L1 Endocrinal function of Kidney (P1 Mid)

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Questions and Answers

What is the primary function of the macula densa in the juxta-glomerular apparatus?

  • Monitor sodium chloride concentration (correct)
  • Facilitate filtration at Bowman’s capsule
  • Secrete renin into the bloodstream
  • Regulate blood flow in the efferent arteriole

Which structure is involved in the secretion of renin?

  • Podocyte
  • Smooth muscle cells
  • Granular cells (correct)
  • Macula densa

Which component of the juxta-glomerular apparatus monitors the flow within the afferent arteriole?

  • Podocyte
  • Granular cell (correct)
  • Distal convoluted tubule
  • Macula densa

What effect does increased sodium chloride transport in the distal convoluted tubule lead to?

<p>Increased adenosine levels affecting the afferent arteriole (C)</p> Signup and view all the answers

Which vessel branches directly from the renal artery and carries blood towards the glomerulus?

<p>Afferent arteriole (C)</p> Signup and view all the answers

What is the primary metabolic waste excreted by the kidneys?

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

What hormone secreted by the kidneys is essential for red blood cell production?

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

Which of the following factors inhibits renin secretion?

<p>Increased blood pressure (B)</p> Signup and view all the answers

Which enzyme is responsible for converting 25 hydroxycholecalciferol to its active form?

<p>1α-hydroxylase (C)</p> Signup and view all the answers

Which substance do prostaglandins secreted by the kidneys act as?

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

In which condition might the kidneys synthesize glucose from amino acids?

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

What is the main action of renin in the body?

<p>Trigger the production of angiotensin II (A)</p> Signup and view all the answers

Which of the following does NOT play a role in the regulation of blood pressure through the kidneys?

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

What is the primary functional unit of the kidney?

<p>Nephron (C)</p> Signup and view all the answers

What are the two main types of nephrons?

<p>Cortical and juxtamedullary nephrons (C)</p> Signup and view all the answers

What is the role of the Juxtaglomerular apparatus?

<p>Regulation of blood pressure (B)</p> Signup and view all the answers

Which segment of the nephron is primarily responsible for reabsorption?

<p>Proximal convoluted tubule (D)</p> Signup and view all the answers

Where in the nephron does filtration occur?

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

Which function is associated with juxtamedullary nephrons?

<p>Concentration of urine (C)</p> Signup and view all the answers

What type of capillaries surround the nephron tubules and participate in reabsorption?

<p>Peritubular capillaries (A)</p> Signup and view all the answers

Which component of the kidney is involved in maintaining the acid-base balance?

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

What is produced as a result of the functional loss of more than ¼ of kidney nephrons?

<p>Renal diseases (C)</p> Signup and view all the answers

Which part of the nephron contains a brush border for increased reabsorption surface area?

<p>Proximal convoluted tubule (C)</p> Signup and view all the answers

How do juxtamedullary nephrons differ from cortical nephrons?

<p>They have longer loops that extend deep into the medulla. (A)</p> Signup and view all the answers

Which part of the nephron is primarily involved with secretion rather than reabsorption?

<p>Distal convoluted tubule (A)</p> Signup and view all the answers

What is the main function of the renal pelvis?

<p>Containment of urine before it enters the ureter (A)</p> Signup and view all the answers

Flashcards

Juxta-glomerular Apparatus (JGA)

A specialized structure within the kidney that regulates blood pressure and filtration rate. It directly controls the release of renin from the granular cells.

Macula Densa

Modified cells lining the distal convoluted tubule (DCT) which monitor the flow rate of fluid in the tubule. Increased NaCl levels in the DCT cause them to release adenosine, leading to vasoconstriction of the afferent arteriole.

Granular Cells

Modified smooth muscle cells in the wall of the afferent arteriole that secrete renin. They are stimulated by decreased blood pressure and decreased flow rate in the afferent arteriole.

Glomerular Capillaries

The specialized capillaries within the Bowman's capsule where filtration occurs.

