The role of microcirculatory and mitochondrial dysfunction in sepsisinduced acute kidney injury (AKI): a. model of sepsis-induced organ dysfunction
|
|
- Meredith Doris Curtis
- 5 years ago
- Views:
Transcription
1 The role of microcirculatory and mitochondrial dysfunction in sepsisinduced acute kidney injury (AKI): a model of sepsis-induced organ dysfunction Hernando Gomez, MD Mentors: Michael R. Pinsky, MD John A. Kellum, MD Brian Zuckerbraun, MD Exemplary Care Cutting-edge Research World-class Education
2 A Unifying Theory of Sepsis-Induced Acute Kidney Injury Work in progress
3 The classic conceptual model AKI Hypovolemia Heart failure Major surgery Sepsis Shock Hypoperfusion Ischemia/hypoxia Classic conception
4 AKI and warm ischemia Exposure to warm ischemia (cardiac arrest) doesn t always result in AKI ALL PRCS* No PRCS RIFLE I or F 31.4% 51.7% 6.4% *PRCS = Post-resuscitation cardiogenic shock Chua, et al. Resuscitation 2012
5 AKI in the absence of overt shock Sepsis-induced AKI can occur in the absence of shock CAP AKI Non severe CAP 20.3% Non severe sepsis 23.8% Not requiring ICU 25% AKI (n=302) AKI (n=386) No AKI (n=962) No AKI (n=1158) 1 Murugan Kidney Int 2010
6 AKI is independent of renal blood flow 2 Systematic review of studies measuring Renal Blood Flow (RBF) in sepsis 1 Species Studies (n,%) RBF n(%) ~ or RBF n(%) Human 3-3 Animals (62%) 60 (38%) Small 65 (41%) 19 (29%) 46 (71%) Large 94 (59%) 53 (56%) 41 (44%) AKI can occur in the setting of increased RBF 2 Sepsis Sepsis Baseline Baseline 1 Langenberg, Bellomo Crit Care 2005, 2 Langenberg et al. Kidney Int 2006
7 Exposure to septic plasma causes AKI-like changes in tubular epithelial cells in vitro 1 Burned septic patient a. Alteration in cell polarity b. Decreased cell-cell interactions (tight junction ZO-1 protein) Vehicle Healthy Burn+ septic AKI No stimuli c. Increased apoptosis (TUNEL) Healthy plasma Burned+ Septic AKI plasma Podocytes and Proximal tubular epithelial cells Sepsis(S) S+AKI Burn+S Burn+ S+AKI 1 Mariano Crit Care 2008
8 Consistent histology findings 1. Microvascular dysfunction Wu et al. JASN Apical tubular epithelial cell vacuolization and loss of brush border Sepsisinduced AKI (S-AKI) is NOT ATN Tiwari et al 3. Inflammation and oxidative stress Wu et al. JASN Paucity of apoptosis/necrosis
9 is there anything else out there?
10 Microvascular dysfunction Inflammation Metabolic response Lack of function Lack of cell death
11 Unifying theory model DAMPs/PAMPs and other inflammatory mediators gain access to the tubular epithelial cell through filtration and peritubular capillary-tec interactions The danger alarm signal Reference 1. El-Achkar Wu
12 Unifying theory model Sluggish microvascular flow amplifies the danger alarm signal on the capillary side, and TLR-4- mediates recognition of DAMPs/PAMPs on the tubular side Reference 1. Tiwari 2005, Wu Goddard 1995, Holthoff Singbartl Kalakeche 2011, El- Achkar 2008 TNFα H 1 = Amplification H 1 Hypothesis H 1
13 TEC response: 1. Prioritization of energy consumption, 2. quality control, and 3. cell cycle arrest Tubular Lumen Signal from S1 cells Filtered mediators Cl - Tubular epithelial cell S2 segment and beyond Endocytosis 1 H 1 H 1 Regulation of energy metabolism Prioritization of utilization Mitophagy Cell cycle arrest Mitochondria Altered energy balance: AMP:ATP Uncoupled respiration ROS/RNS ѱ Apoptosis S1 Tubular epithelial cell 1 Protein synthesis Inflammatory mediators from blood 1 NHE1 Cl - 2 G2 M S G1 G0 Nucleus
14 DAMPs * * The Tubulo-glomerular feedback (TGF) may be the link between tubular injury and decline in GFR Afferent arteriole GFR Efferent arteriole DT Macula Densa CD TAL Injured tubular cells Loop of Henle NaCl PT Peritubular capillary
