Download MBBS Physiology Presentations 4 Renal Gfr And Rbf Lecture Notes

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To understand -

? The forces that determine glomerular filtration rate.

? The regulation of glomerular filtration

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? Autoregulation and its mechanism

? Juxta glomerular apparatus (JGA)
Determinants of GFR

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The GFR is determined by

PG

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G

Sum of the hydrostatic and

colloid osmotic forces across the

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glomerulus ?

P

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B

B=0

Starling forces inform us about

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net fluid movement:

Determinants of GFR

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GFR =Kf x [(P G-P B)-( G- B)]

PG

G

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Net filtration pressure

= 10

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PB

B
Pressures & causes?Decreased Glomerular Filtration Rate (GFR

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GFR =Kf x [(P -P

G )-(

B

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G -

c )]

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B

REGULATION OF GFR
GFR must be precisely regulated

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Intrinsic and Extrinsic Control of GFR

Intrinsic Control mechanisms of GFR

1) Autoregulation

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2) Extrinsic Control mechanisms of GFR
Renal Auto regulation - Intrinsic Control

Some concepts regarding control of GFR

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(flow in glomerulus)
Some concepts regarding control of GFR

regarding flow of glomerulus

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Principle concept : Autoregulation
Renal Auto regulation - Intrinsic Control
a. Myogenic mechanism:

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b.Tubulo-glomerular feedback:

a. Myogenic mechanism of Autoregulation
b. Tubulo-glomerular Feedback response

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- Juxta Glomerular Apparatus?

N
a
C

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l
Tubulo-Glomerular Feedback-TGF ? Apparatus-

(Juxta Glomerulus Apparatus)

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NaCl

Sensor: Macula Densa cells ?

Tubulo-Glomerular Feedback-TGF ? Apparatus-

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(Juxta Glomerulus Apparatus)

N
a

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Cl

Integrator: Juxta-glomerular cells

(JG or Granular cells) ?

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Tubulo-Glomerular Feedback-TGF ? Apparatus-

(Juxta Glomerulus Apparatus)

NaCl

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Effectors:

Renal Afferent and

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Efferent Arterioles

Tubulo-Glomerular Feedback Mechanism
Renin

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ACE

Important physiologic functions of Angiotensin II

Arteriolar vasoconstriction

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antidiuretic hormone

thirst

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aldosterone

NaCl reabsorption

Constrict the glomerular mesangium,

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Hormones that Influence Glomerular Filtration Rate

STIMULUS

GFR

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Vasoconstrictors

Sympathetic nerves

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ECFV

Angiotensin II*

ECFV

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Endothelin

Stretch, AII,

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bradykinin,

epinephrine, ECFV

Adenosine (AA)

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Macula densa NaCl

Vasodilators

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Prostaglandins

(PGE1, PGE2, PGI2)

ECFV, shear

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Nitric oxide

Stress, AII shear

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stress, acetylcholine,

histamine, bradykinin, AT P

Bradykinin

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Prostaglandins,

ACE

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Natriuretic peptides

(ANP, BNP)

ECFV

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These effects of angiotensin I are evident with concentrations that constrict the afferent and efferent arterioles.

ACE, Angiotensin-converting enzyme; AI , angiotensin I ; ANP, atrial natriuretic peptide; ATP, adenosine triphosphate; BNP, brain natriuretic

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peptide; ECFV, extracel ular fluid volume; GFR, glomerular filtration rate; PGE, prostaglandin E; PGI2, prostacyclin; RBF, renal blood flow.
Mesangial Cells
Applied

ACE inhibitors (e.g. captopril, enalapril) -

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Acute kidney injury (AKI) from NSAIDs

Important points of the lecture

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Forces Favoring and opposing glomerular Filtration

1 cause of each PB and PGC
What will happen if GFR is too high or too low?

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Efferent arteriole constriction cause increase or decrease in GFR.

What is principle of myogenic autoregulation and range of fluctuation of

MAP for it?

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Tubulo-Glomerular Feedback Mechanism

Functions of Angiotensinogen II
Self Assessment

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Macula densa cells of DxCT are a

ACE inhibitors are used

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type of

in the treatment of

1) Chemoreceptors

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2) Osmoreceptors

1) Hemolytic anemia

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3) Baroreceptors

2) Hypertension

4) Nociceptors

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3) Hyperthyroidism

4) Hydatid cyst

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Tubulo-glomerular feedback mechanism is

mediated by:

1) Adrenaline

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2) Acetylcholine

3) Adenosine

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4) Prostacycline

Thank you