Kidney Physiology: Reabsorption and Filtration M 3.3

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Questions and Answers

What is the primary factor determining the rate of sodium transport in the proximal tubule?

  • The permeability of the tight junctions between epithelial cells
  • The concentration of sodium in the tubular lumen (correct)
  • The presence of antidiuretic hormone (ADH)
  • The transport maximum of the sodium pump

Why does sodium leak back into the tubular lumen in the proximal tubule?

  • The loose junctions between epithelial cells (correct)
  • The presence of aquaporins in the cell membranes
  • The action of aldosterone on the distal tubules
  • The high permeability of the descending loop of Henle to water

How does the concentration gradient between the tubule lumen and the interstitial fluid affect water reabsorption?

  • It has no effect on water reabsorption
  • It drives osmosis in the opposite direction of solute movement
  • It drives osmosis in the same direction as solute movement (correct)
  • It increases the permeability of the tight junctions to water

Where in the nephron are tight junctions least permeable to water?

<p>The ascending loop of Henle (B)</p> Signup and view all the answers

Which of the following statements about water permeability in the nephron is incorrect?

<p>Water permeability is always high in the ascending loop of Henle (A)</p> Signup and view all the answers

How does aldosterone influence transport maximums?

<p>Aldosterone indirectly influences transport maximums by regulating sodium reabsorption in the distal tubules (B)</p> Signup and view all the answers

What is the role of aquaporins in water reabsorption?

<p>Aquaporins are protein channels that allow water to passively move across cell membranes (D)</p> Signup and view all the answers

Which of these factors is NOT involved in determining the rate of transport in the nephron?

<p>The amount of ATP available (A)</p> Signup and view all the answers

What is the primary function of the thin descending limb of the loop of Henle?

<p>Passive reabsorption of water (A)</p> Signup and view all the answers

Which of the following is NOT reabsorbed in the proximal tubule?

<p>Creatinine (B)</p> Signup and view all the answers

What is the role of the sodium-potassium ATP pump in the thick ascending limb of the loop of Henle?

<p>To maintain a low intracellular sodium concentration (D)</p> Signup and view all the answers

What is the primary mechanism by which magnesium, calcium, and potassium are reabsorbed in the thick ascending limb?

<p>Secondary active transport driven by the electrochemical gradient of sodium (A)</p> Signup and view all the answers

Which of these is NOT a characteristic of the thin ascending limb of the loop of Henle?

<p>Permeable to water (A)</p> Signup and view all the answers

What is the primary function of the sodium-hydrogen counter transporter in the thick ascending limb?

<p>To reabsorb sodium and secrete hydrogen (C)</p> Signup and view all the answers

Which of these solutes is reabsorbed in the proximal tubule?

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

Which of these statements correctly describes the role of the loop of Henle in urine concentration?

<p>The ascending limb of the loop of Henle is impermeable to water, contributing to urine concentration. (B)</p> Signup and view all the answers

What is the purpose of inulin in measuring GFR?

<p>Inulin is used to measure the rate of filtration by the glomeruli. (A)</p> Signup and view all the answers

What is the net filtration pressure in the capillaries?

<p>Capillary pressure minus interstitial hydrostatic pressure minus capillary colloid pressure. (A)</p> Signup and view all the answers

What does a ratio of 3 for inulin concentration in the proximal tubule indicate?

<p>Two-thirds of the filtered water has been reabsorbed. (C)</p> Signup and view all the answers

What is the effect of increasing arterial pressure on peri tubular capillary hydrostatic pressure and reabsorption?

<p>Increased arterial pressure increases peri tubular capillary hydrostatic pressure and decreases reabsorption. (D)</p> Signup and view all the answers

What is tubular balance?

<p>The phenomenon of increased reabsorption rate in response to increased tubular load. (B)</p> Signup and view all the answers

How does increasing resistance in the afferent arterioles affect peri tubular capillary hydrostatic pressure and reabsorption?

<p>Increased resistance in afferent arterioles decreases peri tubular capillary hydrostatic pressure and increases reabsorption. (D)</p> Signup and view all the answers

How does tubular balance help prevent overloading of the distal tubular segments?

<p>By increasing reabsorption rate when tubular load increases. (C)</p> Signup and view all the answers

What is the effect of raising the systemic plasma colloid osmotic pressure on peri tubular capillary reabsorption?

<p>Raising systemic plasma colloid osmotic pressure increases peri tubular capillary reabsorption. (A)</p> Signup and view all the answers

What is the normal rate of tubular capillary reabsorption?

<p>124 ml per minute (A)</p> Signup and view all the answers

What is the filtration coefficient?

<p>A measure of the ease with which fluid can move across the capillary wall. (C)</p> Signup and view all the answers

Which of the following is NOT a factor that governs the rate of reabsorption across the peritubular capillaries?

<p>Hormonal regulation of reabsorption by the renal tubules (C)</p> Signup and view all the answers

How does tubular glomerular feedback contribute to renal autoregulation?

