Salt Sensitivity: Mechanisms, Diagnosis, and Clinical Relevance
|
|
- Alan Daniels
- 6 years ago
- Views:
Transcription
1 Salt Sensitivity: Mechanisms, Diagnosis, and Clinical Relevance Matthew R. Weir, MD Professor and Director Division of Nephrology University of Maryland School of Medicine
2 Overview Introduction Mechanisms Diagnosis Clinical Relevance
3 Perspective of Age, Genes, and Blood pressure Age and gene-related increases in blood pressure provide a slope of change over time. This can be modified with non-pharmacologic or pharmacologic approaches. Earlier in life, dietary modification may prevent or delay the development of higher levels of blood pressure. Later in life, dietary modification may delay requirement for pharmacologic treatment, or reduce the amount of medication required to reach ideal blood pressure goals.
4 BP and Salt Sensitivity Increase with Age Treatment 120 SBP (mmhg) Age (years)
5 Two important considerations You cannot change your age You cannot change your parents
6 Will earlier modification of the slope of change of BP alter the risk for cardiovascular disease?
7 Overview Introduction Mechanisms Diagnosis Clinical Relevance
8 The kidney is the most important organ that keeps blood pressure normal.
9 Renal Regulation of Blood Pressure Regulation of fluid, electrolyte, and acid base balance Regulation of mineral balance Synthesis of hormones (e.g., erythropoietin, renin) and vitamins (1,25 dihydroxycholecalciferol) Degradation of proteins, including hormones Detoxification Excretion of waste products of metabolism
10 Renal Output of Salt & Water Pressure-Natriuresis Shift in Hypertension 4 Normal Blood Pressure 3 Hypertension 2 1 Steady State Salt/Water Intake 120 mmhg 180 mmhg Blood Pressure In chronic hypertension, early afferent arteriolar constriction and later vascular smooth muscle hypertrophy (nephrosclerosis) create a tendency toward reduced renal blood flow and GFR. In chronic hypertension, a higher BP is required to achieve the same degree of salt and water excretion found in a normotensive (pressure-natriuresis resetting). Reprinted with permission from Hall JE et al. Kidney Int. 1996;55:S35 S41.
11 Angiotensin II Generation and Effects Tissue: Heart, Brain, Kidney, Arteries Angiotensinogen Renin Systemic: Liver ACE bypass pathways Angiotensin I Angiotensin II ACE Bradykinin Substance P Enkephalins Other Peptides A n g i o t e n s i n R e c e p t o r s Inactive Fragments AT 1 AT 2 SNS activation Arteriolar constriction Aldosterone release Free radical generation Adapted from Schmieder RE. Am J Hypertens. 2005;18: Thirst Vasopressin release Cardiac and smooth muscle hypertrophy
12 Essential Hypertension Proximal tubule and medullary thick ascending limb of Henle - sites of increased sodium reabsorption in essential hypertension (Hypertension 1984, ibid 1999, ibid 2000 J Hypertens 1991, JAMA 1993) - sites of D 1 -like receptor inhibition of sodium transport ( Pharmacol Ther 1998, Physiol Genomics 2004, Nat Clin Pract Nephrol 2006) Nephron
13 Dopamine and Renal Function Dopamine produced in renal tubules (high nm) from L-DOPA is not converted to norepinephrine. Dopamine exerts its autocrine/paracrine function by regulating tubular mechanisms. Circulating concentrations of dopamine (pm) are too low to stimulate its own receptors affinity (nm). Dopamine administered to increase blood pressure acts on nondopaminergic receptors (b and a- adrenergic receptors). Nephron
14 Renal Proximal Tubular Dopamine is Important in Preventing Salt-Sensitive Hypertension Knockout of aromatic amino acid decarboxylase, which converts L-DOPA to dopamine, in renal proximal tubules in mice produces salt-sensitive hypertension (Zhang MZ, Yao B, Wang S, Fan X, Wu G, Yang H, Yin H, Yang S, Harris RC. J Clin Invest. 2011;121: ). Renal tubules, unlike neural tissues, do not convert dopamine to norepinephrine.
15 Dopamine and Renal Function Renal tubular effects - modulated by state of sodium balance Endogenous dopamine - >50% of sodium excreted under conditions of moderate sodium excess Multiple sites of action - proximal tubule and thick ascending limb (major sites of action) Inhibits multiple sodium transporters/ channels /pump dopamine is multifunctional Reviewed in: Pharmacol Ther 1998, Curr Opin Nephrol Hyper 2001, 2003, Curr Hypertens Rep 2000, 2002, Nephron Physiol 2004, Physiol Genomics 2004, Nat Clin Pract Nephrol 2006, BBA 2010 Nephron
16 Reactive Oxygen Species in Health and Disease Reactive oxygen species is important in microdomain-specific signaling: H 2 O 2 > O 2 -
17 H 2 O 2, a Necessary Evil for Cell Signaling (Rhee SG. Science. 2006;312:1882)
18 Dietary Na?? Na-CSF RAS P Na SNA
19 ? Na-CSF Ouabain AngII HTN?
