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Questions and Answers
What primary effect does increased afferent arteriolar dilation have on glomerular filtration rate (GFR), assuming other factors remain constant?
What primary effect does increased afferent arteriolar dilation have on glomerular filtration rate (GFR), assuming other factors remain constant?
- Decreases GFR by reducing hydrostatic pressure
- Decreases GFR by increasing oncotic pressure
- Has no effect on GFR due to compensatory mechanisms
- Increases GFR by increasing glomerular hydrostatic pressure (correct)
A patient's glomerular filtration rate (GFR) is found to be significantly lower than normal. Which of the following conditions is least likely to be a direct cause of this reduced GFR?
A patient's glomerular filtration rate (GFR) is found to be significantly lower than normal. Which of the following conditions is least likely to be a direct cause of this reduced GFR?
- Increased hydrostatic pressure in Bowman's space
- Decreased glomerular capillary oncotic pressure
- Decreased glomerular capillary hydrostatic pressure
- Increased efferent arteriolar resistance (correct)
What is the functional consequence of damage to the glomerular basement membrane's charge barrier?
What is the functional consequence of damage to the glomerular basement membrane's charge barrier?
- Decreased filtration of negatively charged molecules
- Increased filtration of negatively charged molecules (correct)
- Increased reabsorption of positively charged molecules
- Decreased reabsorption of positively charged molecules
A patient presents with edema, hypertension, and elevated levels of protein in their urine. Damage to which part of the nephron is most likely causing these symptoms?
A patient presents with edema, hypertension, and elevated levels of protein in their urine. Damage to which part of the nephron is most likely causing these symptoms?
During hypotension, what compensatory mechanism is triggered in the efferent arteriole to maintain glomerular filtration rate (GFR)?
During hypotension, what compensatory mechanism is triggered in the efferent arteriole to maintain glomerular filtration rate (GFR)?
After a high-protein meal, what tubuloglomerular feedback response helps to increase glomerular filtration rate (GFR)?
After a high-protein meal, what tubuloglomerular feedback response helps to increase glomerular filtration rate (GFR)?
Which of the following is the most accurate statement about Vitamin D and kidney function?
Which of the following is the most accurate statement about Vitamin D and kidney function?
If a substance is freely filtered, but its clearance is less than GFR, what can you conclude about its handling by the kidney?
If a substance is freely filtered, but its clearance is less than GFR, what can you conclude about its handling by the kidney?
Why is serum creatinine not considered an ideal marker for early-stage kidney injury?
Why is serum creatinine not considered an ideal marker for early-stage kidney injury?
What effect would a drug that blocks angiotensin II receptors have on GFR, assuming no other compensatory mechanisms are in place?
What effect would a drug that blocks angiotensin II receptors have on GFR, assuming no other compensatory mechanisms are in place?
In a patient experiencing increased blood flow due to hypertension, what event directly leads to vasoconstriction of the afferent arteriole as part of tubuloglomerular feedback?
In a patient experiencing increased blood flow due to hypertension, what event directly leads to vasoconstriction of the afferent arteriole as part of tubuloglomerular feedback?
A patient's filtration fraction (FF) is calculated to be 30%. Which of the following is the most likely interpretation of this finding?
A patient's filtration fraction (FF) is calculated to be 30%. Which of the following is the most likely interpretation of this finding?
Which of the following best describes the role of podocytes in the glomerular filtration barrier?
Which of the following best describes the role of podocytes in the glomerular filtration barrier?
In a patient with kidney disease, what would the presence of dysmorphic red blood cells (RBCs) in the urine indicate?
In a patient with kidney disease, what would the presence of dysmorphic red blood cells (RBCs) in the urine indicate?
Which of the following would be the expected effect of increased levels of angiotensin II on the efferent arteriole?
Which of the following would be the expected effect of increased levels of angiotensin II on the efferent arteriole?
A doctor is evaluating a patient for potential kidney dysfunction. Which laboratory measurement would be most indicative of damage specifically to the glomerular basement membrane?
A doctor is evaluating a patient for potential kidney dysfunction. Which laboratory measurement would be most indicative of damage specifically to the glomerular basement membrane?
If both hematuria and albuminuria are present in a patient's urine sample, what is the most likely underlying condition?
If both hematuria and albuminuria are present in a patient's urine sample, what is the most likely underlying condition?
Which of these factors is the LEAST likely to increase the glomerular filtration rate (GFR)?
Which of these factors is the LEAST likely to increase the glomerular filtration rate (GFR)?
In the context of glomerular filtration, what is the significance of the 'slit diaphragm'?
In the context of glomerular filtration, what is the significance of the 'slit diaphragm'?
After an individual ingests a very high-protein diet for an extended period, which renal adaptation is most likely to occur?
After an individual ingests a very high-protein diet for an extended period, which renal adaptation is most likely to occur?
What renal response is expected from increased systemic blood pressure during hypertension?
