patho exam 3
Function of the Renal system - ANSWER Fluid & electrolyte balance
Acid-base balance
Control BP (RAAS)
Releases hormones like - erythropoietin, Vitamin D3, and assists in glucose management
Nephron structure and function - ANSWER functional unit of the kidney
determines what get filtered through and what doesnt.
What do the fenestrations (pores) in the nephron do? - ANSWER -prevent RBC and proteins from
passing
-allows plasma and certain solutes through
note: basement membrane has a negative charge and does not allow proteins in.
Glomerula filtration rate - ANSWER GFR, test to measure amount of blood filtered per min which is
autoregulated by neuro & hormones.
Kidneys autoregulation renal blood flow levels (GFR) - ANSWER maintains range of 80-180 GFR
note: if its less it will lose the ability to autoregulate and cannot filtrate or receive enough blood.
tubuloglomerular feedback mechanism - ANSWER GFR & sodium increase= macula densa cells
stimulate vasoconstriction= decrease GFR
GFR & sodium decrease=macula densa cells stimulate vasodilation= increase GFR
Factors that increase GFR - ANSWER -Extreme increase in systolic BP (>180)
-Low albumin
Factors that decrease GFR - ANSWER -Extremely low systolic (<80)
-obstruction of urine outflow (stricture, renal stones, BPH, tumors)
-Excessive loss of PRO (free fluid from the body..vomiting, diarrhea, diuretic, sweat)
,RAAS System (Low BP) - ANSWER -afferent ateriole triggers renin
RAAS system (High BP) - ANSWER -afferent arteriole constricts leading to decrease in RBF
ADH - ANSWER Promotes water retention
Aldosterone - ANSWER Promotes sodium retention
ANP (atrial natriuretic peptide) - ANSWER -inhibits renin secretion
-acts on the juxtaglomerular apparatus (JGA)
distal convoluted tubule - ANSWER center for pH control
cells of DCT - ANSWER principal cells (aldosterone effect- reabsorbs Na+, secretes K+) and
intercalated cells (secrete H+ in exchange for K+ , or reabsorbs HCO3)
increase oncotic pressure - ANSWER decreased GFR
decreased oncotic pressure - ANSWER increased GFR
normal creatinine levels - ANSWER 0.7-1.4
decline in GFR will be reflected in creatinine level causing them to rise
normal BUN levels - ANSWER 7-20 mg/dL
BUN values rise in states of dehydration w/ acute and chronic renal failure.
Levels also change in result of protein intake and catabolism.
Kidney stone formation causes - ANSWER 1. supersaturation of salts in the urine
2. precipitation of salts from liquid to solid
3. growth through crystallization or agglomeration
, 4. presense or absence of stone inhibitors (uromodulin- tamm horsfall protein)
Acute kidney injury or renal failure - ANSWER -GFR<15
-ischemic injury due to ecf volume deficit and decreased renal blood flow (perfusion)
Prerenal AKI (decreased blood flow to kidney) - ANSWER -decreased cardiac output
-vasodilation
-volume depletion
-blockage
Intrarenal AKI (damage to renal tissue) - ANSWER greatest concerns: pulmonary edema,
hyperkalemia.
also caused by... acute glomerulonephritis
acute tubular necrosis (nephrotoxin like meds, crash injuries, burns)
Postrenal AKI (urine flow obstruction) - ANSWER Increases hydrostatic pressure in bowmANSWER
capsule which meANSWER it opposes filtration in glomerulus. Decreases GFR
Ex: Catheter obstruction, stones, clotes, edema
Chronic kidney disease (injury) - ANSWER Progressive loss of renal function for 3 months or more
GFR>60ml/min
All organ systems are affected
-Diabetic nephropathy most commoon cause
-Chronic glomerulonephritis also associated
Stage 1 CKD - ANSWER GFR >90
normal kidney function
Stage 2 CKD - ANSWER GFR 60-89
creatinine levels rise as GFR declines
Stage 3 CKD - ANSWER GFR 30-59
Function of the Renal system - ANSWER Fluid & electrolyte balance
Acid-base balance
Control BP (RAAS)
Releases hormones like - erythropoietin, Vitamin D3, and assists in glucose management
Nephron structure and function - ANSWER functional unit of the kidney
determines what get filtered through and what doesnt.