20 Na-CSF Ouabain AngII Aldo SNA HTN
21 Two Novel Mechanisms: Distal Nephron Two novel mechanisms that impair renal Na(+) excreting function and result in an increase in BP Mineralocorticoid receptor (MR) activation in the kidney, which facilitates distal Na(+) reabsorption through epithelial Na(+) channel activation, causes salt-sensitive hypertension. Rac1 activation by salt excess causes MR stimulation Renospecific sympathoactivation may cause an increase in BP under considerations of salt excess. Renal beta2 adrenoceptor stimulation in the kidney leads to decreased transcription of the gene encoding WNK4, a negative regulator of Na (+) reabsorption through Na(+) Cl (-) cotransporter in the distal convoluted tubules, resulting in saltdependent hypertension Fujita T, et al. Ann Med Jun;44 Suppl 1:S
22 Overview Introduction Mechanisms Diagnosis Clinical Relevance
23 Salt Sensitivity Salt Sensitivity (SS) of blood pressure is an inappropriate increase in blood pressure following high Na + intake. Salt-Resistant (SR) individuals show an increase in mean arterial pressure (MAP) of 7mmHg or less on both high and low Na + diets. SS affects 25% of the U.S. adult population and has equal morbidity/mortality (independent of blood pressure) to essential hypertension, yet it is difficult to diagnose without extensive clinical tests.
24 Prevalence Estimates (Despite Lack of Agreed Upon Definition) Hypertensives Salt-sensitive 66.9M (30.4%) 58M (26.4%) Hypertensive Non-salt-sensitive 35 million (16%) Salt-sensitive Non-hypertensive 31M(14%) Hypertensive and Salt-Sensitive 26M (11.8%)
25 Hypertensives 66.9M (30.4%) Salt-sensitive 58M (26.4%) Hypertensive Non-salt-sensitive 35 million (16%)? Salt-sensitive Non-hypertensive 31M(14%) Hypertensive and Salt-Sensitive 26M (11.8%)
26 Background Methods Results Summary Conclusion Despite the high incidence of salt-sensitivity it is under-diagnosed Current diagnosis of salt-sensitivity requires extensive protocols 2 liters of saline IV followed by diuretic 2 week controlled diet and 24-hour urines There is not general agreement regarding the optimal diagnostic protocol
27 Overview Introduction Mechanisms Diagnosis Clinical Relevance
28 Innovation: Renal proximal tubule cells from an individual can provide: Instantaneous renal physiology: phenotype of salt handling Instantaneous measure of renal toxicity: possibly related to too much salt in the diet This is the forerunner of personalized medicine!
29 Hazard Ratio (95% CI) 2.6 Cardiovascular Death Sodium Excretion (G/day) Sodium chloride intakes above and below the range of 2.5 to 6.0 grams/day are associated with increased cardiovascular risk (Curr Hypertens Rep. 2012;14: ). Adequate Intake Upper Limit: young adults, <5.8 older adults and elderly (Institute of Medicine, National Academy of Sciences, USA 2005)
30 Clinical Relevance of Salt Sensitivity Reducing the daily sodium chloride intake by 3 G, from the estimated sodium intake of 10.4 G in adult men and 7.3 G in adult women would save 194,000 to 392,000 quality-adjusted life years and $10-24 billion in health costs annually (N Engl J Med. 2010;362:590-9).
31 Clinical Relevance of Salt Sensitivity 1. Salt sensitivity is real, but is impossible to quantify prevalence 2. Salt sensitivity increases as we age 3. The idea that lower salt intake increases risk of CVD mortality is based on evidence with significant methodologic flaws 4. There is a need to develop methods to better classify patients in a simple way which can help focus emphasis on dietary modification
014 Chapter 14 Created: 9:25:14 PM CST
014 Chapter 14 Created: 9:25:14 PM CST Student: 1. Functions of the kidneys include A. the regulation of body salt and water balance. B. hydrogen ion homeostasis. C. the regulation of blood glucose concentration.