What renal response is expected from increased systemic blood pressure during hypertension?
Which of the following is considered the 'gold standard' for measuring glomerular filtration rate (GFR) due to being neither reabsorbed nor secreted?
Which of the following is considered the 'gold standard' for measuring glomerular filtration rate (GFR) due to being neither reabsorbed nor secreted?
What compensatory measure occurs in the proximal convoluted tubule (PCT) in response to an increase in glomerular filtration rate (GFR)?
What compensatory measure occurs in the proximal convoluted tubule (PCT) in response to an increase in glomerular filtration rate (GFR)?
A patient with diabetes has early-stage diabetic nephropathy. What treatment strategy aims to protect kidney function by affecting glomerular dynamics?
A patient with diabetes has early-stage diabetic nephropathy. What treatment strategy aims to protect kidney function by affecting glomerular dynamics?
Which of the following is NOT a typical function of the kidneys?
Which of the following is NOT a typical function of the kidneys?
What is the primary rationale for advising bodybuilders who consume very high amounts of protein to undergo regular urinalysis?
What is the primary rationale for advising bodybuilders who consume very high amounts of protein to undergo regular urinalysis?
Why is kidney transplantation preferred over long-term dialysis, when feasible?
Why is kidney transplantation preferred over long-term dialysis, when feasible?
Which part of the kidney nephron is mainly involved in the reasbsorption of water and solutes?
Which part of the kidney nephron is mainly involved in the reasbsorption of water and solutes?
In the context of kidney function, what is the definition of 'filtered load'?
In the context of kidney function, what is the definition of 'filtered load'?
How does Anti-diuretic hormone (ADH) influence glomerular filtration?
How does Anti-diuretic hormone (ADH) influence glomerular filtration?
Which of the following conditions would most likely result in increased renin secretion by the kidneys?
Which of the following conditions would most likely result in increased renin secretion by the kidneys?
In the context of glomerular function, what is the primary function of mesangial cells?
In the context of glomerular function, what is the primary function of mesangial cells?
If the efferent arteriole is dilated, how would this influence filtration fraction?
If the efferent arteriole is dilated, how would this influence filtration fraction?
How does dilation of afferent arterioles influence the Glomerular Filtration Rate (GFR)?
How does dilation of afferent arterioles influence the Glomerular Filtration Rate (GFR)?
A patient's lab results show that their urine contains acanthocytes. What does this say about the patient?
A patient's lab results show that their urine contains acanthocytes. What does this say about the patient?
What is the purpose of Radionuclides in the context of glomerular filtration?
What is the purpose of Radionuclides in the context of glomerular filtration?
Flashcards
Kidney Functions
Kidney Functions
Main functions include acid-base balance, water balance, electrolytes balance, toxin removal, blood pressure regulation, erythropoietin production and Vitamin D production.
Glomerular Filtration
Glomerular Filtration
The process of filtration of blood in the kidney.
Glomerulus
Glomerulus
Located within the renal cortex, it's a tiny, ball-shaped network of capillaries within the Bowman's capsule that plays a key role in blood filtration and urine formation.
Glomerular Filtration Rate (GFR)
Glomerular Filtration Rate (GFR)
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Mechanisms of GFR Regulation
Mechanisms of GFR Regulation
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Hematuria
Hematuria
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Albuminuria and Proteinuria
Albuminuria and Proteinuria
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Renal Replacement Therapy
Renal Replacement Therapy
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Excess Protein Ingestion & Hyperglycemia
Excess Protein Ingestion & Hyperglycemia
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Kidney Excretory Functions
Kidney Excretory Functions
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Kidney Endocrine Functions
Kidney Endocrine Functions
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Parts of Kidney Nephron
Parts of Kidney Nephron
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Kidney Blood Supply
Kidney Blood Supply
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Glomerular Filtration Barrier Layers
Glomerular Filtration Barrier Layers
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GFR Equation
GFR Equation
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PGC (Glomerular Capillary Pressure)
PGC (Glomerular Capillary Pressure)
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PBS (Bowman's Space Pressure)
PBS (Bowman's Space Pressure)
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Ï€GC (Glomerular Capillary Oncotic Pressure)
Ï€GC (Glomerular Capillary Oncotic Pressure)
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Clearance Principle Equation
Clearance Principle Equation
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Filtered Load (FL)
Filtered Load (FL)
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Filtration Fraction (FF)
Filtration Fraction (FF)
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Afferent Arteriole Effects on GFR
Afferent Arteriole Effects on GFR
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Efferent Arteriole Effects on GFR
Efferent Arteriole Effects on GFR
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Tubuloglomerular Feedback (TGF)
Tubuloglomerular Feedback (TGF)
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Glomerulotubular Balance (GTB)
Glomerulotubular Balance (GTB)
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Clinical signs of Hematuria
Clinical signs of Hematuria
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Albuminuria and proteinuria
Albuminuria and proteinuria
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Creatinine
Creatinine
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Cystatin C
Cystatin C
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Renal Replacements
Renal Replacements
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Effects of Chronic Intake of High Protein
Effects of Chronic Intake of High Protein
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Study Notes
- Kidneys perform acid-base balance, water balance, electrolytes balance, toxin removal, blood pressure regulation, erythropoietin production, and Vitamin D production
- Mnemonic: A WET BED.