15 Preliminary data Sepsis = Alteration in energy metabolism How is energy metabolism regulated in the cell?
16 Preliminary data Over- Activation (AICAR) AMP activated protein kinase (AMPK) Cytokines Sepsis Anabolism Catabolism Inflammation Autophagy Organ Protection
17 Preliminary data Model: Rodent (mice) Cecal Ligation and Puncture (CLP). 22 gauge needle / 2 perforations 4 Groups and interventions (n=5-8/group): CLP Sham CLP+AICAR (100mg/kg) Sham + AICAR
18 Preliminary data Activation of AMPK by AICAR protects against cecal ligation and puncture-induced kidney injury mg/dl Creatinine p<0.05 p<0.05 mg/dl BUN p<0.05 pg/ml Cystatin C p<0.05 p<0.05 Groups Groups Groups
19 Preliminary data Activation of AMPK by AICAR reverses cecal ligation and punctureinduced increases in serum cytokine levels
20 : K12 development Aims Aim 1: To determine the role of microvascular dysfunction on activation of energy regulating pathways in the tubular endothelial cell (TEC), namely, AMPK activation and induction of mitophagy. Microvascular dysfunction Approach: Animal model (rat CLP) and TEC culture. Metabolic response Lack of function Lack of cell death 1. Determine the differences Microvascular in microvascular dysfunction, AMPK activation and mitophagy in animals with and without AKI. (CLP rat model) dysfunction H1: Microvascular dysfunction, and activation of AMPK and mitophagy in AKI > Non AKI 2. Determine the temporal and spatial relationship between microvascular dysfunction and activation of AMPK and mitophagy. (CLP rat model) H1 1 : Microvascular dysfunction precedes AMPK and mitophagy activation H1 2 : Microvascular dysfunction is associated with AMPK and mitophagy activation 3. Determine if microcirculatory dysfunction is associated with energy failure in the TEC. (CLP rat model) H1: Microvascular dysfunction is associated with an increase in AMP/ATP ratio Metabolic response Lack of function Lack of cell death
21 Inflammation Microvascular dysfunction Lack of function Lack of cell death Sepsis-induced AKI: K12 development Aims Aim 2: To determine the signaling mechanisms regulating recognition and response of the TEC to inflammatory mediators Approach: Animal model (rat CLP) and TEC culture. Focus: AMPK signaling, mitophagy activation, energy failure Metabolic response 1. Determine the role of inflammation on AMPK and mitophagy activation, and on energy balance in the TEC (CLP rat model: Microvascular TLR+/+, TLR4 -/-, Leukocyte depletion model; TEC culture with exposure to septic serum) H1 1 : AMPK and mitophagy will not be activated in TLR4-/- TEC dysfunction H1 2 : TLR4-/- mice will not develop microvascular dysfunction after CLP H1 3 : CLP after leukocyte depletion will be associated with a lack of AKI 2. Determine the role of AMPK over-activation on TEC response to inflammation (CLP rat model and TEC culture) Inflammation H1 1 : AMPK over-activation is associated with higher AMP:ATP ratio and less oxidative stress Lack of function Lack of cell death 3. Determine the effect of sera from animals subjected to different severities of CLP (low, moderate, severe) on TEC AMPK and mitophagy activation, and on AMP:ATP ratio in vitro (TEC culture exposed to septic sera from different severity models of AKI) H1 2 : Activation of AMPK and mitophagy will increase with increasing CLP severity sera. Metabolic response
22 : K12 development Aims Aim 3: To define the different clinical/biochemical phenotypes of presentation of sepsis, and their relation to sepsis-induced AKI. Approach: Database exploration HiDenIC and Astute. 1. Determine S-AKI subpopulations based on clinical variables refinement of prior epidemiologic descriptions 2. Determine S-AKI subpopulations using biochemical variables such as urine NGAL, TIMP-2 and IGFBP-7