More informationOutline Urinary System. Urinary System and Excretion. Urine. Urinary System. I. Function II. Organs of the urinary system
Outline Urinary System Urinary System and Excretion Bio105 Chapter 16 Renal will be on the Final only. I. Function II. Organs of the urinary system A. Kidneys 1. Function 2. Structure III. Disorders of
More informationRenal Quiz - June 22, 21001
Renal Quiz - June 22, 21001 1. The molecular weight of calcium is 40 and chloride is 36. How many milligrams of CaCl 2 is required to give 2 meq of calcium? a) 40 b) 72 c) 112 d) 224 2. The extracellular
More informationChapter 19 The Urinary System Fluid and Electrolyte Balance
Chapter 19 The Urinary System Fluid and Electrolyte Balance Chapter Outline The Concept of Balance Water Balance Sodium Balance Potassium Balance Calcium Balance Interactions between Fluid and Electrolyte
More informationBIPN100 F15 Human Physiology (Kristan) Lecture 18: Endocrine control of renal function. p. 1
BIPN100 F15 Human Physiology (Kristan) Lecture 18: Endocrine control of renal function. p. 1 Terms you should understand by the end of this section: diuresis, antidiuresis, osmoreceptors, atrial stretch
More informationRenal Regulation of Sodium and Volume. Dr. Dave Johnson Associate Professor Dept. Physiology UNECOM
Renal Regulation of Sodium and Volume Dr. Dave Johnson Associate Professor Dept. Physiology UNECOM Maintaining Volume Plasma water and sodium (Na + ) are regulated independently - you are already familiar
More informationBlood Pressure Regulation 2. Faisal I. Mohammed, MD,PhD
Blood Pressure Regulation 2 Faisal I. Mohammed, MD,PhD 1 Objectives Outline the intermediate term and long term regulators of ABP. Describe the role of Epinephrine, Antidiuretic hormone (ADH), Renin-Angiotensin-Aldosterone
More informationBlood Pressure Regulation 2. Faisal I. Mohammed, MD,PhD
Blood Pressure Regulation 2 Faisal I. Mohammed, MD,PhD 1 Objectives Outline the intermediate term and long term regulators of ABP. Describe the role of Epinephrine, Antidiuretic hormone (ADH), Renin-Angiotensin-Aldosterone
More informationKidneys in regulation of homeostasis
Kidneys in regulation of homeostasis Assoc. Prof. MUDr. Markéta Bébarová, Ph.D. Department of Physiology Faculty of Medicine, Masaryk University This presentation includes only the most important terms
More informationRenal Pharmacology. Diuretics: Carbonic Anhydrase Inhibitors Thiazides Loop Diuretics Potassium-sparing Diuretics BIMM118
Diuretics: Carbonic Anhydrase Inhibitors Thiazides Loop Diuretics Potassium-sparing Diuretics Renal Pharmacology Kidneys: Represent 0.5% of total body weight, but receive ~25% of the total arterial blood
More information2) This is a Point and Click question. You must click on the required structure.
Class: A&P2-1 Description: Test: Excretory Test Points: 144 Test Number: 28379 Printed: 31-March-10 12:03 1) This is a Point and Click question. You must click on the required structure. Click on the Bowman's
More informationOsmotic Regulation and the Urinary System. Chapter 50
Osmotic Regulation and the Urinary System Chapter 50 Challenge Questions Indicate the areas of the nephron that the following hormones target, and describe when and how the hormones elicit their actions.
More informationUrinary System Organization. Urinary System Organization. The Kidneys. The Components of the Urinary System
Urinary System Organization The Golden Rule: The Job of The Urinary System is to Maintain the Composition and Volume of ECF remember this & all else will fall in place! Functions of the Urinary System
More informationBIPN100 F15 Human Physiology (Kristan) Problem Set #8 Solutions p. 1
BIPN100 F15 Human Physiology (Kristan) Problem Set #8 Solutions p. 1 1. a. Proximal tubule. b. Proximal tubule. c. Glomerular endothelial fenestrae, filtration slits between podocytes of Bowman's capsule.
More informationPHGY210 Renal Physiology
PHGY210 Renal Physiology Tomoko Takano, MD, PhD *Associate Professor of Medicine and Physiology McGill University *Nephrologist, McGill University Health Centre Lecture plan Lecture 1: Anatomy, basics
More informationPhysio 12 -Summer 02 - Renal Physiology - Page 1
Physiology 12 Kidney and Fluid regulation Guyton Ch 20, 21,22,23 Roles of the Kidney Regulation of body fluid osmolarity and electrolytes Regulation of acid-base balance (ph) Excretion of natural wastes
More informationThe principal functions of the kidneys
Renal physiology The principal functions of the kidneys Formation and excretion of urine Excretion of waste products, drugs, and toxins Regulation of body water and mineral content of the body Maintenance
More informationRegulation of Body Fluids: Na + and Water Linda Costanzo, Ph.D.
