Renal and Acid-Base Physiology

Question	Answer
kidney	It maintains constancy of ECF volume and of osmolality by balancing intake and excretion of Na+ and water.
the kidney achieves constancy of extracellular K+ concentration and of blood and cellular	PH by adjusting excretion of H+ and HCO3- .
kidney is the source for	angiotensin II, erythropoietin, prostaglandins
Kidney reabsorption	the greater part of this ultrafiltrate is transported across the tubule wall and reenters the blood
kidney excretion	The fraction that is not reabsorbed remains in the tubules and appears in the terminal urine.
kidney secretion	: Some urinary solvents enter the nephron lumen from tubule cells by secretion.
What are the three parts of the kidney	medulla cortex nephron
nephron consists of	a glomerulus and renal tubule
glomerulus	glomerular capillary network which emegeres from an afferent arterial
what it the renal tubule composed of	proximal tubule loop of hence distal tubule collecting ducts
blood enters kidney through the	renal artery
renal artery's branches	interloper arcuate cortical radial
afferent arterioles deliver blood to	glomerular capillaries
Blood leaves glomerular capillaries via	efferent arterioles
efferent arterioles deliver blood to the	peritubular capillaries
the peritubular capillaries surround the	nephrons
the peritubular capillaries reabsorb	solutes and water
Blood from the peritubular capillaries flows into small veins and then into the	renal vein
juxtamedullary nephrons, the peritubular capillaries have a specialization called	the vasa recta
vassa recta serve as	osmotic exchangers for the production of concentrated urine
plasma is ____ (fraction) of the ECF	1/4
interstitial fluid is ____ (fraction) of the ECF	3/4
Total body water (TBW) is approximately _______% of body weight	60
The percentage of TBW is highest in	newborns and males
The percentage of TBW is lowest in	adult females and adults with a large amount of fat
60-40-20 rule	TBW is 60 ICF is 40 ECF is 20
Glomerular filtration	water and dissolved solutes pass from the blood plasma to the inside of Boman's Capsule and the nephron tubules
glomerular filtration rate (GFR).	volume of this filtrate produced by both kidneys per minute 115 ml per min in woman 125 ml per min in men
Glomerular ultrafiltrate	fluid that enters the glomerular capsule
glomerular capillaries are extremely permeable T or F	True
is filtered, but not reabsorbed or secreted by the renal tubules.	Inulin
Reabsorption of glucose: Na+-glucose cotransport in the proximal tubule reabsorbs glucose from________ ______ into the blood. There are a limited number of Na+-glucose carriers	tubular fluid
Reabsorption of glucose: At plasma glucose concentrations less than 250 mg/dl, all of the filtered glucose can be reabsorbed because plenty of carriers are available; in this range, the line for reabsorption is the same as that for __________	filtration.
Reabsorption of glucose: increases in plasma concentration above 350 mg/dl do not result in increased rates of reabsorption. The reabsorptive rate at which the carrires are_________ is the transport maximum ™.	saturated
Excretion of glucose: At plasma concentrations less than 250 mg/dl, all of the filtered glucose is_________ and excretion is________ . Threshold is approximately 250mg/dl	reabsorbed;zero
Excretion of glucose: At plasma concentrations greater than 350 mg/dl, reabsorption is saturated . the plasma concentration increases, the additional filtered glucose cannot be_________ and is excretes in the urine.	reabsorbed
Na+ is filtered across the	glomerular capillaries
the Na+ in the tubular fluid of Bowman’s space equals that	in plasma
Proximal tubule-reabsorb _________, of the filtered Na+ and H2O, more than any other part of the nephron.	2/3, or 67%
Proximal tubuleis the site of	glumerulo-tubular balance.
The reabsorption of_____ and ______ in the proximal tubule are exactly proportional	Na+ and H2O
Early proximal tubule absorbs	reabsorbs Na+ and H2O with HCO3-, glucose, amino acids, phosphate, and lactate
in the Early proximal tubule Na+ is reabsorbed by_______ with glucose	cotransport
Middle and late proximal tubules	Filtered glucose, amino acids, and HCO3- have already been completely removed from the tubular fluid by reabsorption in the early proximal tubule.
where is Na+ and Cl- reabsorbed together	middle and late proximal tubules
Thick ascending limb of the loop of Henle reabsorbs	reabsorbs 25% of the filtered Na+
Thick ascending limb of the loop of Henle and the Early distal tubule are impermeable to	water
NaCl is reabsorbed without water in	Thick ascending limb of the loop of Henle
since NaCl is reabsorbed without water in the loop of Henle tubular fluid Na+ and tubular fluid osmolarity decrease to less than their concentrations in plasma. this is called	diluting segment.