23 Thank you
24 Thoughts??
Case - Acute Renal Failure
Case - Acute Renal Failure 73 yo diabetic F w hx of mild HBP but normal renal function develops infection of R foot. Over 1 week fever, chills, inflammation swelling of her R foot and leg. She takes Motrin
More informationAcute Kidney Injury for the General Surgeon
Acute Kidney Injury for the General Surgeon UCSF Postgraduate Course in General Surgery Maui, HI March 20, 2011 Epidemiology & Definition Pathophysiology Clinical Studies Management Summary Hobart W. Harris,
More informationMAJOR FUNCTIONS OF THE KIDNEY
MAJOR FUNCTIONS OF THE KIDNEY REGULATION OF BODY FLUID VOLUME REGULATION OF OSMOTIC BALANCE REGULATION OF ELECTROLYTE COMPOSITION REGULATION OF ACID-BASE BALANCE REGULATION OF BLOOD PRESSURE ERYTHROPOIESIS
More informationRENAL PHYSIOLOGY WESTMEAD PRIMARY EXAM
RENAL PHYSIOLOGY WESTMEAD PRIMARY EXAM RENAL PHYSIOLOGY - ANATOMY Glomerulus + renal tubule Each kidney has 1.3 million nephrons Cortical nephrons (85%) have shorter Loop of Henle than Juxtamedullary nephrons
More informationCollin County Community College RENAL PHYSIOLOGY
Collin County Community College BIOL. 2402 Anatomy & Physiology WEEK 12 Urinary System 1 RENAL PHYSIOLOGY Glomerular Filtration Filtration process that occurs in Bowman s Capsule Blood is filtered and
More informationBy: Dr. Foadoddini Department of Physiology & Pharmacology Birjand University of Medical Sciences. Body fluids and.
By: Dr. Foadoddini Department of Physiology & Pharmacology Birjand University of Medical Sciences Body fluids and Renal physiology 25 Volume and Osmolality of Extracellular and Intracellular Fluids
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 informationKidney Structure. Renal Lobe = renal pyramid & overlying cortex. Renal Lobule = medullary ray & surrounding cortical labryinth.
Kidney Structure Capsule Hilum ureter renal pelvis major and minor calyxes renal and vein segmental arteries interlobar arteries arcuate arteries interlobular arteries Medulla renal pyramids cortical/renal
More informationNephron Function and Urine Formation. Ms. Kula December 1, 2014 Biology 30S
Nephron Function and Urine Formation Ms. Kula December 1, 2014 Biology 30S The Role of the Nephron In order for the body to properly function and maintain homeostasis, the amount of dissolved substances
More informationUrinary bladder provides a temporary storage reservoir for urine
Urinary System Organs Kidney Filters blood, allowing toxins, metabolic wastes, and excess ions to leave the body in urine Urinary bladder provides a temporary storage reservoir for urine Paired ureters
More informationA08 Using Kidney Biomarkers for AKI 2: Differential Diagnosis, Interventions and Prognosis
A08 Using Kidney Biomarkers for AKI 2: Differential Diagnosis, Interventions and Prognosis Kent Doi, MD, PhD Emergency and Critical Care Medicine, The Univ of Tokyo, Japan Using kidney biomarkers: Key
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 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 informationSeptic Acute Kidney Injury (AKI) Rinaldo Bellomo Australian and New Zealand Intensive Care Research Centre (ANZIC-RC) Melbourne Australia
Septic Acute Kidney Injury (AKI) Rinaldo Bellomo Australian and New Zealand Intensive Care Research Centre (ANZIC-RC) Melbourne Australia Things we really, honestly know about septic AKI AKI is common
More informationAcute Kidney Injury. APSN JSN CME for Nephrology Trainees May Professor Robert Walker
Acute Kidney Injury APSN JSN CME for Nephrology Trainees May 2017 Professor Robert Walker Kidney International (2017) 91, 1033 1046; http://dx.doi.org/10.1016/ j.kint.2016.09.051 Case for discussion 55year
More informationLECTURE 25: FILTRATION AND CLEARANCE NEPHRON FILTRATION
LECTURE 25: FILTRATION AND CLEARANCE NEPHRON FILTRATION 1. Everything in the plasma is filtered except large proteins and red blood cells. The filtrate in Bowman s capsule is an isosmotic fluid that is
More informationAcute Kidney Injury. Amandeep Khurana, MD Southwest Kidney Institute
Acute Kidney Injury Amandeep Khurana, MD Southwest Kidney Institute 66 yr white male w/ DM, HTN, CAD admitted to an OSH w/ E Coli UTI on 7/24/16, developed E Coli bacteremia and Shock (on vaso + levo)
More informationrenoprotection therapy goals 208, 209
Subject Index Aldosterone, plasminogen activator inhibitor-1 induction 163, 164, 168 Aminopeptidases angiotensin II processing 64 66, 214 diabetic expression 214, 215 Angiotensin I intrarenal compartmentalization
More informationTHE KIDNEY IN HYPOTENSIVE STATES. Benita S. Padilla, M.D.