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Efferent Arteriole

The efferent arteriole carries filtered blood away from the glomerulus to continue its journey through the kidney.

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Kidney Excretion

The kidney's role in removing waste products from the body, including urea, uric acid, creatinine, and foreign compounds like drugs.

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Gluconeogenesis in the Kidney

The process of generating glucose from non-carbohydrate sources, such as amino acids, during prolonged fasting. The kidney contributes to this process.

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Renin and Blood Pressure Regulation

The hormone renin, secreted by the juxtaglomerular apparatus, plays a crucial role in regulating blood pressure by affecting the volume of blood and salt in the body.

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Kidney's Role in Erythropoiesis

The kidney is a vital organ in red blood cell (RBC) production by secreting the hormone erythropoietin, which stimulates the bone marrow to produce RBCs.

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Kidney's Role in Vitamin D Metabolism

The kidney converts vitamin D into its active form, 1,25-dihydroxyvitamin D3, which plays a vital role in calcium homeostasis and bone health.

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Kidney's Role in Acid-Base Balance

The kidney helps regulate the balance of acids and bases in the body by eliminating acids produced during protein metabolism and maintaining buffer systems.

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Prostaglandins in the Kidney

Prostaglandins, particularly PGE2 and PGI2, are secreted by the kidney and play a local role in regulating glomerular filtration rate and renal blood flow.

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Kidney's Role in Vitamin D Activation

The enzyme 1α-hydroxylase converts inactive vitamin D to its active form in the kidney, contributing to calcium homeostasis and bone health.

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Nephron

The functional unit of the kidney, responsible for filtering blood and producing urine. Each kidney contains approximately one million nephrons.

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Renal Corpuscle

The filtering part of the nephron, composed of a ball of capillaries (glomerulus) surrounded by a cup-like structure (Bowman's capsule).

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Renal Tubule

A highly coiled tube that reabsorbs essential substances from the filtered fluid (filtrate) and secretes waste products back into the filtrate. It is divided into proximal and distal segments.

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Proximal Convoluted Tubule (PCT)

The highly coiled initial segment of the renal tubule that reabsorbs most of the water, glucose, electrolytes, and amino acids.

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Distal Convoluted Tubule (DCT)

The highly coiled, final segment of the renal tubule that plays a role in fine-tuning electrolyte balance and reabsorbing water under hormone control.

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Loop of Henle

A U-shaped loop of the renal tubule that further reabsorbs water and electrolytes, contributing to the concentration of urine.

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Juxtaglomerular Apparatus

A specialized region where the distal convoluted tubule contacts the afferent arteriole. It regulates blood pressure through the production of renin.

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Renal Cortex

The outer layer of the kidney, containing the renal corpuscles and convoluted tubules.

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Renal Medulla

The inner layer of the kidney, containing the loop of Henle and collecting ducts.

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Renal Pelvis

The funnel-shaped structure in the kidney that collects urine from the collecting ducts and conveys it to the ureter.

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Cortical Nephron

A type of nephron with a short loop of Henle that stays mainly within the cortex. Plays a primary role in urine filtration.

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Juxtamedullary Nephron

A type of nephron with a long loop of Henle that extends deep into the medulla. Plays a significant role in concentrating urine.

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Peritubular Capillaries

A network of small blood vessels surrounding the renal tubules, involved in reabsorbing water and solutes back into the blood.

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Vasa Recta

Specialized blood vessels in the medulla, involved in maintaining the concentration gradient for urine production.

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Urine Formation

The process of removing waste products and excess fluids from the blood and forming urine.

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Homeostasis of ECF

The ability of the kidney to regulate the volume, composition, and pH of the extracellular fluid (ECF).