What do the fenestrations (pores) in the nephron do? - ANSWER -prevent RBC and proteins from
passing
-allows plasma and certain solutes through
note: basement membrane has a negative charge and does not allow proteins in.
Glomerula filtration rate - ANSWER GFR, test to measure amount of blood filtered per min which is
autoregulated by neuro & hormones.
Kidneys autoregulation renal blood flow levels (GFR) - ANSWER maintains range of 80-180 GFR
note: if its less it will lose the ability to autoregulate and cannot filtrate or receive enough blood.
tubuloglomerular feedback mechanism - ANSWER GFR & sodium increase= macula densa cells
stimulate vasoconstriction= decrease GFR
GFR & sodium decrease=macula densa cells stimulate vasodilation= increase GFR
Factors that increase GFR - ANSWER -Extreme increase in systolic BP (>180)
-Low albumin
Factors that decrease GFR - ANSWER -Extremely low systolic (<80)
-obstruction of urine outflow (stricture, renal stones, BPH, tumors)
-Excessive loss of PRO (free fluid from the body..vomiting, diarrhea, diuretic, sweat)
,RAAS System (Low BP) - ANSWER -afferent ateriole triggers renin
RAAS system (High BP) - ANSWER -afferent arteriole constricts leading to decrease in RBF
ADH - ANSWER Promotes water retention
Aldosterone - ANSWER Promotes sodium retention
ANP (atrial natriuretic peptide) - ANSWER -inhibits renin secretion
-acts on the juxtaglomerular apparatus (JGA)
distal convoluted tubule - ANSWER center for pH control
cells of DCT - ANSWER principal cells (aldosterone effect- reabsorbs Na+, secretes K+) and
intercalated cells (secrete H+ in exchange for K+ , or reabsorbs HCO3)
increase oncotic pressure - ANSWER decreased GFR
decreased oncotic pressure - ANSWER increased GFR
normal creatinine levels - ANSWER 0.7-1.4
decline in GFR will be reflected in creatinine level causing them to rise
normal BUN levels - ANSWER 7-20 mg/dL
BUN values rise in states of dehydration w/ acute and chronic renal failure.
Levels also change in result of protein intake and catabolism.
Kidney stone formation causes - ANSWER 1. supersaturation of salts in the urine
2. precipitation of salts from liquid to solid
3. growth through crystallization or agglomeration
, 4. presense or absence of stone inhibitors (uromodulin- tamm horsfall protein)
Acute kidney injury or renal failure - ANSWER -GFR<15
-ischemic injury due to ecf volume deficit and decreased renal blood flow (perfusion)
Prerenal AKI (decreased blood flow to kidney) - ANSWER -decreased cardiac output
-vasodilation
-volume depletion
-blockage
Intrarenal AKI (damage to renal tissue) - ANSWER greatest concerns: pulmonary edema,
hyperkalemia.
also caused by... acute glomerulonephritis
acute tubular necrosis (nephrotoxin like meds, crash injuries, burns)
Postrenal AKI (urine flow obstruction) - ANSWER Increases hydrostatic pressure in bowmANSWER
capsule which meANSWER it opposes filtration in glomerulus. Decreases GFR
Ex: Catheter obstruction, stones, clotes, edema
Chronic kidney disease (injury) - ANSWER Progressive loss of renal function for 3 months or more
GFR>60ml/min
All organ systems are affected
-Diabetic nephropathy most commoon cause
-Chronic glomerulonephritis also associated
Stage 1 CKD - ANSWER GFR >90
normal kidney function
Stage 2 CKD - ANSWER GFR 60-89
creatinine levels rise as GFR declines
Stage 3 CKD - ANSWER GFR 30-59