<p>By adjusting GFR in response to changes in the flow rate of filtrate. (A)</p> Signup and view all the answers

What is the primary force that drives reabsorption in the peri tubular capillaries?

<p>Capillary colloid osmotic pressure. (D)</p> Signup and view all the answers

If the capillary pressure is 13 mmHg and the interstitial hydrostatic pressure is 6 mmHg, what is the net filtration pressure?

<p>7 mmHg (D)</p> Signup and view all the answers

What is the percentage of filtrate reabsorbed by the proximal tubules?

<p>65% (D)</p> Signup and view all the answers

What is the effect of increasing the capillary osmotic pressure on the net filtration pressure?

<p>It decreases the net filtration pressure. (B)</p> Signup and view all the answers

What is the primary method by which creatinine is removed from the body?

<p>Glomerular filtration (B)</p> Signup and view all the answers

If the rate of creatinine excretion is less than the rate of glomerular filtration, what can be concluded?

<p>Tubular reabsorption is occurring (D)</p> Signup and view all the answers

What is the relationship between creatinine clearance and GFR?

<p>Creatinine clearance is approximately equal to GFR (C)</p> Signup and view all the answers

What is the filtration fraction?

<p>The ratio of GFR to renal plasma flow (C)</p> Signup and view all the answers

What is the significance of measuring creatinine in the blood?

<p>It is used to estimate changes in glomerular filtration rate (B)</p> Signup and view all the answers

What is the primary effect of ANP on the renal tubules?

<p>Decreases sodium and water reabsorption (C)</p> Signup and view all the answers

Which hormone increases tubular reabsorption of calcium?

<p>Parathyroid hormone (B)</p> Signup and view all the answers

What is the effect of sympathetic stimulation on the renal tubules?

<p>Increases sodium reabsorption (B)</p> Signup and view all the answers

What is the definition of renal clearance?

<p>The volume of plasma that is completely cleared of a substance by the kidneys per unit time (A)</p> Signup and view all the answers

What is the relationship between the rate of excretion of a substance and its filtration rate?

<p>Excretion rate is equal to filtration rate only if the substance is not reabsorbed or secreted (B)</p> Signup and view all the answers

Which substance is used to calculate GFR because it is freely filtered and not reabsorbed or secreted?

<p>Inulin (B)</p> Signup and view all the answers

What is the primary mechanism by which creatinine is cleared from the body?

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

Why is creatinine a suitable marker for estimating GFR?

<p>It is freely filtered but not significantly reabsorbed or secreted by the kidneys (D)</p> Signup and view all the answers

Flashcards

Water Permeability

The capacity of cell membranes to allow water to pass through them.

Proximal Tubule Function

Reabsorbs glucose, amino acids, bicarbonate, and excretes waste products.

Loop of Henle Segments

Consists of thin descending, thin ascending, and thick ascending limbs with different functions.

Thin Descending Limb

Highly permeable to water and allows simple diffusion, reabsorbing 20% of filtered water.

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Thick Ascending Limb

Impermeable to water, reabsorbs sodium, chloride, and potassium actively.

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Sodium-Potassium ATP Pump

Maintains low intracellular sodium concentration and enables solute transport.

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Secondary Active Transport

Utilizes sodium gradient to move other solutes like chloride and potassium.

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Tubular Lumen Charge

A slightly positive charge that drives the reabsorption of positively charged solutes.

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Inulin

A substance used to measure Glomerular Filtration Rate (GFR).

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GFR (Glomerular Filtration Rate)

The rate at which the kidneys filter blood, indicative of kidney function.

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Tubular Absorption

The process where substances are reabsorbed from renal tubules back into the blood.

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Proximal Tubule Effect

The region where significant water reabsorption occurs, concentrating filtrate.

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Tubular Balance

Increased tubular reabsorption in response to higher tubular load.

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Hydrostatic and Colloid Forces

Forces that govern the rate of reabsorption in capillaries.

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Renal Autoregulation

Mechanisms that maintain stable GFR despite changes in blood pressure.

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Filtrate Absorption Rate

Normal absorption of water and solutes from the filtrate is about 124 mL/min.

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Electrochemical Gradient

The difference in charge and concentration across a membrane that influences ion movement.

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Transport Maximum

The maximum rate at which substances can be reabsorbed in the renal tubules.

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Aldosterone

A hormone that regulates sodium and water reabsorption in the kidneys.

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Osmosis

The movement of water across a semipermeable membrane from low to high solute concentration.

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Aquaporins

Proteins that facilitate the rapid transport of water across cell membranes.

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Distal Tubule Water Permeability

Water permeability is influenced by antidiuretic hormone, allowing water recovery.

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Loop of Henle

Section of the nephron that helps concentrate urine by managing water and solute reabsorption.

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Glomerular Filtration Rate (GFR)

A measure of kidney function that indicates how well blood is filtered through the kidneys.

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Creatinine Clearance

The volume of plasma that is cleared of creatinine per unit time, used to estimate GFR.

