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PMCOL 303 - Nephrotoxicity Exam With Complete Solution
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PMCOL 303 - NephrotoxicityExam With Complete Solution
what do the kidneys do - Answer concentrate bloodborne waste for elimination -->
produce concentrated urine, save water, excrete wastes
where is the kidney located - Answer upper quadrant, retroperitoneum (behind the
liver/pancreas)
input to the kidney - Answer blood from the descending aorta
output from the kidney - Answer vein joins the ascending inferior vena cava, excreted
waste is transported to the bladder for storage and elimination
functional subunits of the kidney are - Answer nephrons, integrated blood vessel +
tubule networks form "pyramids"
outer region of the kidney cortex is the - Answer cortex
the two inner regions of the kidney are the - Answer outer and inner medulla
nephrons are located where - Answer within the pyramids, spanning all three regions of
the kidney
what is the blood flow through the kidneys - Answer 90% of blood flows through the
cortex (increase in glomeruli = increase in blood flow), 6-10% to the medulla, 1-2% to
papilla
the main exchanging compartments of the kidney are - Answer the nephron
excretory mechanisms do what - Answer concentrate poisons in tubules, might reach
dangerous levels
high [poison] in the tubule drives - Answer diffusion into cells lining tubules (tubular
epithelial cells)
what can cause the precipitation of poisons - Answer high concentrations + removal of
water (this can lead to the concentration of chemicals and induction of damaging
cascades)
active renal transport and metabolism can - Answer uptake and transform chemicals
into poisons
proximal tubule - Answer - water is reabsorbed isosmotically
- transport of K+, HCO3-, Cl-, PO43-, Ca2+, Mg2+, aa, glucose, citric acid cycle
, substrates; and low MW proteins by endocytosis
GFR requires - Answer hydrostatic pressure and oncotic (protein related) draw
3 main cell types of the nephron - Answer - endothelial
- epithelial (focus on tubular epithelial cells)
- podocytes
podocytes - Answer produce little holes through which filtrate flows
what can indicate location of kidney toxicity - Answer changes in urine production
non-oliguric renal failure (inability to concentrate urine) --> - Answer proximal tubule
(most important for taking up chemicals, damage = lack of urine concentrating)
oliguria (reduced urine flow) --> - Answer glomerulus
polyuria (excessive urine flow) --> - Answer loop of Henle, distal tubule, collecting ducts
anuria (no urine flow) --> - Answer post-renal blockages, precipitates
post renal blockage - Answer occurs downstream/outside the kidney (nephron)
precipitates cause - Answer shedding of epithelial cells --> move into filtrate and cause
precipitates in collecting duct
changes in urine chemistry may indicate - Answer location of kidney toxicity
proteinuria - Answer excess protein the urine
proteinuria size of protein indicates location of damage in what way - Answer - high MW
= glomeruli
- low MW = proximal tubule reabsorption
lactate dehydrogenase = - Answer general cell damage
alkaline phosphatases or gamma-glutamyl transferase = - Answer tubule brush border
damage (apical membrane of tubular epithelium)
hematuria (blood in urine) = - Answer sign of glomerular damage: blood is toxic to the
renal tubules (will cause them to shut down)
glucosuria (sugar in urine) = - Answer proximal tubule damage
decline of fxn = - Answer signs of kidney toxicity
what is the most common symptom of kidney damage (50% mortality) - Answer acute
kidney injury (AKI)
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