BMS11-1035 Kidney Function II: Production of concentrated urine by the kidney

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Define osmolality and its importance to renal function. Describe the processes of salt and water absorption throughout the nephron. Describe the mechanism of production of concentrated urine. Describe the counter-current mechanism. Describe the recycling of urea. Explain the role of ADH in collecting duct. Describe the renal handling of Ca2+, Mg2+, phosphate and potassium.
Evian Chai
Flashcards by Evian Chai, updated more than 1 year ago
Evian Chai
Created by Evian Chai over 4 years ago
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Proximal Tubule Na+ Reabsorption - Na+ moves into cell via ...exchanger and ...symporter - ...maintains low Na+ in cell - negative charge on lumen repels Cl-, HCO3- etc. 1. Na+/H+ 2. Na+/nutrient (Glucose, AA etc.) 3. Na+/K+ ATPase
Thick Ascending Limb Na+ Reabsorption - ... cotransporter to transport Na+ - ... maintains low Na+ in cell - K+ channels allow K+ out into filtrate, creating ... and driving Na+ into cell 1. Na+/K+/2Cl- 2. Na+/K+ ATPase 3. positive charge
Distal Tubule Na+ Reabsorption - cotransporter transports Na+ in - ... keeps Na+ concentration in cell low 1. Na+/Cl- 2. Na+/K+ ATPase
Collecting Duct Na+ Reabsorption -2 cell types: ... cells (Na+), ...cells (H+) - In ... cell, ....and Na+/K+ ATPase 1. Principle 2. Intercalated 3. Principle 4. Na+ channels
What is the definition of clearance? What is the equation? What is the unit? 1. The volume of plasma cleared of a substance in a given time 2. C=(ion concentraton in urine*volume of urine)/ion concentration in plasma 3. mL/min
Clearance Values: ...: <120ml/min eg. most solutes No change: .../min eg. ... ...:>120ml/min eg. ... 1. Reabsorption 2. 120, inulin 3. Secretion, PAH
Describe the mechanisms of ADH in the collecting duct 1. ADH binds to V2 2. Activates G protein/adenylyl cyclase 3. PKA causes translocation of AQP2 to membrane 4. H20 can enter via aquaporins
H20 Reabsorption depends on which 3 factors? 1. Osmosis 2. Sodium reabsorption (bc H20 reabsorption coupled with Na+, bulk flow) 3. Tubule permeability - increased by AQP1/tight junctions on membrane
Making Concentrated Urine How is the concentration gradient created? 1. ...pumps Na+ out via Na+/K+/2Cl- co transporter Thick ascending limb
Making concentrated urine How is water removed from the LoH? 2. ... picks up ..., loses ... (osmosis) as it descends due to increasing solute concentration down the medulla 1. Descending limb 2. Na+ 3. H20
Making concentrated urine Why does osmolarity decrease up the ascending tubule? 3. ... impermeable to H20 - solutes move out, H20 remains - Osmolarity decreases up ascending tube Thin ascending limb
Name the 3 places of urea reabsorption and their mechanism? 1. Proximal Tubule-passive reabsorption 2. LoH- apical secretion via VTA2 3. Inner Medullary Collecting Duct- Reabsorbed into cell via VTA1 and leaves cell into interstitium via VTA3
Osmolality Ranges: Plasma: ...mosm/kg Urine: ...mosm/kg Concentrated if >plasma Dilute if <plasma Main determinant is ... 1. 285-295 2. 50-1400 3. Sodium
Potassium is the major ... in body, determines ... 1. Intracellular cation 2. Resting membrane potential
What is Renal Plasma flow? What is it measured by? What is it usually? 1. Amount of blood to kidneys/time 2. PAH because no reabsorption 3. Usually 600mL/min
What is the equation for renal blood flow? Plasma flow- (1-haematocrit aka RBC proportion) = 600/0.55
Sodium reabsorption occurs in: PCT (...%) Thick Ascending Limb (...%) DCT (...%) Collecting Duct (...%) 1. PCT: 65 2. Thick Ascending Limb of LoH: 25 3. DCT: 2-5 4. CD: 5
What are the 4 factors increasing K+ secretion? 1. Na+ entry through Na+ channels 2. Aldosterone, which stimulates K+/Na+ channels 3. High tubular flow rate 4. Alkalosis, which enhances K+ movement
What are the sites of K+ reabsorption? 1. Thick ascending limb via Na+/K+/2Cl- cotransporter 2. Distal tubule via K+/H+ exchanger 3. In CD by intercalated cells with K+ channels or K+/Cl- cotransporter - outweight by principal cell K+ secretion
Principle cells reabsorb ... and secrete... Na+ K+
What is the role of ADH in urea recycling? ADH increases water permeability but not urea permeability in outer medullary/cortical collecting ducts, allowing urea to concentrate in the tube As a result, there is a concentration gradient of urea created within the tube, driving urea reabsorption later on in the inner medullary collecting duct
What measures clearance experimentally vs. clinically? Experimentally: inulin Clinically: creatinine
... supplies blood without washing gradient away via counter current exchange Counter current exchange is when loops slow blood flow so reabsorbed solutes can reenter interstitual fluid/mantian concentration gradient Vasa Recta
Urea is .... at the level of the renal corpuscle and undergoes ... in the kidney as majority is 1. Freely Filtered 2. Recycling 3. Reabsorbed
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