Kidneys, Ureters, and Beyond!
What is the main function of the peritubular capillaries?
What is reabsorption of water and nutrients from the renal medulla into the blood stream
Name 2 hormones secreted by the heart that cause renal excretion of water.
What is Atrial Natriuretic Peptide (ANP) Brain Natriuretic Peptide (BNP)
What is the clinical term for inflammation of the bladder?
cystitis
Bonus: What is the clinical name for kidney stones?
Explain the effect of a thiazide diuretic (hydrochlorothiazide) on sodium, water and potassium.
Thiazide diuretics inhibit the sodium-chloride symporter in the distal convoluted tubule (DCT), which reduces sodium reabsorption. This results in increased sodium excretion in the urine, lowering sodium levels in the blood (hyponatremia) in some cases.
Increased water excretion: As sodium is excreted, water follows due to osmotic forces, leading to increased urine output (diuresis). This helps reduce excess fluid in the body, which is useful for treating conditions like hypertension and edema.
Increases potassium excretion: Thiazide diuretics promote the excretion of potassium in the urine, which can result in hypokalemia (low potassium levels).
What % of each glomerular filtrate is reabsorbed under normal conditions? sodium: water: glucose: urea: Creatinine
Sodium: >99% Water: >99% Glucose: 100% Urea: 50% Creatinine: 0%
when kidneys excrete Na+ it is also accompanied by excretion of _____________ (sodium's best friend).
What is water
Where does aldosterone exert its effect?
What is distal convoluted tubule
What is the functional unit of the kidney? What does it do?
Nephron makes urine. (Glomerular Filtration, Tubular Absorption and Tubular Secretion)
This class of diuretics inhibits the reabsorption of Na⁺-K⁺, Cl⁻ and H20 in the nephron loop (aka loop of Henle) increasing urine output and leading to potassium loss.
loop diuretic (furosemide)
Bonus!! Name one VS and one lab level you check prior to administering a loop diuretic.
Descibe the trigone area of the bladder.
It is formed by left ureter, right ureter and urethra. It is where UTI persist.
What is the effect of aldosterone?
It causes sodium to be reabsorbed which causes water to be reabsorbed thereby increasing BP. Bonus!!How does it affect urinary output?
Explain how the kidneys regulate BP.
When the kidneys sense that the BP is too low the JGA (located near Bowman's capsule) releases enzyme renin. Renin converts angiotensinogen into Angiotensin I. Angiotensin Converting Enzyme (ACE) converts it to Angiotensin II which causes Aldosterone to be released by adrenal cortex.
The nurse notifies the doctor that a patient on furosemide has a potassium level of 3.1. The doctor prescribes spironolactone. Explain how this med will help.
How Spironolactone Helps:
1. Potassium-Sparing Effect:
Spironolactone is a potassium-sparing diuretic that works by blocking the action of aldosterone in the distal tubule and collecting duct of the nephron.
Aldosterone normally promotes sodium retention and potassium excretion, so by blocking its action, spironolactone reduces potassium loss. This helps increase potassium retention, preventing further depletion of potassium in the body.
Diagram a nephron including: the tubular structures; the vascular structures;
Bonus!! Indicate the following: where most of the reabsorption takes place, where aldosterone and ADH exert their effect; the difference between the afferent and efferent arterioles
Why will a person in renal failure often develop anemia?
There kidneys fail to produce erythropoietin.
If the systolic blood pressure falls below ___________ it is dangerous for the kidney.
What is SBP of 70.
This class of medications helps reduce urinary urgency by relaxing the detrusor muscle of the bladder, allowing for greater bladder capacity and less frequent urges to urinate.
What are anticholinergics (e.g., oxybutynin)?
These medications work by blocking the action of acetylcholine on muscarinic receptors, which helps to relax the detrusor muscle, reducing involuntary bladder contractions and thus controlling urinary urgency.
Also what are beta-3 adrenergic agonists (Mirabegron) which works by activating beta-3 adrenergic receptors in the detrusor muscle, which causes relaxation of the detrusor muscle, increasing bladder capacity and reducing the frequency of contractions that lead to urinary urgency.
Explain anatomically why a patient with glomerulonephritis has proteinuria and hematuria.
Glomerulonephritis is an inflammatory condition affecting the glomeruli, the tiny filtering units within Bowman's capsule in the kidneys. The hallmark symptoms, proteinuria (protein in the urine) and hematuria (blood in the urine), arise due to structural and functional damage to the glomerular filtration barrier.
ADH exerts its effect on which portion of the tubular structure within the kidney?
What is the collecting duct
Where do most renal calculi form?
renal papilla
Location: Apex of the renal pyramids in the medulla, leading into the renal calyces.
Function: Urine is drained from the collecting ducts through the renal papillae into the calyces, which help direct it to the renal pelvis and then to the ureter.