine.

    Signup and view all the flashcards

    Albuminuria

    The presence of albumin in urine, indicating a pathological condition.

    Signup and view all the flashcards

    Permeability increase

    In a diseased state, glomeruli allow more substances to pass into urine.

    Signup and view all the flashcards

    Albumin vs Globulins

    Albumins are smaller proteins that pass more easily through damaged glomeruli than globulins.

    Signup and view all the flashcards

    Pathological condition

    A condition indicating disease; albuminuria is always pathological.

    Signup and view all the flashcards

    Substances for GFR measurement

    Inulin, Cystatin C, and creatinine are used.

    Signup and view all the flashcards

    Purpose of measuring GFR

    Detect renal insufficiency and adjust drug dosages.

    Signup and view all the flashcards

    Age effect on GFR

    GFR decreases with age affecting kidney function.

    Signup and view all the flashcards

    Weight's influence on creatinine

    Creatinine production depends on muscle mass and weight.

    Signup and view all the flashcards

    Adjusting creatinine for gender

    Multiply by 0.85 for females due to less muscle mass.

    Signup and view all the flashcards

    Creatinine level significance

    Indicates kidney efficiency in filtering waste.

    Signup and view all the flashcards

    ARF

    Acute Renal Failure; sudden loss of kidney function.

    Signup and view all the flashcards

    Blood Urea Nitrogen (BUN)

    Increases with acute kidney injury, indicating dysfunction.

    Signup and view all the flashcards

    Serum creatinine levels

    Measures kidney function; rises with injury.

    Signup and view all the flashcards

    Study Notes

    Kidney Functions

    • Kidneys regulate water and electrolytes.
    • They maintain acid-base balance.
    • They remove waste products from protein and nucleic acid metabolism (e.g., urea, creatinine, uric acid).
    • They produce hormones.

    Kidney Control by Hormones

    • Arginine vasopressin (AVP, also known as ADH) influences water balance.
    • Aldosterone promotes sodium reabsorption in the nephron.
    • Parathyroid hormone promotes tubular reabsorption of calcium and phosphate.
    • Excretion and synthesis of 1,25-dihydroxycholecalciferol (active vitamin D) occur.
    • Renin, produced by juxtaglomerular cells, catalyzes the formation of angiotensin I and ultimately aldosterone synthesis.

    Renal Function Tests

    • Blood urea and blood urea nitrogen (BUN)

    • Serum creatinine

    • Glomerular filtration rate (GFR)

    • Substances with nitrogen are classified as protein nitrogen and non-protein nitrogen (NPN). Urea accounts for 75% of NPN.

    • Urea is the major nitrogenous waste product of protein catabolism.

    • More than 90% of urea is excreted through the kidneys.

    Uremia and Azotemia

    • Uremia: high urea nitrogen in blood
    • Azotemia: significant increase in plasma urea and creatinine in kidney insufficiency.
    • Pre-renal uremia is caused by extra-renal factors like high protein diets, increased protein catabolism, dehydration, and heart failure.
    • Renal uremia is caused by diminished glomerular filtration, as in acute or chronic kidney diseases like glomerulonephritis and polycystic kidney disease.
    • Post-renal uremia is usually due to obstruction of urine flow (e.g., malignancies, stones, prostate enlargement).

    Serum Creatinine

    • Creatinine is a breakdown product of creatine phosphate.
    • It is produced in the kidneys, liver, and pancreas.
    • It's transported by blood to muscle and brain where it's phosphorylated into phosphocreatine.
    • Muscle creatine phosphate is used as an immediate energy source in muscle contraction.
    • Creatinine levels are related to muscle mass.
    • Creatinine is freely filtered by glomeruli, with a small percentage secreted by renal tubules.
    • Creatinine excretion is relatively constant in the urine.
    • In renal diseases, creatinine excretion is impaired and reflected by increased creatinine in the blood.
    • Serum creatinine levels are higher in males than in females.
    • High-protein diets and catabolic states affect plasma creatinine concentration (less than that of urea).

    Glomerular Filtration Rate (GFR)

    • GFR is the amount of glomerular filtrate formed per unit of time in all nephrons of both kidneys.
    • Inulin, cystatin C, and creatinine are used to measure GFR.
    • GFR measurement aids in detecting renal insufficiency.
    • GFR adjustment helps in calculating medication dosages.
      • GFR = (140 - age in years) * weight (kg) * 0.85 (if female) / serum creatinine (mg/dL) * 72.

    Uric Acid

    • Nucleic acids contain purines (adenine and guanine) and pyrimidines.
    • Purine breakdown yields uric acid.
    • Uric acid is mainly present in plasma as sodium urate.
    • Hyperuricemia is abnormally high uric acid in the blood.
    • Gout is a medical condition caused by uric acid precipitation in aqueous solutions (e.g., synovial fluid).
    • Uric acid is formed through de novo synthesis, endogenous DNA/RNA metabolism, and dietary nucleic acid breakdown.
    • Most (70%) uric acid is excreted by the kidneys.
    • Other (30%) uric acid is excreted in the gut, broken down by bacteria.
    • Increased production or decreased excretion of uric acid can lead to gout.

    Proteinuria

    • Proteinuria is the presence of excess protein in the urine.
    • Glomerular proteinuria arises from glomerular damage.
    • Overflow proteinuria occurs if plasma concentrations of low molecular weight proteins increase.
    • Tubular proteinuria arises from decreased tubular capacity to reabsorb proteins.
    • Creatinine/protein ratio help assess if proteinuria is benign or pathological for any glomerular disease.
    • Microalbuminuria is an early indicator of nephropathy.

    Studying That Suits You

    Use AI to generate personalized quizzes and flashcards to suit your learning preferences.

    Quiz Team

    Related Documents

    Kidney Function & Tests (PDF)

    Description

    This quiz covers the essential functions of the kidneys, including their role in regulating water, electrolytes, and waste products. It also explores hormonal control mechanisms that influence renal function and key renal function tests. Test your knowledge on how kidneys maintain homeostasis and their interactions with hormones.

    More Like This

    Use Quizgecko on...
    Browser
    Browser