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Download MBBS Nephrology PPT 6 Nephrology Basics Lecture Notes

Download MBBS (Bachelor of Medicine, Bachelor of Surgery) Nephrology PPT 6 Nephrology Basics Lecture Notes

This post was last modified on 07 April 2022

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? Tubular Function
? Endocrine Functions

? Renal blood flow normally drains pproximately

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20% of the cardiac output, or 1000 mL/min.

? Blood reaches each nephron through the

afferent arteriole leading into a glomerular

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capillary where large amounts of fluid and

solutes are filtered to form the tubular fluid.

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? The distal ends of the glomerular capil aries coalesce to

form an efferent arteriole leading to the first segment

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of a second capil ary network (cortical peritubular

capil aries or medul ary vasa recta) surrounding

the tubules.

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? Thus, nephrons have two capil ary beds arranged in a

series separated by the efferent arteriole that

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regulates the hydrostatic pressure in both capil ary

beds.

? The distal capil aries empty into smal venous branches

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that coalesce into larger veins to eventual y form the

renal vein.

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? The proximal tubule is responsible for

reabsorbing ~60% of filtered NaCl and water,

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as well as ~90% of filtered bicarbonate and

most critical nutrients such as glucose and

amino acids.

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? The proximal tubule uses both cellular and

paracellular

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transport

mechanisms.
? The loop of Henle consists of three major

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segments: descending thin limb, ascending thin

limb, and ascending thick limb.

? These divisions are based on cel ular morphology

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and anatomic location, but also correlate with

specialization of function.

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? Approximately 15?25% of filtered NaCl is

reabsorbed in the loop of Henle, mainly by the

thick ascending limb.

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? The loop of Henle has an important role in

urinary concentration by contributing to the

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generation of a hypertonic medullary interstitium

in a process cal ed countercurrent multiplication.

? The loop of Henle is the site of action for the

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most potent class of

diuretic agents (loop diuretics) and also

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contributes to reabsorption of calcium and

magnesium ions
? The distal convoluted tubule reabsorbs ~5% of

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the filtered NaCl.

? This segment is composed of a tight

epithelium with little water permeability.

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? The collecting duct modulates the final

composition of urine.

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? The two major divisions, the cortical collecting

duct and inner medullary collecting duct,

contribute to reabsorbing ~4-5% of filtered

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Na+ and are important for hormonal

regulation of salt and water balance.

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Arteries/brain/adrenals

Kidneys/adipose tissues
Renal Function Tests

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? Blood Urea
? Serum Creatinine
? Serum Electrolytes
? Serum Calcium

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? Serum Phosphate

Urine Examination

? Dip stick

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? Microscopy
? 24 hrs Urine
Renal Imaging

? Skiagram

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? USG
? CT scan
? MRI