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Study Notes

Renal Module Information

  • Course code: IMP-07- 20318
  • Phase: I
  • Year/semester: 2nd year / Semester 3
  • Academic year: 2022-2023

Lecture 1: Endocrine Function of the Kidney

  • Intended Learning Outcomes (ILOs):
    • Describe functions of the renal system.
    • Identify types of nephrons and their functions.
    • Describe the juxtaglomerular apparatus and its significance.

Structure of the Urinary System

  • The urinary system comprises the kidneys, renal arteries, renal veins, aorta, ureters, urinary bladder, and urethra.

Kidney Composition

  • Composed of 6-18 lobes.
  • Each lobe consists of a pyramid of medulla covered by cortex.

Nephron

  • Functional unit of the kidney.
  • Each kidney has one million nephrons.
  • 1/4 of kidney nephrons can carry the function; more loss causes renal disorders.
  • Divided into renal corpuscles (filtering) and renal tubules (reabsorption & secretion).
    • Renal corpuscles:
      • Glomerulus (ball of capillaries)
      • Bowman's capsule (expanded, double-walled cup)
    • Renal tubules:
      • Proximal convoluted tubules (PCT)
      • Loop of Henle
      • Distal convoluted tubules (DCT)
      • Collecting tubules (CT)

Types of Nephrons

  • Cortical nephrons (80%): Glomeruli close to the surface, short loops of Henle.
  • Juxtamedullary nephrons (20%): Glomeruli near the medulla, long loops of Henle.

Kidney Functions

  • Homeostasis of ECF: Maintains water, electrolyte balance, and pH & osmolarity.
  • Excretion of metabolic wastes: Removes urea, uric acid, creatinine, and foreign compounds (e.g., drugs).
  • Gluconeogenesis: Synthesizes glucose from amino acids during prolonged fasting.
  • Regulation of arterial blood pressure: Secretes renin.

Endocrine Functions

  • Secretion of erythropoietin.
  • Secretion of renin.
  • Conversion of vitamin D into active form.
  • Secretion of prostaglandins (PGE2 & PGI2).
    • Vasodilator (PGE2)
    • Vasoconstrictor (PGA2)
  • Regulation of acid-base balance.
  • Regulation of body buffer stores.

Renin

  • Hormone secreted by the juxtaglomerular apparatus.
  • Important for salt conservation, regulating blood volume and blood pressure.
    • Stimuli for Renin secretion:
      • Renal ischemia
      • Hypotension
      • Hemorrhage
      • Sympathetic stimulation
      • Increased blood catecholamines
    • Inhibitors for Renin secretion:
      • Increased blood pressure
      • Increased NaCl or Na reabsorption across the macula densa
      • Angiotensin II
      • Vasopressin (ADH)
      • Aldosterone
  • Renin-angiotensin-aldosterone system (RAAS): The most crucial hormonal system for sodium level regulation.

Erythropoietin

  • Hormone secreted by peritubular capillaries in response to hypoxia (low oxygen).
  • Stimulates red bone marrow to produce red blood cells (RBCs).
  • Kidney plays a vital role in erythropoiesis.
  • About 85% of the body's erythropoietin is produced by the kidneys.

Prostaglandins

  • Secreted by the kidney as PGE2 & PGI2.
  • Regulates glomerular filtration rate (GFR) and renal blood flow.
  • Locally acting in the kidney.

Regulation of 1,25-dihydroxy vitamin D3

  • 1α-hydroxylase enzyme converts 25-hydroxycholecalciferol into 1,25 dihydroxycholecalciferol (calcitriol).
  • Essential for calcium homeostasis and bone formation.
  • Regulation in renal diseases is critical as it prevents bone decalcification.

Juxtaglomerular Apparatus (JGA)

  • Structure that lies between the afferent arteriole and the distal convoluted tubule (DCT).
  • Two main cell types:
    • Macula densa: Cells in the DCT wall that monitor sodium chloride (NaCl) concentration in the tubular fluid.
    • Granular cells: Cells in the afferent arteriole wall that secrete renin.
  • Monitors blood flow and plays a crucial role in regulating blood pressure.

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