Excretory Functions
- Include filtration, reabsorption, secretion, micturition
Endocrine Functions
- Kidneys release erythropoietin, which acts on hematopoietic stem cells in bone marrow to produce red blood cells
- Kidneys release renin, secreting hormones and vasoactive substances to produce vasoactive products like angiotensin II, regulating arterial blood pressure
- Kidneys produce the active form of Vitamin D (calcitriol), important for normal calcium deposition in bone, calcium reabsorption in the gastrointestinal tract, and calcium-phosphate regulation
Parts of the Kidney Nephron
- Glomerulus: Responsible for filtration of blood
- Bowman's capsule: Handles the reabsorption of solutes
- Proximal convoluted tubule: Reabsorbs solutes
- Loop of Henle: Concentrates urine
- Distal convoluted tubule: Regulates various processes
- Collecting duct: Recovers water
Blood Supply
- Kidneys receive 22% of the cardiac output
- Cardiac Output (CO) = Heart Rate (HR) x Stroke Volume (SV)
- Implication: The 3 most affected organ systems in kidney failure—brain, heart, and lungs (also the adrenal glands)
Glomerulus
- The vital component of the kidney’s filtration system with a pivotal role in blood filtration and urine formation
- Located in the renal cortex
- It's a tiny, ball-shaped network of capillaries within the Bowman’s capsule
- Human kidneys can have 800,000 to 1.5 million nephrons, decreasing over time with aging or kidney disease
Glomerular Capillary Membrane
- Filtration barrier is composed of three major layers
- Capillary Endothelium: 70-1000 â„« thick; second most selective; "Size barrier"
- Glomerular Basement Membrane: 200-500 â„« thick, but normally 300-350 nm; "Charge barrier", most selective
- Podocytes (Foot Processes): 40-140 â„« thick; smallest and last protection
Glomerular Filtration Rate (GFR)
- GFR = Kf [ (Pgc + πbs) - (Pbs + πgc) ]
- Factors favoring filtration: includes hydrostatic pressure in glomerular capillary
Clearance Principle
- CLx = (Ux × V) / Px
Filtered Load (FL)
- FL = GFR X Plasma Solute Concentration
- Example:
- GFR = 120 mL/min. Plasma [Na] = 140 mmol/L
- FL = 120 mL/min x 140 mmol/1000mL = 16.8 mmol/min
Filtration Fraction (FF)
- FF = GFR / Renal Plasma Flow (RPF)
- Normal FF = 20%
Hormonal GFR Regulation
-
Governed by the diameters of afferent and efferent arterioles
-
Afferent arteriole has a direct relationship with GFR
- Dilation: Higher GFR
- Constriction: Lower GFR
-
Efferent arteriole has an indirect relationship; opposite effect
- Dilation: Lower GFR
- Constriction: Higher GFR
-
Important hormone that predominantly constricts capillaries of efferent arterioles
- Afferent arterioles also affected, but less significantly
Tubuloglomerular Feedback (TGF)
- First line of defense that occurs at the juxtaglomerular apparatus of the distal convoluted tubule (DCT)
- Regulates GFR by adjusting afferent arteriole tone based on NaCl concentration detected by the macula densa
Glomerulotubular Balance (GTB)
- Second line of defense that occurs at the proximal convoluted tubule (PCT)
- Primarily adjusts tubular reabsorption rates to match changes in GFR
- Increased glomerular filtration pressure; increased GFR; increased Na and water reabsorption by PCT
- Decreased glomerular filtration pressure; decreased GFR; decreased Na and water reabsorption by PCT
Hematuria
- Blood in the urine ranges from red to tea-colored
- Presence of dysmorphic RBCs (acanthocytes)
- Presence of normal-looking RBCs in the urine
Albuminuria and Proteinuria
- Albumin in the urine signals podocyte injury
- Podocyte effacement causes albumin to flood the urine
- Symptoms are proteinuria or nephrotic syndrome
Renal Replacement Therapy
- Transplant involves transplanting a kidney from matching donor and replacing a failing kidney
- Hemodialysis uses a machine to filters waste products; a form of treatment for a failing kidney in itself
- Peritoneal Dialysis (PD) uses the peritoneum to filter waste internally
- Dialysis extends kidney life. Transplants are an expensive treatment option that requires paying for anti-rejection medications
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Description
Overview of the kidney's excretory and endocrine functions, including acid-base balance, erythropoietin and Vitamin D production, and blood pressure regulation. Covers the structure and function of nephron parts like the glomerulus, Bowman's capsule, and Loop of Henle.