Regulation of Body Fluids: Na + and Water Linda Costanzo, Ph.D. OBJECTIVES: After studying this lecture, the student should understand: 1. Why body sodium content determines ECF volume and the relationships
More informationRenal System and Excretion
Renal System and Excretion Biology 105 Lecture 19 Chapter 16 Outline Renal System I. Functions II. Organs of the renal system III. Kidneys 1. Structure 2. Function IV. Nephron 1. Structure 2. Function
More informationRenal Physiology Part II. Bio 219 Napa Valley College Dr. Adam Ross
Renal Physiology Part II Bio 219 Napa Valley College Dr. Adam Ross Fluid and Electrolyte balance As we know from our previous studies: Water and ions need to be balanced in order to maintain proper homeostatic
More informationNOTES: CH 44 Regulating the Internal Environment (Homeostasis & The Urinary System)
NOTES: CH 44 Regulating the Internal Environment (Homeostasis & The Urinary System) HOMEOSTASIS **Recall HOMEOSTASIS is the steady-state physiological condition of the body. It includes: 1) Thermoregulation:
More informationOutline Urinary System
Urinary System and Excretion Bio105 Lecture Packet 20 Chapter 16 Outline Urinary System I. Function II. Organs of the urinary system A. Kidneys 1. Function 2. Structure B. Urine formation 1. Hormonal regulation
More informationRENAL FUNCTION An Overview
RENAL FUNCTION An Overview UNIVERSITY OF PNG SCHOOL OF MEDICINE AND HEALTH SCIENCES DIVISION OF BASIC MEDICAL SCIENCES DISCIPLINE OF BIOCHEMISTRY & MOLECULAR BIOLOGY PBL MBBS II SEMINAR VJ. Temple 1 Kidneys
More informationNa concentration in the extracellular compartment is 140
هللامسب Na regulation: Na concentration in the extracellular compartment is 140 meq\l. Na is important because: -It determines the volume of extracellular fluid : the more Na intake will expand extracellular
More informationRENAL SYSTEM 2 TRANSPORT PROPERTIES OF NEPHRON SEGMENTS Emma Jakoi, Ph.D.
RENAL SYSTEM 2 TRANSPORT PROPERTIES OF NEPHRON SEGMENTS Emma Jakoi, Ph.D. Learning Objectives 1. Identify the region of the renal tubule in which reabsorption and secretion occur. 2. Describe the cellular
More informationRenal Physiology - Lectures
Renal Physiology - Lectures Physiology of Body Fluids PROBLEM SET, RESEARCH ARTICLE Structure & Function of the Kidneys Renal Clearance & Glomerular Filtration PROBLEM SET Regulation of Renal Blood Flow
More informationChapter 44. Regulating the Internal Environment. AP Biology
Chapter 44. Regulating the Internal Environment Homeostasis Living in the world organisms had a choice: regulate their internal environment maintain relatively constant internal conditions conform to the
More informationBIOL2030 Human A & P II -- Exam 6
BIOL2030 Human A & P II -- Exam 6 Name: 1. The kidney functions in A. preventing blood loss. C. synthesis of vitamin E. E. making ADH. B. white blood cell production. D. excretion of metabolic wastes.
More informationGlomerular Capillary Blood Pressure
Glomerular Capillary Blood Pressure Fluid pressure exerted by blood within glomerular capillaries Depends on Contraction of the heart Resistance to blood flow offered by afferent and efferent arterioles
More informationBlood Pressure Regulation Graphics are used with permission of: Pearson Education Inc., publishing as Benjamin Cummings (http://www.aw-bc.
Blood Pressure Regulation Graphics are used with permission of: Pearson Education Inc., publishing as Benjamin Cummings (http://www.aw-bc.com) Page 1. Introduction There are two basic mechanisms for regulating
More informationHuman Urogenital System 26-1
Human Urogenital System 26-1 Urogenital System Functions Filtering of blood, Removal of wastes and metabolites Regulation of blood volume and composition concentration of blood solutes ph of extracellular
More informationHuman Physiology - Problem Drill 17: The Kidneys and Nephronal Physiology
Human Physiology - Problem Drill 17: The Kidneys and Nephronal Physiology Question No. 1 of 10 Instructions: (1) Read the problem statement and answer choices carefully, (2) Work the problems on paper
More informationExcretion Chapter 29. The Mammalian Excretory System consists of. The Kidney. The Nephron: the basic unit of the kidney.
Excretion Chapter 29 The Mammalian Excretory System consists of The Kidney 1. Vertebrate kidneys perform A. Ion balance B. Osmotic balance C. Blood pressure D. ph balance E. Excretion F. Hormone production
More informationRunning head: NEPHRON 1. The nephron the functional unit of the kidney. [Student Name] [Name of Institute] Author Note
Running head: NEPHRON 1 The nephron the functional unit of the kidney [Student Name] [Name of Institute] Author Note NEPHRON 2 The nephron the functional unit of the kidney The kidney is an important excretory
More informationorgans of the urinary system
organs of the urinary system Kidneys (2) bean-shaped, fist-sized organ where urine is formed. Lie on either sides of the vertebral column, in a depression beneath peritoneum and protected by lower ribs
More informationBIOLOGY - CLUTCH CH.44 - OSMOREGULATION AND EXCRETION.
