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Renal 1 Exam 1 L3-Glomerular Filtration
3 questions
12
Medical
Graduate
01/25/2011

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Term
Glomerular filtration 1st step in urine formation
Definition

  • filtrates is Free of blood cells & proteins
(proteinuria = renal injury) 
  • modified passing through nephron
  • free passage of water, small solutes (glucose, aa, electrolytes)

Term
What are the 3 distinct layers of the glomerular membrane? (capillary to bowman's space)
Definition

  1.  Fenstrated capillary endothelium- permeable to water & dissolved solutes
  2. Glomerular basement membrane- collagen, glycoproteins contain anionic charges
  3. Podocyte epithelium- slit pores b/w podocytes restricts large molecules

Term
What is the impact of electrostatic charge on filtering of large molecules?
Definition

  • cations- flow the fastest w/respects to comparative radius size
  • neutral
  • anions- remember that on Glomerular BM the proteins contain anionic charges (repel)
* majority of proteins in blood act like anions
* DN apply to small electrolytes (pass freely)

Term
GFR is the product of 3 physical factors...
Definition

  1. hydraulic permeability- of glomerular mem
  2. Surface Area for filtration

--> product of 1 & 2= ultrafiltration coefficient Kf

 

3. Capillary ultrafiltration pressure (UP)-driving force, determined by hydrostatic & colloid osmotic pressures in glomerular cap

 

GFR= Kf * UP

Term

Mechanisms for altering GFR

(GFR= Kf * UP)

Definition

 

  • Altered Kf: mesangial cell contraction, located w/in glomerular capillary loops, contraction shortens the loop, lowers Kf 
  • Altered UP: changesin Pgc (pressure in glom capillary)
  • Pgc determined by 3 factors:

- renal arterial BP

- afferent arteriolar resistance

-efferent arteriolar resistance

 

Term
Afferent arteriolar constriction causes...
Definition

 

  • greater prssure drop upstream of glom. cap
  • Pgc falls (lowers GFR)
  • Renal blood flow falls (due to increased resistance)
  • Pressure rises before and drops afterwards (include peritubular cap P)

* see slides 25, 26, 27 

Term
Efferent Arteriolar constriction causes...
Definition

 

  • pooling of blood in glomerular capillaries
  • increased Pgc (increases GFR)
  • pressure drops downstream (includes peritubular cap P) 
  • affects on renal blood flow:

 

- severe blood becomes stagnant (GRF drops)

- moderate, will increase GFR

 

* see slides 25, 26, 27 

Term
2 mechanisms for Autoregulation of renal blood flow & GFR
Definition

 

  1. Myogenic- response to increased systemic arterial P , intrinsic property of vascular smooth musc to resist stretch (stretch causes contraction-> narrowing of vessels, decreased R, RBF, GFR)
  2. Tubuloglomerular feedback-involves the juxtaglomerular apparatus (JGA) responds to:
  • increased GFR (w/increased BP, the Macula densa senses the increase in fluid deliver to prod vasoconstrictors to decrease fluid)
  • decreased GFR (w/decreased renal BP, less Na, Cl filtered & delivered to MD, MD signals granular cells to secrete renin to produce angiotensin II)

 

Term
 juxtaglomerular apparatus (JGA) components...
Definition

 

  • Macula densa- in end wall of thick ascending limb of Henle's loop
  • Extraglomerular mesangial cells (AKA lacis cells)- communicates info from the MD to the smooth musc of the afferent arterioles
  • juxtaglomerular (granular) cells - in afferent & efferent arteriole smooth musc
JGA responds to BP changes to maintain GFR nearly constant (minimal changes)

 

Term
Angiotensin II in kidney does what?
Definition

  • released in response to renin release by the MD due to decreased GFR
  • it is a potent vasoconstrictor to restore the BP
  • efferent arteriolar vasoconstrition:

- moderate causes minimizes fall in GFR

-severe GFR falls due to stagnant blood flow

Term
Prostaglandins role on smooth muscle in renal arterioles
Definition

  • released by endothelial cells
  • causes smooth musc vasodilation
  • dampens the vasoconstriction by angiotensin II & SNS
  • why is this important?
- to avoid such profound blood constriction to kidney, ischemia protection mechanism 

Term
SNS stimulation affects
Definition

  • constriction of afferent (lesser extent efferent) arterioles to decrease RBF & GFR
  • increase renin secretion by granular cells, which stimulates angiotensin II products to cause arteriolar constriction to raise BP and my stabilize GFR (if moderate degree)

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