THE KIDNEY IN HYPOTENSIVE STATES Benita S. Padilla, M.D. Objectives To discuss what happens when the kidney encounters low perfusion To discuss new developments and clinical application points in two scenarios
More informationRENAL PHYSIOLOGY DR.CHARUSHILA RUKADIKAR ASSISTANT PROFESSOR PHYSIOLOGY
RENAL PHYSIOLOGY DR.CHARUSHILA RUKADIKAR ASSISTANT PROFESSOR PHYSIOLOGY GROSS ANATOMY Location *Bean-shaped *Retroperitoneal *At level of T12 L1 vertebrae. *The right kidney lies slightly inferior to left
More information014 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 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 informationClinical Significance of ARF. Hospital Acquired Renal Insufficiency. Case - Acute Renal Failure. Hospital Acquired Renal Insufficiency
Case - Acute Renal Failure 73 yo diabetic F w hx of mild HBP but normal renal function develops infection of R foot. Over 1 week fever, chills, inflammation swelling of her R foot and leg. She takes Motrin
More informationHDAC Inhibition for Prevention of Fibrosis Following Sepsisinduced
HDAC Inhibition for Prevention of Fibrosis Following Sepsisinduced AKI John A. Kellum, MD, MCCM Professor of Critical Care Medicine, Medicine, Bioengineering and Clinical & Translational Science Vice Chair
More information19. RENAL PHYSIOLOGY ROLE OF THE URINARY SYSTEM THE URINARY SYSTEM. Components and function. V BS 122 Physiology II 151 Class of 2011
19. RENAL PHYSIOLOGY THE URINARY SYSTEM Components and function The urinary system is composed of two kidneys, the functionally filtering apparatus, which connect through two tubular structures called
More informationCopyright 2009 Pearson Education, Inc. Copyright 2009 Pearson Education, Inc. Figure 19-1c. Efferent arteriole. Juxtaglomerular apparatus
/6/0 About this Chapter Functions of the Kidneys Anatomy of the urinary system Overview of kidney function Secretion Micturition Regulation of extracellular fluid volume and blood pressure Regulation of
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 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 informationUrinary biomarkers in acute kidney injury. Max Bell MD, PhD Karolinska University Hospital Solna/Karolinska Institutet
Urinary biomarkers in acute kidney injury Max Bell MD, PhD Karolinska University Hospital Solna/Karolinska Institutet Development of AKI-biomarkers Early markers of AKI, do we need them? GFR drop Normal
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 informationRenal Physiology II Tubular functions
Renal Physiology II Tubular functions LO. 42, 43 Dr. Kékesi Gabriella Basic points of renal physiology 1. Glomerular filtration (GF) a) Ultrafiltration 2. Tubular functions active and passive a) Reabsorption
More informationBCH 450 Biochemistry of Specialized Tissues
BCH 450 Biochemistry of Specialized Tissues VII. Renal Structure, Function & Regulation Kidney Function 1. Regulate Extracellular fluid (ECF) (plasma and interstitial fluid) through formation of urine.