!! www.clutchprep.com Osmoregulation regulation of solute balance and water loss to maintain homeostasis of water content Excretion process of eliminating waste from the body, like nitrogenous waste Kidney
More informationRole of Minerals in Hypertension
Role of Minerals in Hypertension Lecture objectives By the end of the lecture students will be able to Define primary and secondary hypertention and their risk factors. Relate role of minerals with hypertention.
More informationOne Minute Movies: Molecular Action at the Nephron Joy Killough / Westwood High School / Austin,TX
One Minute Movies: Molecular Action at the Nephron Joy Killough / Westwood High School / Austin,TX To prepare your nephron model: ( A nephron is a tubule and the glomerulus. There are about a million of
More informationNephron Anatomy Nephron Anatomy
Kidney Functions: (Eckert 14-17) Mammalian Kidney -Paired -1% body mass -20% blood flow (Eckert 14-17) -Osmoregulation -Blood volume regulation -Maintain proper ion concentrations -Dispose of metabolic
More informationIntroduction to the kidney: regulation of sodium & glucose. Dr Nick Ashton Senior Lecturer in Renal Physiology Faculty of Biology, Medicine & Health
Introduction to the kidney: regulation of sodium & glucose Dr Nick Ashton Senior Lecturer in Renal Physiology Faculty of Biology, Medicine & Health Objectives Overview of kidney structure & function Glomerular
More informationRENAL PHYSIOLOGY. Physiology Unit 4
RENAL PHYSIOLOGY Physiology Unit 4 Renal Functions Primary Function is to regulate the chemistry of plasma through urine formation Additional Functions Regulate concentration of waste products Regulate
More informationUrinary System. BSC 2086 A & P 2 Professor Tcherina Duncombe Palm Beach State College
Urinary System BSC 2086 A & P 2 Professor Tcherina Duncombe Palm Beach State College Filter plasma, separate and eliminate wastes Functions Regulate blood volume and pressure Regulate osmolarity of body
More informationUrinary Physiology. Chapter 17 Outline. Kidney Function. Chapter 17
Urinary Physiology Chapter 17 Chapter 17 Outline Structure and Function of the Kidney Glomerular Filtration Reabsorption of Salt and Water Renal Plasma Clearance Renal Control of Electrolyte and Acid-Base
More informationMechanism: 1- waterretention from the last part of the nephron which increases blood volume, venous return EDV, stroke volume and cardiac output.
Blood pressure regulators: 1- Short term regulation:nervous system Occurs Within secondsof the change in BP (they are short term because after a while (2-3 days) they adapt/reset the new blood pressure
More informationOsmoregulation and Renal Function
1 Bio 236 Lab: Osmoregulation and Renal Function Fig. 1: Kidney Anatomy Fig. 2: Renal Nephron The kidneys are paired structures that lie within the posterior abdominal cavity close to the spine. Each kidney
More informationUse the following diagram to answer the next question. 1. In the diagram above, pressure filtration occurs in a. W b. X c. Y d. Z
Part A: Multiple Choice Questions Value: 32 Marks Suggested time: 40 minutes Instructions: For each question select the best answer and record your choice on the Scantron card provided. Using an HB pencil,
More informationCardiorenal Syndrome Prof. Dr. Bülent ALTUN Hacettepe University Faculty of Medicine Department of Internal Medicine Division of Nephrology
Cardiorenal Syndrome Prof. Dr. Bülent ALTUN Hacettepe University Faculty of Medicine Department of Internal Medicine Division of Nephrology Heart and Kidney The kidney yin dominates water, The heart yang
More informationRenal-Related Questions
Renal-Related Questions 1) List the major segments of the nephron and for each segment describe in a single sentence what happens to sodium there. (10 points). 2) a) Describe the handling by the nephron
More informationI. Metabolic Wastes Metabolic Waste:
I. Metabolic Wastes Metabolic Waste: a) Carbon Dioxide: by-product of cellular respiration. b) Water: by-product of cellular respiration & dehydration synthesis reactions. c) Inorganic Salts: by-product
More informationRenal Functions: Renal Functions: Renal Function: Produce Urine
Renal Functions: Excrete metabolic waste products Reabsorb vital nutrients Regulate osmolarity: Maintain ion balance Regulate extracellular fluid volume (and thus blood pressure) Renal Functions: Regulate
More informationUrinary System and Excretion. Bio105 Lecture 20 Chapter 16
Urinary System and Excretion Bio105 Lecture 20 Chapter 16 1 Outline Urinary System I. Function II. Organs of the urinary system A. Kidneys 1. Function 2. Structure III. Disorders of the urinary system
More informationAP Biology. Homeostasis. Chapter 44. Regulating the Internal Environment. Homeostasis
Chapter 44. Regulating the Internal Environment omeostasis Living in the world organisms had a choice: regulate their internal environment maintain relatively constant internal conditions conform to the
More informationHyponatremia in Heart Failure: why it is important and what should we do about it?
