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Inner portion of kidney where urine is collected
Renal Pelvis
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Functional unit of the kidney. Contains glomerulus and tubules. Each kidney contains ~1.2 million of these
Nephron
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transfers urine to the bladder
Ureter
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End product of muscle metabolism
Plasma Creatinine
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End product of protein metabolism
BUN - Blood Urea Nitrogen
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Amt of blood cleared of creatinine in one minute. Measure of the glomerular filtration rate.
Creatinine clearance
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Most accurate measurement of kidney's ability to concentrate and dilute urine
Osmolality
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Outer portion of kidney; contains 85% of the nephrons
Cortex
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Middle portion of the kidney; w/medullary pyramids, Henle's loop, distal & collecting tubules
Medulla
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Branches off from abdominal aorta; supplies blood to the kidney
Renal artery
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Carries blood leaving the kidney
Renal vein
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Beginning of the nephron; bundle of capillaries; filtration of water, ee's, urea, creatinine, uric acid, glucose, amino acid
Glomerulus
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Cup-like depression of nephron that surrounds the glomerulus
Bowman's Capsule
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Hormone that stimulates bone marrow to produce rbc's; released when there is decreased O2 delivery to the kidneys
Epoietin
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Kidneys are major organs to produce Calcitriol - active form of what vitamin?
Vitamin D
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This system regulates renal blood flow by incr syst arterial pressure. Starts with release of renin:
- RAAS: Renin Angiotensin Aldosterone System
- Renin stimulates secretion of Ang II
- Ang II stimulates secretion of aldosterone by adrenal cortex
- Aldosterone is a potent VASOPRESSOR
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Hormone secreted by posterior pituitary that affects concentration of final urine output:
ADH - Antidiuretic Hormone
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Two hormones secreted by posterior pituitary:
ADH and Oxitocin
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Final adjustment to acid-base balance happens here:
- Distal tubules
- Reabsorbs Na and H20
- Excretes K, urea, some drugs
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Three processes of nephrons that occur to form urine:
- Filtration (of blood)
- Reabsorption (of essential materials)
- Excretion (of nonessential materials)
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Taking back of fluids and other substances through body tissues:
Reabsorption (into blood)
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Active transport of certain chemicals from the bloodstream into the tubules:
Secretion (from blood)
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These reabsorb Na, H2O, urea, K, HCO3, Ca, Phos, amino acids, uric acid:
Proximal tubules
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Concentrates or dilutes the urine, reabsorbs water then Na:
Loop of Henle
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Reabsorbs water as necessary; adjusts reabsorption or secretion of Na and K as necessary
Collecting duct
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ADH
- Regulates urine volume
- Acts on distal tubule/collecting ducts
- Increases H2O reabsorption & urine concentration
- Secreted from posterior pituitary
- Decreases urine output
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ANP - atrial natriuretic hormone
- Secreted by muscle fibers in atria
- Promotes loss of Na via the urine
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Aldosterone
- Secreted by adrenal cortex
- Increases Na absorption
- Controls K secretion
- Works with ADH to increase H2O retention
- Depresses formation of renin
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Renin
- Enzyme secreted by kidneys
- Helps regulate Na retention
- Initiates Ang/AngII (Ang II is vasoconstrictor)
- RAAS regulates renal blood flow w/> syst art pres
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Erythropoietin
- Hormone produced by kindeys if low arterial O2
- Stimulates RBC production
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Kidneys produce Calcitriol - active form of:
Vitamin D
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Calcitriol
- Produced by kidneys
- Stimulates intestinal Ca and Phosp absorption
- Affects bone metabolism
- Modulates immune system
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24 hour urine specimen testing what elements:
- Creatinine (waste product secr by muscle tiss)
- Creatinine clearance (glomerular filtration)
- Protein
- Urea nitrogen (prod of protein metab.)
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BUN - Blood Urea Nitrogen
- Measures nitrogenous urea in blood
- Urea produced by protein metabolism
- "Protein on a bun"
- Low secretion = renal disorders, hi prot diet, excess prot metabolism
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Serum Creatinine
- Nitrogenous waste from muscle metabolism of creatinine
- Reflects glomerular filtration rate
- Measures renal damage better than BUN
- Only cause of >BUN = severe renal damage
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Elevated urine osmolality caused by:
- SIADH secretion
- Acidosis
- Hypernatremia
- HF
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Decreased urine osmolality caused by:
- Diabetes insipidus
- Hypercalcemia
- Excess fluid intake
- Renal tubular necrosis
- Aldosteronism
- Hypokalemia
- Severe pyelonephritis
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Azotemia
- Elevated nitrogenous waste products in blood
- Increased serum urea & creatinine levels
- Does not manifest S/S of Kidney Failure
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Uremia
- Syndrome of kidney failure
- Characterized by >BUN and >Creatinine levels
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