3rd lecture - renal clearance

8/13/2019 3rd Lecture - Renal Clearance

1/13

Phys i o l ogy Team 43

!"#$%%&' !%)*+,-.

/'&%-# !% 0+'&-.1#-

!"#$%2&'.&3 !%)4&56

7&' !%)8'+,-8'-

9& !%)0#1.-:

0+'&..1# !% ;$.1-6

0&

"#$%&&'()*(+ "&,)()'(+-

.('-/ "&012(-#-

"#$%&*(&-3 "&*%4(''-)

"#$%&(5-5 "&0)(*($

")*6$ "&*('5%/-

7(,,6' "&0*88,(

"#$%&9()*(+ "&0,)('-$()

Yafa Al-shamlan

Sara Al-anazy

Lama Mokhlis

Tmader alaofi

Hayfa alabdulkareem

Dalal fatani Jomanah alshammari

Shehanah alomair

Alaa Al-anazi

Ghaida Al-suqir

Manar aljebreen

Rand Al-hwil

Afnan Al-hargan

.6(* &6($6',

:8)(**6$ ",-'-

78%' "&0;)(


2/13

Renal lood flow and RenalClearance Renal Blood flow:

"#$ %&'($) *$+$&,$- $./*$0$1) #&2# 3144' 5146 +4078*$' 6&/# 4/#$* 4*28(-9 /4 -:771)/#$ %&'($)- 6&/# $(4:2# 718-08 54* /#$ #&2# *8/$- 45 2140$*:18* 5&1/*8/&4(;


3/13

Calculation of renal blood flow:.8 >(&>%&(26 2)6 9?@ &6('(+>6 84 G"HDG"HI JKG"H L MNOGG"H I QRQ01C0&(@ $55$+/&,$ *$(81 718-08 5146 JS=G?L

DK ?%2 #6>(%,6 8+&E PQR 84 G"H -+ ('26'-(& #&88$ -, '6*8A6$ #E2)6 3-$+6E (&>%&(26 2)6 ">2%(& '6+(& B&(,*(

4&8< J"9G@N

H=G?@ S=G?C$./*8+/&4( *8/&4= 585/0.9= 650ml/min

TK 78< %&(26 2)6 '6+(& #&88$4&8< J9?@N

9?@I 9G@OJS0)6*(28>'-2N

I TUQOJS00.VUNISSWX *&O*-+

1'9?@ I 96+(& ('26'E B'6,,%'6 Y 96+(& A6-+ B'6,,%'6

.82(& 96+(& A(,>%&(' B'6,,%'6

ZZG"H -, %,6$ 28 *6(,%'6 2)6 9?@

ZZD[9".\7\7[ -, %,6$ 28 *6(,%'6 2)6 ]@9

AK FGHI@ F1$8*8(+$ 45 GHI

DK UGHI@ U*&($ GHI +4(+$(/*8/&4(@ Q;RQ02C01

TK V@ :*&($ 5146 *8/$9 &/ +8( 3$ 0$8-:*$' 3) DW#*- +411$+/&(2 :*&($;

X:774-&(2 @ AWWN 01CDW #*- AWWNYDWYZN@ A01C0&(

WK GGHI@ 8*/$*&81 718-08 GHI +4(+$(/*8/&4(

S./*8+/&4( *8/&4@JGGHIK=$(81 ,$(4:- GHILCGGHI @

JN;NAKN;NNALCN;NAL@ N;M

I$08/4+*&/@ "#$ #$08/4+*&/ J&- /#$ ,41:0$ 7$*+$(/82$ JEL 45 *$' 3144' +$11- &(

3144';


4/13

Auto regulation:

! \2^, ( @66$#(>3 *6>)(+-,* 28 366B 9?@ (+$ ]@9 '6&(2-A6&E >8+,2(+2 $6,B-26 *('36$>)(+F6, -+ "?G

!9(+F6 84 (%28 '6F%&(2-8+ -, #62(*6 &88+,2'->2-8+ 84 6446'6+2 ('26'-8&6a

9-,6, -+ B'6,,%'6 '6,%&2, -+ >8+,2'->2-8+ 84 (446'6+2 ('26'-8&6 \+ ,6A6'6 >(,6, 84 -+>'6(,6$ "?G 6446'6+2 $-&(2(2-8+ >%' (&8+F 2-8+a