Objectives Hyponatremia in Heart Failure: why it is important and what should we do about it? Pathophysiology of sodium and water retention in heart failure Hyponatremia in heart failure (mechanism and
More informationVertebrates possess kidneys: internal organs which are vital to ion and water balance and excretion.
The Kidney Vertebrates possess kidneys: internal organs which are vital to ion and water balance and excretion. The kidney has 6 roles in the maintenance of homeostasis. 6 Main Functions 1. Ion Balance
More informationFunc%ons of the Urinary System
Func%ons of the Urinary System Excre%on Regula%on of blood volume Regula%on of blood pressure Regula%on of blood- solute concentra%on Regula%on of ph of extracellular fluid Regula%on of erythropoiesis
More informationRENAL PHYSIOLOGY. Danil Hammoudi.MD
RENAL PHYSIOLOGY Danil Hammoudi.MD Functions Regulating blood ionic composition Regulating blood ph Regulating blood volume Regulating blood pressure Produce calcitrol and erythropoietin Regulating blood
More informationCASE 13. What neural and humoral pathways regulate arterial pressure? What are two effects of angiotensin II?
CASE 13 A 57-year-old man with long-standing diabetes mellitus and newly diagnosed hypertension presents to his primary care physician for follow-up. The patient has been trying to alter his dietary habits
More informationPhysiology Lecture 2. What controls GFR?
Physiology Lecture 2 Too much blood is received by the glomerular capillaries, this blood contains plasma, once this plasma enters the glomerular capillaries it will be filtered to bowman s space. The
More informationSunday, July 17, 2011 URINARY SYSTEM
URINARY SYSTEM URINARY SYSTEM Let s take a look at the anatomy first! KIDNEYS: are complex reprocessing centers where blood is filtered through and waste products are removed. Wastes and extra water become
More informationUrine Formation by the Kidneys: I. Glomerular Filtration, Renal Blood Flow and Their Control.
Urine Formation by the Kidneys: I. Glomerular Filtration, Renal Blood Flow and Their Control. Chapter 26 Yanal A Shafagoj. MD. PhD Lecture-1 Introduction 31/3/2015 1 University of Jordan Faculty of Medicine
More information1. remove: waste products: urea, creatinine, and uric acid foreign chemicals: drugs, water soluble vitamins, and food additives, etc.
Making Water! OR is it really Just Water Just Ask the Nephron!! Author: Patricia L. Ostlund ostlundp@faytechcc.edu (910) 678-9892 Fayetteville Technical Community College Fayetteville, NC 28303 Its just
More informationBlood Pressure Regulation. Slides 9-12 Mean Arterial Pressure (MAP) = 1/3 systolic pressure + 2/3 diastolic pressure
Sheet physiology(18) Sunday 24-November Blood Pressure Regulation Slides 9-12 Mean Arterial Pressure (MAP) = 1/3 systolic pressure + 2/3 diastolic pressure MAP= Diastolic Pressure+1/3 Pulse Pressure CO=MAP/TPR
More informationRegulating the Internal Environment. AP Biology
Regulating the Internal Environment 2006-2007 Conformers vs. Regulators Two evolutionary paths for organisms regulate internal environment maintain relatively constant internal conditions conform to external
More informationHYPERTENSION IN CKD. LEENA ONGAJYOOTH, M.D., Dr.med RENAL UNIT SIRIRAJ HOSPITAL
HYPERTENSION IN CKD LEENA ONGAJYOOTH, M.D., Dr.med RENAL UNIT SIRIRAJ HOSPITAL Stages in Progression of Chronic Kidney Disease and Therapeutic Strategies Complications Normal Increased risk Damage GFR
More informationRenal physiology D.HAMMOUDI.MD
Renal physiology D.HAMMOUDI.MD Functions Regulating blood ionic composition Regulating blood ph Regulating blood volume Regulating blood pressure Produce calcitrol and erythropoietin Regulating blood glucose
More informationCh. 44 Regulating the Internal Environment
Ch. 44 Regulating the Internal Environment 2006-2007 Conformers vs. Regulators Two evolutionary paths for organisms regulate internal environment maintain relatively constant internal conditions conform
More informationKidney and urine formation
Kidney and urine formation Renal structure & function Urine formation Urinary y concentration and dilution Regulation of urine formation 1 Kidney and urine formation 1.Renal structure & function 1)General
More informationHyperaldosteronism: Conn's Syndrome
RENAL AND ACID-BASE PHYSIOLOGY 177 Case 31 Hyperaldosteronism: Conn's Syndrome Seymour Simon is a 54-year-old college physics professor who maintains a healthy lifestyle. He exercises regularly, doesn't
More informationبسم هللا الرحمن الرحيم ** Note: the curve discussed in this page [TF]/[P] curve is found in the slides, so please refer to them.**
بسم هللا الرحمن الرحيم ** Note: the curve discussed in this page [TF]/[P] curve is found in the slides, so please refer to them.** INULIN characteristics : 1 filtered 100 %. 2-Not secreted. 3-Not reabsorbed
More informationThe kidneys are excretory and regulatory organs. By
exercise 9 Renal System Physiology Objectives 1. To define nephron, renal corpuscle, renal tubule, afferent arteriole, glomerular filtration, efferent arteriole, aldosterone, ADH, and reabsorption 2. To
More informationQuestions? Homework due in lab 6. PreLab #6 HW 15 & 16 (follow directions, 6 points!)
