The fluid filtered by the glomerular capillary filtration membrane and released into the
proximal convoluted tubule is _______ free but contains ____________ and _______
_________ in the same concentrations as found in plasma - protein; electrolytes (i.e.
sodium chloride and potassium); organic molecules (i.e. creatinine urea and glucose)
In the glomerulus, the ________ ________ determines permeability of glomerular
capillary membrane - Basement membrane
What does glomerular filtration depend on (3)? - •Size and charge of substances
•Hydrostatic pressure in the capillaries
•Oncotic pressure in the capillaries
,Between BP ___ - ____ mmHg the kidneys maintain a constant GFR - 80-180
Autoregulation of renal blood flow:
Response to increased systemic BP - Afferent arterioles constrict, preventing an
increase in filtration pressure.
Autoregulation of renal blood flow:
Response to decreased systemic BP - GFR decreases and the amount of sodium in
macula densa decreases
•RAAS activated
•Vasoconstriction, increase in sodium and water reabsorption, BP returns to norm
________ is a good index of renal function, ______ is a good index for hydration -
creatinine; BUN
Creatinine is most valuable for monitoring the progress of chronic rather than acute
renal disease. -
Aging and Renal Function: (increased or decreased) excretion of glucose - increased
GU Endocrine Functions (3) - •Renin- Angiotensin -Aldosterone System or RAAS
•Erythropoietin (EPO) Hormone regulates RBC production in bone marrow; made in
kidneys- stimulated by hypoxia
•Vitamin D (hormone)- Transformed in the active form in the kidneys; Increases calcium
absorption from GI tract
Intracellular body fluid is (half/double) extracellular fluid - Double
Treatment: Give albumin to pull fluid into blood vessel and then give them Lasix
Edema from kidney failure - Glomerulonephritis (Kidney failure, damage to basement
membranes) causes albumin loss and massive edema
Edema from capillary membrane damage - Cause: From infection (inflammation,
swelling)
Treatment: treat infection with antibiotics and sometimes steroids
Edema from lymphatic obstruction - Lymphedema
Breast cancer surgery patients have to removed lymphatics around area
possibly from tumor blocking or scar tissue from surgery
Edema from hypertension - Can occur with heart failure
Mechanism: capillary pressure is too high
Treatment: Diuretics, Pressure stockings, Treat BP
Edema from DVT - Mechanism: blood cannot flow through vessel, pressure increase,
fluid leaks out
Treat DTV (don't give Lasix)
The extracellular compartment is divided into ______ and ___________ - plasma
(vascular compartment) and interstitium
Function of Atrial Natriuretic Peptides - Decreases tubular resorption and promotes
urinary excretion of sodium
Water balance is regulated by _________ and __________ - thirst perception and the
antidiuretic hormone (ADH)
Both are regulated by serum osmolality & blood volume
Diabetes Insipidus (3 types) - •Deficiency of or decreased response to ADH
•Neurogenic - strokes, head injury, surgery
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