Term
| secreted by zona glomerulosa, enhances sodium resorption(decreases sodium excretion), and K+ excretion |
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Definition
| where is aldosterone secreted and what does it do (overall effect)? |
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Term
| a decrease in sodium is detected by the macula densa and so angiotensin 2 is increased, leading to aldosterone secretion |
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Definition
| what is the main thing that stimulates aldosterone secretion? |
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Term
1) late DCT & cortical collecting tubule: the principal cells increase Na+ resorption and increase K+ secretion
2) intercalated cells of the collecting tubule: increase H+ secretion and HCO3 reabsorption |
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Definition
| where are the 3 places aldosterone acts? |
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Term
| it makes it worse because it causes K+ secretion |
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Definition
| what does aldosterone do to hypokalemia? |
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Term
1) it enhances ENaC synthesis on the luminal side
2) it enhances the Na+/K+ pump on the basolateral side of the cell
3) it increases the K+ channels to the lumen |
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Definition
| what does aldosterone do to specific pumps on the principal cells? |
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|
Term
| excess aldosterone production |
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Definition
| What causes Conn's syndrome? |
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Term
|
Definition
Na+ retention
hypOkalemia
alkalosis
hypertension
what disease is characterized by these things? |
|
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Term
| aldosterone is secreted and it causes excess aldosterone secretion: Conn's syndrome |
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Definition
what disease is associated with a benign tumor in the zona glomerulosa?
(hint: what is secreted here?) |
|
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Term
|
Definition
| what causes Addison's disease? |
|
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Term
|
Definition
what disease is characterized by:
Na+ wasting
hypERkalemia
hypOtension |
|
|
Term
|
Definition
| what disease is caused by an adrenal insufficiency, usually autoimmune? |
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|
Term
1) angiotensin 2 - stimulates adrenal cortex directly and constricts efferent arteriole
2) increased plasma K+
3) ACTH - stimulates ALL adrenal function, mostly cortisol from fasiculata though |
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Definition
| what are the 3 things that stimulate aldosterone secretion? |
|
|
Term
1) atrial naturiuretic factor (ANF/ANP)
2) increased Na+ concentration (osmolarity) |
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Definition
| what 2 things decrease aldosterone secretion? |
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|
Term
1) PCT
2) LoH
3) DCT
4) collecting tubules |
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Definition
| where does angiotensin 2 increase Na+ reabsorption? |
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|
Term
1) increases filtration fraction (GFR) which increases peritubular oncotic pressure
2) decrease peritubular capillary hydrostatic pressure |
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Definition
| what does angiotensin 2 constricting the efferent arteriole do? |
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|
Term
| Asp-Arg-Val-Tyr-Ile-His-Pro-Phe it is an octomer |
|
Definition
| what is the sequence of Angiotensin 2? |
|
|
Term
| ACE inhibitors & A-II receptor antagonists |
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Definition
|
|
Term
the -prils!