Questions? Homework due in lab 6 PreLab #6 HW 15 & 16 (follow directions, 6 points!) Part 3 Variations in Urine Formation Composition varies Fluid volume Solute concentration Variations in Urine Formation
More informationExcretion and Waste Management. Biology 30S - Miss Paslawski
Excretion and Waste Management Biology 30S - Miss Paslawski Lesson 1 Waste Products and Organs 2 3 Excretion Excretion: Process by which dissolved metabolic wastes are separated from body fluids and removed
More informationKD02 [Mar96] [Feb12] Which has the greatest renal clearance? A. PAH B. Glucose C. Urea D. Water E. Inulin
Renal Physiology MCQ KD01 [Mar96] [Apr01] Renal blood flow is dependent on: A. Juxtaglomerular apparatus B. [Na+] at macula densa C. Afferent vasodilatation D. Arterial pressure (poorly worded/recalled
More informationNovember 30, 2016 & URINE FORMATION
& URINE FORMATION REVIEW! Urinary/Renal System 200 litres of blood are filtered daily by the kidneys Usable material: reabsorbed back into blood Waste: drained into the bladder away from the heart to the
More informationCounter-Current System Regulation of Renal Functions
Counter-Current System Regulation of Renal Functions Assoc. Prof. MUDr. Markéta Bébarová, Ph.D. Department of Physiology Faculty of Medicine, Masaryk University This presentation includes only the most
More informationPrinciples of Renal Physiology. 4th Edition
Principles of Renal Physiology 4th Edition Principles of Renal Physiology 4th Edition Chris Lote Professor of Experimental Nephrology, University of Birmingham, UK SPRINGER SCIENCE+BUSINESS MEDIA, B.V.
More informationHormonal Control of Osmoregulatory Functions *
OpenStax-CNX module: m44828 1 Hormonal Control of Osmoregulatory Functions * OpenStax This work is produced by OpenStax-CNX and licensed under the Creative Commons Attribution License 3.0 By the end of
More informationP215 Spring 2018: Renal Physiology Chapter 18: pp , Chapter 19: pp ,
P215 Spring 2018: Renal Physiology Chapter 18: pp. 504-520, 525-527 Chapter 19: pp. 532-548, 553-560 I. Main Components of the Renal System 1. kidneys 2. ureters 3. urinary bladder 4. urethra 4 Major Functions
More informationChapter 23. The Nephron. (functional unit of the kidney
Chapter 23 The Nephron (functional unit of the kidney Renal capsule The Nephron Renal cortex Nephron Collecting duct Efferent arteriole Afferent arteriole (a) Renal corpuscle: Glomerular capsule Glomerulus
More informationNephron Structure inside Kidney:
In-Depth on Kidney Nephron Structure inside Kidney: - Each nephron has two capillary regions in close proximity to the nephron tubule, the first capillary bed for fluid exchange is called the glomerulus,
More informationFluid and electrolyte balance, imbalance
Fluid and electrolyte balance, imbalance Body fluid The fluids are distributed throughout the body in various compartments. Body fluid is composed primarily of water Water is the solvent in which all solutes
More informationDIURETICS-2. Dr. Shariq Syed. Shariq AIKC/TYB/2014
DIURETICS-2 Dr. Syed Structure of Kidney Blood filtered by functional unit: Nephron Except for cells, proteins, other large molecules, rest gets filtered Structure of Kidney 3 major regions of nephron
More informationBasic mechanisms of Kidney function
Excretion Basic mechanisms of Kidney function Urine formation in Amphibians Urine formation in Mammals Urine formation in Insects Nitrogen balance Kidneys The most fundamental function of kidneys) is to
More informationHuman Anatomy and Physiology - Problem Drill 23: The Urinary System, Fluid, Electrolyte and Acid-Base Balance
Human Anatomy and Physiology - Problem Drill 23: The Urinary System, Fluid, Electrolyte and Acid-Base Balance Question No. 1 of 10 Which of the following statements about the functions of the urinary system
More informationUrinary system. Lab-7
Urinary system Lab-7 Excretion: processes that remove wastes and excess materials from the body Urinary system (kidneys): excretes nitrogenous wastes, excess solutes, and water The Kidneys Regulate Water
More informationBODY FLUID. Outline. Functions of body fluid Water distribution in the body Maintenance of body fluid. Regulation of fluid homeostasis
