WEEK 3 - Renal Injury
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What is the primary function of the renal system?
To regulate blood volume and composition of body fluids and to excrete wastes
What are the three additional functions of the kidneys?
• Synthesis of the active form of vitamin D • Blood pressure regulation via the RAAS • Erythropoietin synthesis for blood cell production via the bone marrow
Where are the kidneys located anatomically?
They lie in the retroperitoneal space, posterior to the abdominal wall, outside of the abdominal sac
Which kidney is located lower than the other?
The right is lower than the left (due to the presence of the liver)
How do the kidneys regulate pH?
Via the excretion of protons or the retention of bicarbonate
How do the kidneys regulate BGLs?
Via gluconeogenesis - conversion of amino acids to glucose
How much cardiac output do the kidneys receive? Via which artery?
20-25% via the renal artery
Major vessels, nerves and the ureters enter and exit the kidneys via which structure?
The hilum
What does the renal cortex contain?
85% of nephrons (outer region of the kidney)
What does the renal medulla contain?
15% of nephrons and the renal pyramids (inner region of the kidney)
How is the renal pelvis formed?
Minor calyces join to form the major calyces, major calyces join to form the renal pelvis
What is the structural and functional unit of the kidney?
The nephron
Which area of the nephron is responsible for filtration?
The glomerulus and Bowman’s capsule
Which areas of the nephron are responsible for reabsorption?
• Proximal convoluted tubule - Distal convoluted tubule
Which area of the nephron is responsible for concentration?
The loop of Henle (via the peritubular capillaries)
Which area of the nephron is responsible for secretion?
The distal convoluted tubule
By what means substances reabsorbed via the nephron?
Water and urea = passive transport (descending LoH) Ions and salts = active transport (ascending LoH)
There are three ions that are resorbed or excreted depending on hormonal influences. Which ions are these?
Na+ Ca2+ Mg2+
Define GFR (not just what the letters stand for)
Glomerular Filtration Rate The quantity of glomerular filtrate produced each minute by ALL NEPHRONS in BOTH KIDNEYS
Normal GFR?
125mL/min OR 180L/hour
What proportion of filtrate is resorbed by the kidneys?
99%
When are you no longer considered to have a healthy GFR and why?
After the age of 30 due to age-dependent loss of nephrons
What three factors is GFR reliant on?
• Net filtration pressure • Filtration membrane permeability • Total surface area available
Renal injury is characterised by?
A sustained decline in GFR