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Renal Plasma Flow

The total amount of plasma that passes through the kidneys per unit time.

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Filtration Fraction

The ratio of GFR to renal plasma flow, indicating how much plasma is filtered by the kidneys.

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Tubular Reabsorption and Secretion

Processes in the kidneys where substances are either reabsorbed back into the bloodstream or secreted into urine.

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Net Filtration Pressure

The difference between capillary pressure and opposing pressures (interstitial and colloid).

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Reabsorption

Process of moving fluids back into capillaries from interstitial fluid.

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Filtration Coefficient

A measure of the capacity of capillaries to filter fluid.

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Hydrostatic Pressure

Pressure exerted by a fluid in the capillary that promotes filtration.

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Colloid Osmotic Pressure

Pressure exerted by proteins in the blood that pulls fluid into the capillaries.

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Interstitial Hydrostatic Pressure

The pressure from the interstitial fluid pushing against the capillaries.

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Arterial Pressure Influence

Changes in arterial pressure affect hydrostatic pressures in capillaries.

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Systemic Plasma Colloid Osmotic Pressure

Osmotic pressure from plasma proteins affecting capillary reabsorption.

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ANP Function

Atrial natriuretic peptide (ANP) inhibits sodium and water reabsorption in the kidneys, promoting excretion.

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Parathyroid Hormone

Parathyroid hormone increases calcium reabsorption and decreases phosphate reabsorption in the kidneys.

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Sympathetic Stimulation

Activation of sympathetic nerves increases renin release and decreases sodium excretion.

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Renal Clearance

Renal clearance is how much plasma is cleared of a substance by the kidneys over time.

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GFR Calculation

Glomerular filtration rate (GFR) can be calculated using inulin, which is neither reabsorbed nor secreted.

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Creatinine

Creatinine is a byproduct of muscle metabolism cleared by glomerular filtration, used to estimate GFR.

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Sodium and Water Reabsorption

The kidneys reabsorb sodium and water, which is inhibited by ANP for fluid balance.

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Filtration Rate

The filtration rate of a substance is equal to the rate at which it is excreted, when not reabsorbed.

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Study Notes

Reabsorption in the Tubules

  • Reabsorption of large molecules like proteins occurs via pinocytosis. Proteins attach to the brush border, are encapsulated, digested into amino acids, and reabsorbed through the basal lateral membrane. This is active transport requiring energy.

Filtration

  • Filtration is non-selective, meaning substances not bound to proteins are filtered.
  • Glomerular filtration is significant compared to urine output.
  • Tubular reabsorption is highly selective.
  • Substances like glucose and amino acids are almost completely reabsorbed, while sodium and chloride vary based on body needs. Waste products like urea are poorly reabsorbed and excreted.
  • Reabsorption mechanisms can be controlled independently.

Reabsorption Mechanisms

  • Substances must move from the tubular lumen through the tubular epithelial membrane to the renal interstitial fluid, then through the peritubular capillary membrane to the blood.
  • Transcellular or paracellular pathways can be used.
  • Hydrostatic and colloid osmotic pressures regulate absorption.

Active Transport

  • Active transport moves substances against electrochemical gradients, requiring energy (e.g., sodium-potassium ATPase pump).

Secondary Active Transport

  • Coupled indirectly to an energy source (e.g., ion gradients).
  • Sodium-potassium pump creates a low intracellular sodium concentration, driving sodium into the cell. This then drives other substances into the cell.

Tubular Reabsorption Summary

  • Step 1: Sodium diffuses from the tubular lumen to the cell.
  • Step 2: Sodium moves across the basal outer membrane, against the electrochemical gradient, via sodium potassium ATPase pump
  • Step 3: Sodium, water and other substances are reabsorbed from the interstitial fluid into peritubular capillaries, driven by hydrostatic and colloid osmotic pressure gradients.

Secondary Active Transport (Glucose/Amino Acids)

  • Sodium gradient facilitates movement of glucose/amino acids into the cell
  • Carrier proteins in the apical membrane couple Na+ gradient to glucose movement (secondary active transport)

Transport Maximum

  • Limited rate of reabsorption due to saturation of transport systems.
  • When the load exceeds the transport maximum, excess substances are excreted in the urine. (e.g., glucose)

Reabsorption of Water

  • Proximal tubule highly permeable to water, reabsorbing most water.
  • Loop of Henle: Descending limb is highly permeable to water; Ascending limb is impermeable to water.
  • Distal tubules and collecting ducts: Water permeability regulated by ADH (antidiuretic hormone).

Sodium and Chloride Reabsorption

  • Sodium reabsorption is coupled to chloride reabsorption.
  • Chloride concentration gradient in tubular fluids drives passive chloride reabsorption.

Other substances

  • Urea reabsorption, but to a lesser extent than chloride.
  • Creatinine is not reabsorbed, excreted in the urine.

Electrochemical Gradient

  • Water follows sodium and chloride to maintain osmotic balance.

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