BODY FLUID Nutritional Biochemistry Yue-Hwa Chen Dec 13, 2007 Chen 1 Outline Functions of body fluid Water distribution in the body Maintenance of body fluid Intake vs output Regulation of body fluid Fluid
More informationRegulation of fluid and electrolytes balance
Regulation of fluid and electrolytes balance Three Compartment Fluid Compartments Intracellular = Cytoplasmic (inside cells) Extracellular compartment is subdivided into Interstitial = Intercellular +
More informationRENAL PHYSIOLOGY. Zekeriyya ALANOGLU, MD, DESA. Ahmet Onat Bermede, MD. Ankara University School of Medicine Dept. Anesthesiology and ICM
RENAL PHYSIOLOGY Zekeriyya ALANOGLU, MD, DESA. Ahmet Onat Bermede, MD. Ankara University School of Medicine Dept. Anesthesiology and ICM Kidneys Stabilize the composition of the ECF (electrolyte,
More informationPrinciples of Anatomy and Physiology
Principles of Anatomy and Physiology 14 th Edition CHAPTER 27 Fluid, Electrolyte, and Acid Base Fluid Compartments and Fluid In adults, body fluids make up between 55% and 65% of total body mass. Body
More informationThe Urinary S. (Chp. 10) & Excretion. What are the functions of the urinary system? Maintenance of water-salt and acidbase
10.1 Urinary system The Urinary S. (Chp. 10) & Excretion 10.1 Urinary system What are the functions of the urinary system? 1. Excretion of metabolic wastes (urea, uric acid & creatinine) 1. Maintenance
More informationGeneral Anatomy of Urinary System
General Anatomy of Urinary System URINARY SYSTEM ORGANS Kidneys (2) Ureters (2) Urinary bladder Urethra KIDNEY FUNCTIONS Control blood volume and composition KIDNEY FUNCTIONS Filter blood plasma, eliminate
More information** TMP mean page 340 in 12 th edition. Questions 1 and 2 Use the following clinical laboratory test results for questions 1 and 2:
QUESTION Questions 1 and 2 Use the following clinical laboratory test results for questions 1 and 2: Urine flow rate = 1 ml/min Urine inulin concentration = 100 mg/ml Plasma inulin concentration = 2 mg/ml
More information1. a)label the parts indicated above and give one function for structures Y and Z
Excretory System 1 1. Excretory System a)label the parts indicated above and give one function for structures Y and Z W- renal cortex - X- renal medulla Y- renal pelvis collecting center of urine and then
More informationBlood Pressure Fox Chapter 14 part 2
Vert Phys PCB3743 Blood Pressure Fox Chapter 14 part 2 T. Houpt, Ph.D. 1 Cardiac Output and Blood Pressure How to Measure Blood Pressure Contribution of vascular resistance to blood pressure Cardiovascular
More informationBasic Functions of the Kidneys
Dr. Adelina Vlad Basic Functions of the Kidneys Eliminate plasma METABOLIC WASTE PRODUCTS and FOREIGN COMPOUNDS The kidney are the primary means for eliminating metabolic waste products (urea, creatinine,
More informationRENAL PHYSIOLOGY. Zekeriyya ALANOGLU, MD, DESA Ahmet Onat Bermede, MD, Ankara University School of Medicine Dept. Anesthesiology and ICM
RENAL PHYSIOLOGY Zekeriyya ALANOGLU, MD, DESA Ahmet Onat Bermede, MD, Ankara University School of Medicine Dept. Anesthesiology and ICM Kidneys Stabilize the composition of the ECF (electrolyte, H
More informationBIOH122 Human Biological Science 2
BIOH122 Human Biological Science 2 Session 16 Urinary System 1 The Kidneys Bioscience Department Endeavour College of Natural Health endeavour.edu.au Session Plan o Functions of Urinary system o The Kidneys:
More informationBlood Pressure Regulation 2. Faisal I. Mohammed, MD,PhD
Blood Pressure Regulation 2 Faisal I. Mohammed, MD,PhD 1 Objectives Outline the intermediate term and long term regulators of ABP. Describe the role of Epinephrine, Antidiuretic hormone (ADH), Renin-Angiotensin-Aldosterone
More informationLecture 16: The Nephron
Lecture 16: The Nephron Reading: OpenStax A&P Text Chapter 25 Primary functions of the kidneys 1. Regulating osmolarity (blood concentration!) A. Regulating blood pressure B. Maintaining ion balance C.
More informationBIOH122 Human Biological Science 2
BIOH122 Human Biological Science 2 Session 17 Urinary System 2 Glomerular Filtration Bioscience Department Endeavour College of Natural Health endeavour.edu.au Session Plan o Overview of Renal Physiology
More information