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CHEM 201 - WT2 - Renal
Terms in this set (128)
What hormone formed by neuronal cells of the hypothalamus and stored in pituitary gland has vasopressor and antidiuretic functions?
Antidiuretic hormone (ADH)
What is excess nitrogenous compounds in the blood called?
What condition is characterized by insufficient synthesis of ADH?
What condition is characterized by the kidney's inability to support life?
End-stage renal disease
What type of proteins are abnormal urine/blood proteins with unusual solubility properties? (commonly found in *multiple myeloma patients)
Bence Jones proteins
What is glomerular filtration rate (GFR)?
Rate of small molecules filtered through the kidney's glomeruli
What condition is characterized by inflammation of the capillary loops in glomeruli?
What structures are tufts of blood vessels found in each nephron involved in filtration?
What process is the removal of elements via diffusion through a semipermeable membrane?
What condition is characterized by blood in the urine?
What part of the kidney is the *medulla?
The inner region. Consists mostly of loops of Henle, surrounding capillaries and collecting ducts
What part of the kidney is the cortex?
The outer region
What is the renal pelvis?
The large cavity at the entrance of the kidney that receives the urine
What is the hilus of the kidney?
The area of the kidney where the blood supply enters
Main function of the renal capsule?
Membranous layer that protects the kidney against trauma
What is the main function of the urethra?
To transport the urine from the bladder to the outside
What is the main function of the bladder?
To store urine
What is the main function of ureters?
To transfer the urine from the renal pelvis to the bladder
*What are the main biological functions of the kidney?
endocrine (primary and secondary)
What is the major nitrogen-containing product of protein catabolism?
What reaction measures creatinine by reacting with alkaline picrate?
What word means the excess or decrease uric acid in the blood?
*What is a disorder in the metabolism of purine/pyrimidine called?
*what is found in the joints in patients with gout?
uric acid salts
What condition is characterized as excess blood in the urine?
*Volume of plasma from which a given substance is completely cleared by the kidney per unit of time
*Inflammation of the kidney and its pelvis as a result of infection
What kind of dialysis is it when the diffusion happens through the peritoneal membrane?
What general condition is associated with any defective kidney glomeruli?
*What is the functional/anatomical unit of the kidney?
*how many nephrons are in each kidney
up to 1 million
What condition is characterized by the presence of renal calculi?
What is inflammation of the kidney called?
What is the crushing of calculus with the urinary system or gall bladder followed by washing out of the fragments?
What are the components of the nephron?
proximal and distal tubule
loop of Henle
What is the main function of the renal calyces?
Collect the urine before passing it along to the ureter and the bladder
What are medullary rays?
Striation in the renal pyramids within the medulla
What are elongated blood vessels within the kidney called?
What kind of capillaries are the connective tissue for the glomeruli?
What membrane is the barrier to protect the passage into the lumen?
What structure is made when the proximal convoluted tubule progresses towards the renal medulla?
*What kidney structure is the most metabolically active part of the nephron? (reabsorption of 60-80% of glomerular filtrate)
*the cells forming the distal tubule of the nephron start at the ____________ , and extend to the ____________
first fusion with other tubules to form the collecting ducts
*sodium chloride reabsorption and some potassium and hydrogen ion excretion occurs at
the distal tubule
The ascending loop of Henle with the Bowman's capsule make what kidney structure?
What is the main function of the juxtaglomerular apparatus?
To maintain systemic blood pressure
*JGA maintains systemic blood pressure through regulation of
intravascular blood volume and sodium concentration
*what hormone is released in response to decreased afferent arteriolar pressure and decreased intraluminal sodium delivery to the macula densa
The production of renin eventually produces ADH through the stimulation/conversion of what intermediate hormones?
Angiotensin 1 and 2
What enzyme converts angiotensin 1 to angiotensin 2 in the lungs?
Angiotensin converting enzyme (ACE)
*vasoconstriction and aldosterone release act in concert with A-II to increase the release of
antidiuretic hormone (ADH, Vasopressin)
What percent of cardiac output is sent to the kidney?
What percent of the blood flow to the kidney is supplied to the renal cortex?
*how does the renal glomerular perfusion pressure compare to the systemic pressure?
they are independent of each other
systemic is maintained at 90-200 mmHg, and glomerular pressure at a constant 45 mmHg
What is micturition?
*traits of urine from a healthy individual
Clear and sterile
pH of 5.0 - 6.0
specific gravity of 1.015 - 1.025
urine output in normal adults
about 500 mL/day
What is the most common urine disorder?
urination < 100 mL/day
urination < 400 mL/day
urination > 3 L/day
or 50mL/kg body weight/day
The first step in urine formation is
filtration of plasma water through the glomeruli
Why is urine often called ultrafiltrate?