More informationUrinary System (Anatomy & Physiology)
Urinary System (Anatomy & Physiology) IACLD CME, Monday, February 20, 2012 Mohammad Reza Bakhtiari, DCLS, PhD Iranian Research Organization for Science & Technology (IROST) Tehran, Iran The Urinary System
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 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 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 informationIdentify and describe. mechanism involved in Glucose reabsorption
Define tubular reabsorption, tubular secretion, transcellular and paracellular transport. Identify and describe mechanism involved in Glucose reabsorption Describe tubular secretion with PAH transport
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 informationBiomarkers of renal diseases. By Dr. Gouse Mohiddin Shaik
By Dr. Gouse Mohiddin Shaik Introduction Renal system performs several functions Excretory Waste products like urea, creatinine, drug, toxins clearance Regulatory Water, electrolyte and acid base balance
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 informationSeptic AKI in ICU patients
Septic AKI in ICU patients Prof. Achim Jörres, M.D. Dept. of Nephrology and Medical Intensive Care Charité University Hospital Campus Virchow Klinikum Berlin, Germany achim.joerres@charite.de Agenda Epidemiology
More informationSoto K, Coelho S, et al. Hospital Fernando Fonseca
SEPTIC INDUCED ACUTE KIDNEY INJURY Soto K, Coelho S, et al. Hospital Fernando Fonseca Introduction- Epidemiology RIFLE/AKIN Classification Scheme for AKI diagnosis 4.2 23 53 % Absence of other clear and
More informationRENAL PHYSIOLOGY, HOMEOSTASIS OF FLUID COMPARTMENTS (1)
RENAL PHYSIOLOGY, HOMEOSTASIS OF FLUID COMPARTMENTS (1) Dr. Attila Nagy 2017 Functional roles of the kidney 1.Homeostasis of fluid compartments (isosmia, isovolemia, isoionia, isohydria,) 2. Elimination
More informationBiomarkers, the Kidney and the Heart: Acute Kidney Injury
Biomarkers, the Kidney and the Heart: Acute Kidney Injury 12th Annual Conference on Biomarkers in Heart Failure and Acute Coronary Syndromes: Diagnosis, Treatment and Devices San Diego May 13, 2016 Ravindra
More informationRenal Physiology - Lectures
Renal Physiology 2011 Lisa M. Harrison-Bernard, PhD lharris@lsuhsc.edu Renal Physiology - Lectures Physiology of Body Fluids 2. Structure & Function of the Kidneys 3. Renal Clearance & Glomerular Filtration
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 informationUrinary System Laboratory
Urinary System Laboratory 1 Adrenal gland Organs of The Urinary System Renal artery and vein Kidney Ureter Urinary bladder Figure 26.1 2 Urethra Functions of the urinary system organs: Urethra expels urine
More informationLab Activity 31. Anatomy of the Urinary System. Portland Community College BI 233
Lab Activity 31 Anatomy of the Urinary System Portland Community College BI 233 Urinary System Organs Kidneys Urinary bladder: provides a temporary storage reservoir for urine Paired ureters: transport
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 informationUrinary System kidneys, ureters, bladder & urethra
Urinary System kidneys, ureters, bladder & urethra Kidney Function Filters blood removes waste products conserves salts, glucose, proteins, nutrients and water Produces urine Endocrine functions regulates
More informationCollin College. BIOL Anatomy & Physiology. Urinary System. Summary of Glomerular Filtrate
Collin College BIOL. 2402 Anatomy & Physiology Urinary System 1 Summary of Glomerular Filtrate Glomerular filtration produces fluid similar to plasma without proteins GFR ~ 125 ml per min If nothing else
More informationProf. Michael Joannidis Medical Intensive Care and Emergency Unit Department of Internal Medicine Medical University Innsbruck Innsbruck, Austria
1 di 27 Prevention of AKI: experimental promises and clinical realities Michael Joannidis, Innsbruck, Austria Chairs:Norbert Lameire, Ghent, Belgium Gert Mayer, Innsbruck, Austria Prof. Michael Joannidis
More informationSUPPLEMENTARY INFORMATION
Supplementary information S1 Studies of the effect of AKI duration on outcomes Study Study group (n) Criteria for AKI Definition of RR Outcomes Uchino et al. All patients admitted to (2010) 1 a university-affiliated
More informationUrinary System kidneys, ureters, bladder & urethra
Urinary System kidneys, ureters, bladder & urethra Filters blood removes waste products conserves salts, glucose, proteins, nutrients and water Produces urine Kidney Function Endocrine functions regulates
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 informationFunctions of the kidney
Physiology of Urinary tract Kidney, Ureter, Urinary bladder Urethra Kidney function Excretion Physiology of volume regulation Functions of the kidney Excretion of dangerous substances endogenous (metabolites):
More informationAKI: definitions, detection & pitfalls. Jon Murray
AKI: definitions, detection & pitfalls Jon Murray Previous conventional definition Acute renal failure (ARF) An abrupt and sustained decline in renal excretory function due to a reduction in glomerular
More informationSupplemental Figure 1. (A) Western blot for the expression of RIPK1 in HK-2 cells treated with or without LPS (1 µg/ml) for indicated times.