Distal tubule and collecting duct together reabsorb__% of the filtered Na+	8%
Early distal tubule reabsorbs NaCl by a	reabsorbs NaCl by a Na+-Cl- cotransporter called the cortical diluting segment.
the Early distal tubule is also called the	called the cortical diluting segment.
principal cell reabsorb ____ and ____.	reabsorb Na+ and H2O.
Principal cells secrete	secrete K+.
Aldosterone increases	Na+ reabsorption and increases K+ secretion.
Antidiuretic Hormone increases ______ __________ by directing the in secretion of H2O channels in the luminal membrane.	H2O permeability
In the absence of ADH, the principal cells are virtually impermeable to ________	water.
alpha Intercalated cells-secrete	H+ by a H+ adenosine triphosphatase (ATP ase),
H+ adenosine triphosphatase (ATP ase) is stimulated by	aldosterone.
alpha Intercalated cells reabsorb	K+ by a H+, K+-ATPase.
Most of the body’s K+ is located in the	ICF
A shift of K+ out of cells causes	hyperkalemia
A shift of K+ into cells causes	hypokalemia.
K+ is filtered, reabsorbed, and secreted by the	nephron.
K+ balance is achieved when urinary excretion of K+ exactly equals	intake of K+ in the diet.
Filtration occurs freely across the	glomerular capillaries.
Proximal tubule-reabsorbs 67% of the filtered	K+ along with Na+ and H2O
Thick ascending limb of the loop of henle-reabsorbs____%of the filtered K+.	reabsorbs 20%
Reabsorption involves the___ ___ ___ _________ in the luminal membrane of cells in the thick ascending limb of the loop of henle	Na+-K+-2Cl- cotransporter
Secretion of K+ occurs in the	principal cell
Secretion of K+ depends on factors such as	dietary K+, aldosterone levels, acid-base status, and urine flow rate.
On a high-K+ diet, intracellular K+ increases so than the driving force for K+ secretion also increases.-On a low-K+ diet, intracellular K+ decreases so that the driving force for K+ secretion decreases.	True
the alpha-intercalated cells are stimulated to reabsorb K+ by the	H+, K+-ATPase.
Hyperaldosteronism	increases K+ secretion and causes hypokalemia.
Hypoaldosteronism	decreases K+ secretion and causes hyperkalemia.
H+ and K+ exchange for each other across the __________ _____ ___________	basolateral cell membrane.
Acidosis________ K+ secretion	decreases
Alkalosis __________K+ secretion	increases
The blood contains excess H+; therefore, H+ enters the cell across the basolateral membrane and K+ leaves the cell. As a result, the intracellular K+ concentration and the driving force for K+ secretion decrease.	Acidosis
Alkalosis	The blood contains too little H+; therefore, H+ leaves the cell across the basolateral membrane and K+ enters the cell. As a result, the intracellular K+ concentration and driving force for K+ secretion increase.
urea is reabsorbed passively in the	proximal tubule
ADH increases the urea permeability of the	inner medullary collecting ducts
50 % of urea is reabsorbed passively in the proximal tubule. What happens to the other 50	Rest are impermeable.
Phosphate is reabsorbed in the proximal tubule by	Na+-phosphate cotransport
85% of phosphate is reabsorbed	in the proximal tubule
15% of filtered phosphate is	excreted in urine.
Parathyroid hormone inhibits	phosphate reabsorption in the proximal tubule by activating adenylate cyclase, PTH causes phosphaturia and increased urinary cAMP.
60% of Ca+ is filtered across	the glomerular capillaries.
the proximal tubule and thick ascending limb reabsorb more than 90% of the filtered	calcium
the distal tubule and collecting duct reabsorb___% of the filtered Ca+ by an active process.	8%
what increases Ca+ reabsorption by activating adenylate cyclase in the distal tubule.	PTH
Magnesium (Mg2+) is reabsorbed in the	proximal tubule, thick ascending limb of the loop of Henle, and distal tubule.
hypercalcemia causes an increase in	Mg2+ excretion
hyperosmotic urine	urine osmolarity> blood osmolarity
Production of concentrated urine is produced when	circulating ADH levels are high (e.g., water deprivation, hemorrhage, SIADH).
Corticopapillary osmotic gradient-high ADH	is the gradient of osmolarity from the cortex (300mOsm/L to the papilla (1200mOsm/L), and is composed primarily of NaCl and urea.
