Flashcards
Renal biochemistry
Flashcards do conjunto (15)
- 1What is osmolalityNumber of particles in 1kg of solution
- 2What is osmolarity?Number of particles in 1L of solvent
- 3How is osmolality calculated?2([Na]+[K]) + [glucose] + [urea]
- 4Vasopressin/ADH: Where is it produced? Where does it act? What does it cause? What triggers it?Produced by hypothalamus supra-optic and paraventricular nucleus.
Acts on collecting duct of kidney.
Triggers increased water reabsorption via aquaporins and increased urea permeability
Triggered by osmotic trigger: extracellular osmolality > intracellular
non-osmotic trigger: hypovolaemic - 5Renin: Where is it produced? Where does it act? What does it cause? What triggers it?Juxtaglomerular cells.
Angiotensinogen in blood
Increased H2O uptake due to increased Na+ and Cl- uptake. Increased K+ and H+ excretion
Triggered by low sodium; low arterial pressure; decreased renal blood flow - 6What is acute tubular necrosis?Occurs due to decreased plasma volume and/or low renal perfusion (so is pre-renal or renal cause).
The resulting low GFR (hence pre-renal uraemia) requires fluid to be given
If fluid not given then there is hypoxic damage and ATN occurs - 7What investigations should be done potential ATN?- Serum creatinine
- Urinary sodium concentration U[Na+] - 8What can U[Na+] be used for?Differentiate between pre-renal uraemia and acute tubular necrosis
- 9What sodium levels do we see in pre-renal uraemia and ATN?Pre-renal uraemia: U[Na] <20 as RAAS activated to counteract the low perfusion volume
ATN: U[Na] >20 and low urinary output as kidneys are no longer responding to aldosterone - 10What are the biochemical and subsequent clinical features of AKI? (4)- Failure to remove nitrogenous waste: malaise, confusion, nausea
- Retention of potassium: cardiac changes
- Fluid overload: cardiac failure, oedema, high BP
- Retention of acidic waste products: acidotic - 11What is Fanconi syndrome?Globular tubular defect that results in loss of many products into urine
- 12What are the biochemical changes seen in CKD? Stage 3aHypertension and increased CVD risk
- 13What are the biochemical changes seen in CKD? Stage 3bLow Ca as there is less Vitamin D produced.
2dary hyperparathyroidism occurs - 14What are the biochemical changes seen in CKD? Stage 4Anaemia due to reduced EPO production
Anorexia
Increased phosphate as unable to excreted - 15What are the biochemical changes seen in CKD? Stage 5Na and water retention
Metabolic acidosis: reduced H+ excretion at the proximal tubules
Hyperkalaemia: reduced excretion as the distal tubular Na/Ke exchange not working
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- Clinical biochemistry FlashCards sobre Renal biochemistry, criado por Katherine Chin em 06-06-2018.
- Criado por
- Katherine Chin
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