NonProtein Nitrogen/Renal Fxn

Urinary Filtrate Flow

1. Bowman’s capsule

2. PCT-Promixal convoulted tuble

3. Desceding loop of Henle

4. Ascending loop of Henle

5. DCT-Distal convoulted tuble

6. collecting duct

7. renal calyces

8.ureter

9. bladder

10. urethera

What are the three step of renal physiology?

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Glomerular Filtration

Tubular Reabsorption

Tubular secretion

;

;

Blood Flow in Kidney

Renat Artery

Afferent Arteriole

Glomerulus

Efferent Arteriole

Peritubular Capillaries

Vasa Recta

Renal Vein

Parts of Urinary System

2 Kidneys

2 Ureters

Bladder

Nephrons

Cortex

Medulla

Glomerular Filtration

In glomerulus filtrates

1st step in nephron

Tubular resorption

reabsorbs fluids and electrolytes filterred by glomerulus

usually performed by passive or active transport

Tubular secretion
Substances are passed through peritubular capillaries to tubular filtrate.
Fxn of tubular secretion

Elimainated waste products not filtered by glomerulus

Regulates acid base balance by secreting

Active transport

Uses ATP

combined with carrier protein reaches threshold concentration wher substance can not be reabsorbed and excerted in urine

Passive transport

Used by urea and water

Does not need ATP

Moves subatnces from high concentration to low concentration

NPN Percenatges

BUN 45%

Amino Acid 20%

Uric Acid 20 %

Creatinine 5%

Creatine 1-2%

Ammonia 0.2%

BUN
direct realtionship to GFR
CS of BUN

Increase in azotemia in BUN and NPN

classified into prerenal, renal and postrenal

decreased BUN

decreased protein inatke

severe liver disease

overhydration

3rd mester in pregnancy

soucres of BUN

exogenous protein

endogenous proetein

CS of Creatinine

Increases in urinary tract obstruction

Decreases in kindey and muscle diseases

CS of Uric Acid

Underproduction, over excertion = hyperuricemia

primary gout= over production

Kidney stones and renal diseases

Ref Range for BUN
7-18mg/dL
BUN fxn
Urea is the N-end product of prptein and AA metabolism used for screening kindeny fx
Creatinine fxn
Index of renal fxn measures GFR product not filereted by gf
Ref range of Creatinine

Serum: 0.5-1.5mg/dL

Urine: 0..8-2.0 gm/24hr

Creatinine Clerance



;

measures GFR

U/P x V = ml/min

;

1440min/24hr

fxn of Uric Acid
Aste product filtered by glomerulus
Ref Range for Uric Acid Men
3.5-7.2mg/dl
Ref range for uric Acid Women
2.6-6.0 mg/dl
cs of ammonia
increased due to renal failure/liver disease which is toxic to CNS

Acute Glomerular Nephritis-AGN

Area affected

Glomeruli, Nephron from autoimmune process
Causes if Acute Glomerulonephritis

In children and young adults it is caused by group A streptococcal infection

antigen-antobody that trigger inflammatory response in basement memebrane

Symptoms of Acute glomerular nephritis

rapid fever

maliase-feeling bad

nausea

oliguria-low out put of urine

hematuria

proteinuria

Elevated BUn/creatinine

Decreased GFR

Acute Gloomerular Nephrtitis
Area where Chronic Glomerular Nep affects

nephron-permanet damage

leads to irreversible kindeny damage

Symptoms of Chronic Golmerular Nephritis

edema

Fatigue

High BP

Anemia

Metabolic acidosis

Proteinuria

Decreased urine

little urine passage to no nrine passing

area affected by nephrotic sydronme
Glomercular membrane-change in permeability
Nephrotic sydrome is caused by

complications due to glomerulonephritis

circulatory disorders

;

Symptoms of Nephrotic syndrome

Massive proteinuria

Albuminuria

Pitting edma

High and Low albumin levels

;

Area that afftected by; acute pyelonphritis
Renal Tubules
Causes of Acute pyelonphritis

Gram negative bacteria

untreated cystitis and lower urinary tract infection

Symptoms of acute pyelonephritis

vesicoureteral reflux

WBC

postive leukocyte esterase and nitrate

postive proteinuria

decreased SP

Area affected by chronic pyelonephritis
renal tubules
causes of chronic pyelonephritis
vesicoureteral reflux
Symptoms of chronic py.

Polyuria

Nocturia

Area affected by cystitis
bladder
Causes of dysuria
intestinal flora associated with pyelonephritis
Enhancing factor of GF

Presure of Glomerlular capilaries is high

Basement membrane is negativly charged

Causes Acute Glomerulonephritis
Group A strepococcus in children and young adults
Symptoms of Acute Glomerulonephritis

1. Onset rapid fever

2. decreased urine output

3. Malisia

4. Urina in protein

5. Blood in urine

6. Nausea

Damage from acute glomerularnephritis
Glomerular Nephron
Damage from chronic glomerular nephritis
permanent damage to nephron
Causes of chronic glomerular nephritis
Many different possibilties that lead to irreversible damage
Symptoms of chronic glomerular nephritis

1. Decreased urine

2. little to no urine output

3. Edema

4. Fatigue

5.High Blood Pressure

6.Metabolic Acidosis

where nephrotic syndrome causes damage
glomercular membrane permability changes
Causes of nephrotic syndrome
complications glomerulonephritis or circulatory disorders
Symptoms

Massive protein in uria

Alot of lipidema

Low alot of albumina

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