1) captropril
2) benazipril
3) ramipril |
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Definition
| what are the ACE inhibitors? |
|
|
Term
the -artans
1) losartan
2) candesartin
3) irbesartan |
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Definition
| what are the A-II receptor antagonists? |
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|
Term
1) decrease aldosterone
2) directly inhibit Na+ reabsorption
3) decrease efferent arteriolar resistance (decrease GFR)
ultimately: natriuresis and diuresis to decrease blood pressure |
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Definition
| what does ACE inhibitors/ A-II receptors antagoinists do (3 things)? ultimately? |
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Term
|
Definition
| what does ANF/ANP do to Na+? |
|
|
Term
| cardiac atria, in response to stretch (high blood volume) |
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Definition
| where in ANF/ANP secreted? |
|
|
Term
1) Na+ reabsorption
2) renin release
3) aldosterone formation |
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Definition
| what does ANF inhibit? (3 things) |
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|
Term
increase GFR by dilating the afferent arteriole
counteracts renin/angiotensin to minimize blood volume expansion |
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Definition
| what does ANF do to GFR? how? |
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|
Term
| basically aldosterone loses effect over time because ANP compensates to prevent the blood volume(and pressure) from getting to high |
|
Definition
| what is aldosterone escape? |
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|
Term
| causes increased reabsorption |
|
Definition
| what does the sympathetic nervous system do to sodium? |
|
|
Term
| decreases both, which stimulates renin release, and stimulates Na+ retention |
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Definition
| what does sympathetic stimulation do to GFR and renal blood flow? |
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|
Term
| sympathetic nervous system effects (increase sodium retention) |
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Definition
| what is the response to heart failure that is the opposite of ANF? |
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|
Term
| sympathetic nervous system effects (increase sodium retention) |
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Definition
| what is the response to heart failure that is the opposite of ANF? |
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|
Term
when the atria sense high pressure, they 1) increase peritubular hydrostatic pressure
2) decrease renin and aldosterone
3) increase release of intrerenal natiuretic factors such as prostaglandins
--> sodium excretion |
|
Definition
| what does pressure natiuresis do? |
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|
Term
neither, it is independent of both
it is a protective mechanism to prevent overexpansion of the total blood volume |
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Definition
| Is renal pressure natiuresis dependent on hormones or the sympathetic nervous system? |
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|
Term
volume: Na + retention
osmolarity: H2O retention |
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Definition
| volume sensing controls ____, whereas osomolarity sensing controls ______ |
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|
Term
1) albumin excretion
2) plasma concentration of waste products (BUN, creatinine)
3) urine specific gravity
4) imaging methods
5) Isotope renal scans
6) biopsy
7) clearance methods (24hr creatinine clearance) |
|
Definition
| what are 7 ways to assess kidney function? |
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|
Term
|
Definition
| concept that describes RATE at which substances are removed from the plasma |
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|
Term
|
Definition
| the VOLUME of plasma completely cleared of a substance PER MINUTE by the kidneys |
|
|
Term
Cs = (Us x V) / Ps
Cs =clearance of a substance
Ps =plasma concentration of substance
Us =urine concentration of substance
V =urine flow rate |
|
Definition
| what is the clearance equation? |
|
|
Term
|
Definition
| for a substance that is freely filtered but not reabsorbed or secreted, renal clearance = ? |
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|
Term
|
Definition
| for inulin, 125-I-iothalamate, and creatinine amount filtered = ? |
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|
Term
| the clearance of inulin (urine conc. of inulin * urine flow rate)/plasma conc. of inulin |
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Definition
|
|
Term
inverse relationship, high creatinine in the blood means low GFR
why? because creatinine is secreted at about a constant rate by skeletal muscle and so is cleared at a constant rate. Clearance failure = fail kidney |
|
Definition
| what is the relationship between plasma creatinine and GFR? |
|
|
Term
|
Definition
| what is the equation for tubular reabsorption? |
|
|
Term
| plasma concentration of the substance |
|
Definition
|
|
Term
|
Definition
| excretion = Urine concentration of a substance x ? |
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|
Term
| urine concentration of the substance |
|
Definition
| reabsorpbtion = (GFR - plasma concentration of substance ) - ( ? x urine flow rate) |
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|
Term
|
Definition
| secretion = ? - filtration |
|
|
Term
|
Definition
| if a substance is completely cleared from the plasma, what does it's clearance rate equal? |
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|
Term
| PAH clearance, it is freely filtered, and secreted so it is almost completely cleared from the plasma |
|
Definition
| what is used to estimate effective renal plasma flow? why? |
|
|
Term
|
Definition
| if a substance's clearance is less than inulin, what does that mean? |
|
|
Term
|
Definition
| if a substance's clearance is greater than inulin, what does that mean? |
|
|
Term
inulin - 125 ml/min
PAH - 600 ml/min
glucose- 0 ml/min
sodium - 0.9 ml/min
urea - 70 ml/min |
|
Definition
| what are the clearances of inulin, PAH, glucose, sodium, urea? |
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