Supplemental Figure 1. (A) Western blot for the expression of RIPK1 in HK-2 cells treated with or without LPS (1 µg/ml) for indicated times. Western blots shown are representative results from 3 independent
More informationBody fluid volume is small (~5L (blood + serum)) Composition can change rapidly e.g. due to increase in metabolic rate
Renal physiology The kidneys Allow us to live on dry land. Body fluid volume is small (~5L (blood + serum)) Composition can change rapidly e.g. due to increase in metabolic rate Kidneys maintain composition
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 informationRENAL PHYSIOLOGY, HOMEOSTASIS OF FLUID COMPARTMENTS
RENAL PHYSIOLOGY, HOMEOSTASIS OF FLUID COMPARTMENTS (2) Dr. Attila Nagy 2017 TUBULAR FUNCTIONS (Learning objectives 54-57) 1 Tubular Transport About 99% of filtrated water and more than 90% of the filtrated
More informationQUIZ/TEST REVIEW NOTES SECTION 1 RENAL PHYSIOLOGY FILTRATION [THE KIDNEYS/URINARY SYSTEM] CHAPTER 19 CHAPTER 19
QUIZ/TEST REVIEW NOTES SECTION 1 RENAL PHYSIOLOGY FILTRATION [THE KIDNEYS/URINARY SYSTEM] CHAPTER 19 CHAPTER 19 Learning Objectives: Differentiate the following processes: filtration, reabsorption, secretion,
More informationChapter 26 The Urinary System
Chapter 26 The Urinary System Kidneys, ureters, urinary bladder & urethra Urine flows from each kidney, down its ureter to the bladder and to the outside via the urethra Filter the blood and return most
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 information11/05/1431. Urine Formation by the Kidneys Tubular Processing of the Glomerular Filtrate
Urine Formation by the Kidneys Tubular Processing of the Glomerular Filtrate Chapter 27 pages 327 347 1 OBJECTIVES At the end of this lecture you should be able to describe: Absorptive Characteristics
More informationFigure 26.1 An Introduction to the Urinary System
Chapter 26 Figure 26.1 An Introduction to the Urinary System Components of the Urinary System Kidney Produces urine Ureter Transports urine toward the urinary bladder Urinary Bladder Temporarily stores
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 informationBasic Urinary Tract Anatomy and Histology
Basic Urinary Tract Anatomy and Histology The two kidneys are located in the retroperitoneum on either side of the vertebral bladder and the contraction of the detrusor muscle. Any mechanical barrier,
More information** Accordingly GFR can be estimated by using one urine sample and do creatinine testing.
This sheet includes the lecture and last year s exam. When a patient goes to a clinic, we order 2 tests: 1) kidney function test: in which we measure UREA and CREATININE levels, and electrolytes (Na+,
More informationKidney Functions Removal of toxins, metabolic wastes, and excess ions from the blood Regulation of blood volume, chemical composition, and ph
The Urinary System Urinary System Organs Kidneys are major excretory organs Urinary bladder is the temporary storage reservoir for urine Ureters transport urine from the kidneys to the bladder Urethra
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 informationNovel Biomarkers in Critically Ill Patients and the Emergency Room
Novel Biomarkers in Critically Ill Patients and the Emergency Room Jay L. Koyner MD Section of Nephrology University of Chicago Research Funding: NIDDK, Abbvie, Astute, Argutus Outline Background / Pitfalls
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 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 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 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 informationUrine Formation. Urinary Physiology Urinary Section pages Urine Formation. Glomerular Filtration 4/24/2016
Urine Formation Urinary Physiology Urinary Section pages 9-17 Filtrate Blood plasma minus most proteins Urine
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 informationUrinary system. Urinary system
INTRODUCTION. Several organs system Produce urine and excrete it from the body Maintenance of homeostasis. Components. two kidneys, produce urine; two ureters, carry urine to single urinary bladder for
More informationGlomerular filtration rate (GFR)
LECTURE NO (2) Renal Physiology Glomerular filtration rate (GFR) Faculty Of Medicine Dept.Of Physiology The glomerulus Is a tuft of capillaries enclosed within a Bowman capsule. It is supplied by an afferent
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 informationWaste Products & Kidney Function
Waste Products & Kidney Function urinary system principal means of metabolic waste removal urinary system is closely associated with reproductive system urogenital system share embryonic development share
More informationOutline the functional anatomy, and the physiological factors, that determine oxygen delivery to the renal medulla.