It's composition is similar to plasma, with large molecules removed
*What percent of electrolytes and water in the ultrafiltrate are reabsorbed through the proximal convoluted tubule?
*The proximal convoluted tubule is predominantly concerned with
*corticomedullary osmotic gradient
filtered sodium is reabsorbed in the ascending loop of Henle without concomitant reabsorption of water, generating dilute urine
*What kidney structure is the most active region for the homeostatic regulation of plasma electrolytes and plasma acid-base concentrations?
The distal tubule
*production of aldosterone in the adrenal cortex is stimulated by
the renin-angiotensin system and by high plasma potassium concentration
*what happens when H+ must be conserved to maintain plasma pH
distal tubule cells reduce the secretion of H+, reduce NH4+ generation, reduce Na+/H+ exchange, and increase bicarbonate excretion
Cortical and medullary ducts are impermeable to urea except
when acted upon by ADH
*What is primary endocrine function?
*What is secondary endocrine function?
To be the site of action for hormones produced by other organs
*What hormones are excreted by the kidney?
*what hormones do the kidneys degrade?
insulin and aldosterone
*What is creatinine?
final product of phosphocreatine degradation
Creatinine is secreted in what body fluid?
Creatinine is a diagnostic indicator of what?
Creatine is synthesized where?
Liver, kidney, pancreas
What percent of urea is excreted in the kidney?
Urea is what percent of non-protein nitrogen in the body?
What is the major catabolic product of adenosine and guanosine?
Uric acid is the principle nitrogenous excretion in
birds and reptiles
*how much uric acid is reabsorbed in the proximal convoluted tubule?
*What is one serious problem with Jaffe reaction?
It has low specificity for creatinine
*what reaction involves creatine and picrate ion in an alkaline medium to yield an orange-red complex
*spectrophotometric approaches to ammonia quantitation include
Berthelot reaction and enzymatic assays
What is the most practical test to determine renal function?
In order to determine GFR clearance, S must be
Stable, inert, freely filtered, and not metabolized, secreted, reabsorbed or synthesized
Equation to calculate renal clearance
GFR = (Us x V)/Ps
What substrate provides the most accurate estimate of GFR?
What are 3 methods used to test glomerular permeability?
Dipstick method, 24hr test, and BJP detection
What are 2 lab tests that can determine GFR?
Inulin clearance test (reference method)
creatinine clearance test
Creatinine clearance test requires what two things
24-hour urine collection
blood creatinine measurement during the 24-hour period
GFR measurements may be based on either the _____ or _____ clearance of the marker
What 2 ways are used to measure renal concentrating abilities?
Specific gravity, osmolality
what method is sensitive for testing albumin in urine
Bence Jones proteins are associated with detecting what diseases?
Multiple myeloma and tumor markers
two common methods in measuring the tubules concentrating ability
specific gravity determination
osmolality test (more valid test)
GFR is a reliable indicator of the number of what?
Decreased GFR always precedes what condition?
GFR is used as a guide to dosage of renally excreted drugs to prevent
What rate is the most sensitive measurement of functional change within the kidney?
What is the most important cause of renal injury that ends in fibrosis?
Increased workload on each nephron
Patients present to the clinician for urinalysis because of what common conditions?
Blood/urine abnormality, symptoms/signs, systemic disease with known renal involvement
Initial management of urinalysis includes:
Clinical history, clinical examination, assessment of urine sediment
Turbid urine indicates what?
infection or fat particles
Foamy urine when shaken indicates what?
Acute renal failure (ARF) is defined as kidney damage that progresses over what length of time?
hours - days
chronic kidney disease is defined as what?
kidney damage or GFR <60 mL/min/1.73m^2 for >3 months
stage 5 in the NKF KDOQI guidelines
kidney failure or GFR less than 15 mL/min/m2
What is the primary cause of ARF?
Vascular, glomerular, and interstitial disorders
Non modifiable CRF factors include
age, sex, race, function level
Modifiable CRF factors include
proteinuria, blood pressure, smoking
Proteinuria along with diabetes is defined as
Overt nephropathy is defined as proteinuria that is
> 0.5 g/day
What quantity of protein must be in the urine to be considered proteinuria?
> 80 g/mL
Diabetic nephropathy is the most common cause of what condition in the US?
What is the secondary cause of ESRD is the US?
red cell casts are indicative of
glomerular bleeding and glomerular pathology
What is the separation of macromolecules and ions based on their diffusion rate?
What are 2 types of physical dialysis processes?
Diffusion and convection
What are the 3 most used forms of dialysis?
Hemodialysis, hemodiafiltration, peritoneal dialysis
The dialysate for peritoneal dialysis is instilled where?
In the peritoneal cavitiy
What is the most common dialysis used to treat kidney failure?
What feature is the most important part of hemodialysis?
What is the most effective renal replacement therapy?
What is excess urea in the blood?
How many kidneys does Tom Hanks have?