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How much H2O is reabsorbed at the PCT?
How much and what all is reabsorbed at the DCT and what helps that?
12 to 15% H2O with the help of ADH
Na+ with the help of aldosterone
What is reabsorbed at the Loop of Henle?
What and how much and what helps with reabsorbtion at the Collecting Ducts?
5% of H2O with ADH
Na+ with aldosterone
What molecules are too large to filter?
Plasma Protein molecules
RBC's and WBC's
Where is Aldosterone secreted?
What 2 hormones does the kidneys synthenizes/secretes?
What is measured in the formula to calculate kidney function?
Creatinine Clearance (CRCl)
What is Nephrolithiasis and what is the symptoms?
Kidney Stones made from urinary salts
What is Toxemia and what are the symptoms?
Toxic blood caused by kidney failure
Elevated blood pressure
What is Glomerulonephritis and what are the symptoms?
Inflammation of the glomerulus
- low urine volume
- dark urine
What is Pyelonephritis?
Infection of the kidneys
What is Diabetes Insipidus and what are the symptoms?
Increase of urine due to a lack of ADH
What is Cystitis and what are the symptoms?
Inflammation of the urinary bladder
blood in the urine
What is a UTI?
Urinary Tract Infection or the presence of microorganisms
What is Acute Renal Failure?
The abrupt stoppage of filtration due to low blood volume and acute kidney damage
What is Chronic Renal Failure?
Irreversible decline in filtration caused by diabetes & high blood pressure
What is Bladder Spasm?
Continual contraction or relaxation of the smooth muscle wall of the urinary bladder
What is Benign Prostatic Hyperplasia and symptom?
Enlargement of the male prostate gland
incomplete bladder emptying
What is H2O and Electrolyte Disorders?
Dehydration - Extreme loss of H2O
Edema - accumulation of excess water caused by confestive <3 failure, renal disease
Hypokalemia - Deficiency of K+ in serum
Hypocalcemia - Deficiency of Ca+ in serum
Respiratory Acidosis - Too much CO2 not removed from the body via hypoventilation
Respiratory Alkalosis - Low levels of CO2 in the body via hyperventilation
Metabolic Acidosis - Excessive acidity in the blood via kidney disease
Metabolic Alkalosis - High levels of alkaline substance caused by vomiting
- Congestive <3 failure
Infection or inflammation in the nephritism, glomerulonephritis and pylonephritis
Changes in urine output
- Oliguria - decreased
- Anuria - no urine
Increase ammonia levels
Uremia/toxemia - accumulation of nitrogenous waste products
Increase in flood fluid levels
Edema - accumulation of excess fluid
Increased Na+ in urine
How do diurectics help Congestive Heart Failure?
Pulls excess fluid from the lungs
How do diurectics help hypertension?
Remove excess fluid to reduce vascular resistance
How do diurectics help ascites?
Remove excess abdominal fluid back into circulation
How do diurectics help Edema?
Pull excess fluid out of interstitial tissues and back into the systemic circulation
How does diuretics help Nephrolithiasis?
Promote excretion of salts
Type of Diurectic
Osmotic Diurectics work on the PCT
Failure of kidney to produce urine
Osmotic Diurectics used to treat intra-ocular & intra-cranial pressure
Mannitol - Osmitrol
Do Not dispense if crystals are present
Drugs for Sodium Re-absorption Inhibitors and mechanism/side effect
Bumetanide - Burinex
Furosemide - Lasix
Blocks re-absorption of Na+ @ Loop of Henle "Loop Diurectics"
Failure of the kidneys to produce urine
Thiazide & thiazide-like diurectics:
Blocks re-absoprtion of Na+ @ DCT
Chlorothiazide - Diuril
Chlorthalidone - Hygroton
Metolazone - Zaroxolyn
Hydrochlorothiazide - Orectic, Esidrex, Hydrodiuril, Microzide
SE: Photosensitivity for Metolazone & Hydrochlorothiazide
Promotes elimination of Na+ and reabsorption of K+
Spironolactone - Aldactone
SE: Gynecomastia (man boobs)
Eplenerone - Inspra
SE: K+ Sparring
Triametene - Dyrenium
Since the primary side effect of the thiazides is hypokalemia & primary side effect of the aldosterone antaonists is hyperkalemia, combining the two diurectics increases the therapeutic effects and decreases side effects. These agents are primarily active in the distal tubule.
Diurectic Combinations Drugs
- Triamterene and Hydrochlorothiazide
- - Dyazide, Maxzide
Lozol - Indapamide
Carbonic Anhydrase Inhibitors
Inhibits carbonic anhydrase in the PCT to cause re-absorption of C2O4
Acetazolamide - Diamox
- Reduces eye pressure for patient going into surgery
- Acute Mountain Sickness
Suppresses urine and rate of excretion
- Vasopressin - Pitressin
- Diabetes insipidue & vascoconstrictor in shock
- Desmopressin - DDAVP, Stimate
- Nocturnal Enuresis, Diabetes Insipidus
What's the 4 functions of the renal system?
- 1. Filters blood to remove waste
- 2. Regulates water balance through hormone production
- 3. Regulates electrolyte balance
- 4. Regulates acid base balance