2011-2-21 Outline the functional anatomy, and the physiological factors, that determine oxygen delivery to the renal medulla. Oxygen delivery = Blood flow CaO 2 Where Blood flow determined by (arterial
More informationAP2, Lab 7 - THE URINARY SYSTEM
AP2, Lab 7 - THE URINARY SYSTEM I. SYSTEM COMPONENTS (Figs. 25.1 25.4) KIDNEYS Each kidney contains approx. 1,000,000 tubular NEPHRONS which produce FILTRATE from the plasma and then add to or take from
More informationAfter studying this lecture, you should be able to...
Reabsorption of Salt and Water After studying this lecture, you should be able to... 1. Define the obligatory water loss. 2. Describe the mechanism of Na ++ reabsorption in the distal tubule and explain
More informationVasopressors in septic shock
Vasopressors in septic shock Prof. Jean-Louis TEBOUL Medical ICU Bicetre hospital University Paris-South France Questions 1- Why do we use vasopressors in septic shock? 2- Which first-line agent? 3- When
More informationCHAPTER 25 URINARY. Urinary system. Kidneys 2 Ureters 2 Urinary Bladder 1 Urethra 1. functions
CHAPTER 25 URINARY Kidneys 2 Ureters 2 Urinary Bladder 1 Urethra 1 fluid waste elimination secretion of wastes control blood volume and BP control blood ph electrolyte levels RBC levels hormone production
More informationChapter 25 The Urinary System
Chapter 25 The Urinary System 10/30/2013 MDufilho 1 Kidney Functions Removal of toxins, metabolic wastes, and excess ions from the blood Regulation of blood volume, chemical composition, and ph Gluconeogenesis
More informationDoppler ultrasound, see Ultrasonography. Magnetic resonance imaging (MRI), kidney oxygenation assessment 75
Subject Index Acidemia, cardiorenal syndrome type 3 146 Acute Dialysis Quality Initiative (ADQI) acute kidney injury biomarkers, see Acute kidney injury; specific biomarkers cardiorenal syndrome, see specific
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 informationFunctional Renal Physiology and Urine Production
Functional Renal Physiology and Urine Production Urinalysis can provide insight into hydration status, renal function or dysfunction, systemic disease, and toxic insults. Accurate interpretation of urinalysis
More informationAnatomy/Physiology Study Guide: Unit 9 Excretory System
Anatomy/Physiology Study Guide: Unit 9 Excretory System 1) In the space below, list the primary structures (organs) and their corresponding functions. Structures: Functions: KIDNEY 1) URETER BLADDER URETHRA
More informationFiltration and Reabsorption Amount Filter/d
Renal Physiology 2011 Lisa M. Harrison-Bernard, PhD Contact me at lharris@lsuhsc.edu Renal Physiology Lecture 3 Renal Clearance and Glomerular Filtration Filtration and Reabsorption Amount Filter/d Amount
More informationThe topic of normal vascular and glomerular anatomy is introduced
Normal Vascular and Glomerular Anatomy Arthur H. Cohen Richard J. Glassock The topic of normal vascular and glomerular anatomy is introduced here to serve as a reference point for later illustrations of
More informationRNPDC CCNP Anatomy and Physiology: Renal System Pre-Quiz 2015
RNPDC CCNP Anatomy and Physiology: Renal System Pre-Quiz 2015 1. In which abdominal cavity do the kidneys lie? a) Peritoneum. b) Anteperitoneal. c) Retroperitoneal. d) Parietal peritoneal 2. What is the
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 informationPRE-RENAL AKI: DOES IT LEAD TO ATN. Sushma Bhusal
PRE-RENAL AKI: DOES IT LEAD TO ATN Sushma Bhusal 9.9.14 CASE PRESENTATION CC : 31 AAM presented with Fatigue, malaise and body aches x 10 days HPI: STD testing done 2 weeks prior, all results negative
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 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 informationHistology Urinary system
Histology Urinary system Urinary system Composed of two kidneys, two ureters, the urinary bladder, and the urethra, the urinary system plays a critical role in: 1- Blood filtration,(filtration of cellular
More information