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RENAL Dr; bashardoust.

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Presentation on theme: "RENAL Dr; bashardoust."— Presentation transcript:

1 RENAL Dr; bashardoust

2 Glomerular Filtration
Renal blood flow = 1.2 L/min Renal plasma flow = 700 ml/min (60 % of RBF) GFR = 125 ml/min = 180 L/day filtered plasma Filtered fraction = GFR  RPF = 125  700 = 20% Urine output = 1 ml/min or 1500 ml/day = 1% of filtered plasma

3 Renal Anatomy Functional unit is the nephron Functions of nephron
Approximately 1.25 million/kidney 80% are cortical – short loop of Henle 20% are juxtamedullary – loop of Henle projects into medulla Cortical nephrons only dilute urine Juxtamedullary nephrons dilute and concentrate urine Functions of nephron Glomerular filtration Tubular reabsorption Tubular secretion

4 Filtration, Reabsorption, Secretion
A: filtered, no reabsorption or secretion - inulin, creatinine B: filtered, some reabsorption - electrolytes C: filtered, complete reabsorption - glucose, amino acids D: filtered, plus additional secretion - K+, H+

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6 Anatomy: Cap. loops J.G.App. DCT Afferent Arteriole Efferent

7 Glomerular Filtration:
Collagen IV Laminin Fibronectin Entactin etc. BLOOD Proteins 3.6nm/70,000MW Glomerular Capillary Lumen L.R.I L.D. L.R.E Foot Process Podocyte (Visceral epithelium) GBM + Plasma - Proteins FILTRATE Bowman’s Capsule Space

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9 Azotemia Renal Failure
Table Laboratory Findings in Acute Renal Failure Index Prerenal Azotemia Oliguric Acute Renal Failure BUN/PCr Ratio >20:1 10-15:1 Urine sodium (UNa), meq/L <20 >40 Urine osmolality, mosmol/L H2O >500 <350 Fractional excretion of sodium <1% >2% FENa = UNa * PCr * 100 PNa * UCr Urine/plasma creatinine (UCr/PCr) NOTE: BUN, Blood urea nitrogen; PCr, plasma creatinine; UNa, urine sodium concentration; PNa, plasma sodium concentration; UCr, urine creatinine concentration.

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