Two-thirds of the filtered H2O is reabsorbed isosmotically (with Na+, Cl-, HCO3-. Glucose, AAs, ) in the	proximal tubule.
. Collecting ducts have high	ADH
Glomerulonephritis	disorder of glomeruli. It is characterized by body tissue swelling (edema), high blood pressure, and the presence of red blood cells in the urine.
causes of Glomerulonephritis	Primary, affecting only the kidneys, Secondary, caused by a vast array of disorders that affect other parts of the body.
Causes:Acute Glomerulonephritis	a complication of throat or skin infection by streptococcus -staphylococcus and pneumococcus, -viral infections, such as chickenpox, -parasitic infections, such as malaria.-Noninfectious causes of acute glomerulonephritis include: -membranoproliferative glomerulonephritis, -immunoglobulin A (IgA) nephropathy, -systemic lupus erythematosus (lupus)
Causes Chronic Glomerulonephritis:	hereditary nephritis, an inherited genetic disorder. In many people, the cause of chronic glomerulonephritis cannot be identified.
Symptoms of Glomerulonephritis:	Edema: Puffiness of the face Eyelids but later is prominent in the legs. -Blood pressure -headaches -visual disturbances-coma -nausea -general feeling of illness (malaise)-weakness, fatigue-fever -Loss of appetite, nausea, vomiting -abdominal pain-joint pain
Treatment for Glomerulonephritis:	diet that is low in protein and sodium Diuretics may be prescribed to help the kidneys excrete excess sodium and water. High blood pressure needs to be treated. Angiotensin-converting enzyme (ACE) inhibitors and angiotensin II receptor blockers (ARBs). antibiotics ( bacterial infection)
Pyelonephritis	bacterial infection (90% is by Escherichia Coli) of one or both kidneys.
symptoms of Pyelonephritis	Chills, fever, back pain, nausea, and vomiting can occur.Urine and sometimes blood tests are done to diagnose pyelonephritis.
treatment of Pyelonephritis	Antibiotics are given to treat the infection
causes for Stones in the Urinary Tract	urine becomes too saturated with salts that can form stones or because the urine lacks the normal inhibitors of stone formation. Citrate is such an inhibitor.
what is the inhibitor of stones in the urinary tract	citrate
About 80% of the stones are composed of	calcium, and the remainder are composed of various substances, including uric acid, cystine.
Stones are more common in people with	hyperparathyroidism
Treatment Stones in the Urinary Tract	Drinking plenty of fluids drugs to help pass -Potassium citrate Calcium channel blockers (such as Verapamil)
The pain of renal colic may be relieved with	nonsteroidal anti-inflammatory drugs (NSAIDs) or opioids.
Two types of acid are produced in the body:	Volatile acid Nonvolatile acids
Nonvolatile acids	are also called fixed acids
Nonvolatile acids	sulfuric acid H2SO4 (a product of protein catabolism) and phosphoric acid (a product of phospholipid catabolism)-are normally produced at a rate of 40-60mmoles/day.
Volatile acid is CO2 and is produced from	aerobic metabolism of cells.
Buffers	prevent a change in pH when H+ ions are added to or removed from a solution.-are most effective within 1.0 pH unit of the pK of the buffer.
The major extracellular buffer is	HCO3
the HCO3 buffer is produced from	CO2 and H2O.
Phosphate is most important as a	urinary buffer;
. Intracellular buffers	Organic phosphates Proteins Hemoglobin
, deoxyhemoglobin is a better buffer than oxyhemoglobin	True
Reabsorption of filtered HCO3--occurs primarily in the	proximal tubule.
. H+ and HCO3 are produced in ________ ______ _____ from CO2 and H2O	proximal tubule cells
Metabolic acidosis	Overproduction or ingestion of fixed acid or loss of base produces an increase In arterial (H+) (acidemia).
Acidemia causes	hyperventilation
hyperventilation is the respiratory compensation for	metabolic acidosis.
. Renal correction of metabolic acidosis consists of increased excretion	excess fixed H+ as titratable acid and NH4+, and increased reabsorption of new HCO3-, which replenishes the HCO3- used in buffering the added fixed H+.
Metabolic alkalosis	. Loss of fixed H+ or gain of base produces a decrease in arterial H+ (alkalemia) results in an increase in arterial HCO3-
Alkalemia causes	hypoventilation
hypoventilation	which is the respiratory compensation for metabolic alkalosis.
Renal correction of metabolic alkalosis consists of increased excretion	of HCO3- because the filtered load of HCO3- exceeds the ability of the renal tubule to reabsorb it.

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Renal and Acid-Base Physiology

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