Three processes controlling GFR:

Sa :E8F6+-> (%28 '6F%&(2-8+Xa H8'*8+(& '6F%&(2-8+ J2%#%&8F&8*6'%&(' d '6+-+0(+F-826+,-+Nea "%28+8*-> '6F%&(2-8+ J6L2'-+,->NVa 7-2'-> 1L-$6 J71NC

oCauses arteriolar vasodilationoElevated NO may result in hyperfiltration of early Diabetes MellitusoReduced NO after salt intake may lead to hypertension


5/13

1. Myogenic auto regulation:

.)6 (#-&-2E 84 #&88$ A6,,6&, 28 '6,-,2 f2'62>)-+F HE$'8,2(2-> G'6,,%'6 ,2'62>)-+F M6,,6&, 2-8+2. Hormonal Regulation:

\a .%#%&8F&8*6'%&(' 466$#(>3\\a 96+-+0(+F-826+,-+ "&$8,26'8+6\\\a 12)6' H8'*8+6,

3. Autonomic Regulation of GFR:

g\+ +8'*(& >8+$-2-8+ fE*B(2)62-> 7f )(, &-22&6 -+4&%6+>6 8+ ]@9

g ?G J)6*8'')(F6N ,E*B(2)62-> M(,8>8+,2'->2-8+ 84 '6+(& ('26'E 9?@

A(,8>8+,2'->2-8+ 84 (446'6+2 ]@9

.1 c\M[9. ?h11c .1 M\."h 19]"7f


6/13

\a .%#%&8F&8*6'%&(' 466$#(>3C ]@9 ,&8< 4&8< 7(>& '6(#,8'B2-8+ 28 2)6 >-'>%&(2-8+ $%6 28 )EB826+,-8+ 7(>& (2

*(>%&( $6+,( &6($-+F 28C

Sa '6+-+ (+F-826+,-+ \\ 6446'6+2 A(,8>8+,2'->2-8+ ]@9Xa "446'6+2 $-&(2-8+ ]@9

4 7$*54*0 /#$ 5:(+/&4( 45 8:/4 *$2:18/&4(9 /#$ %&'($)- #8,$ 8 5$$'38+% 0$+#8(&-0 /#8/ 1&(%- +#8(2$- &( -4'&:0 +#14*&'$

4(+$(/*8/&4( 8/ /#$ 08+:18 '$(-8 6&/# /#$ +4(/*41 45 *$(81 8*/$*&418* *$-&-/8(+$; "#$ /:3:142140$*:18* 5$$'38+% 0$+#8(&-0 #8- D

4074($(/- /#8/ 8+/ /42$/#$* /4 +4(/*41 [?=\ A-/ 8( 855$*$(/ 8*/$*&418* 5$$'38+% 0$+#8(&-0 8(' D(' 8( $55$*$(/ 8*/$*&418*

$$'38+% 0$+#8(&-0; "#$-$ 5$$' 38+% 0$+#8(&-0- '$7$(' 4( -7$+&81 8(8/40&+81 8**8(2$0$(/- 45 /#$ ]:./82140$*:18* +4071$.;

#$ ]:./82140$*:18* +4071$. +4(-&-/- 45 08+:18 '$(-8 +$11- &( /#$ &(&/&81 74*/&4( 45 /#$ '&-/81 /:3:1$ 8(' ]:./82140$*:18* +$11- &( /#$

6811- 45 /#$ 855$*$(/ 8(' $55$*$(/ 8*/$*&41$-; "#$ 08+:18 '$(-8 +$11- -$(-$ +#8(2$- &( ,41:0$ '$1&,$*) /4 /#$ '&-/81 /:3:1$ 3) 68) 45

2(81- /#8/ 8*$ (4/ +4071$/$1) :('$*-/44'; S.7$*&0$(/81 -/:'&$- -:22$-/ /#8/ '$+*$8-$' [?= 08) -146 /#$ 5146 *8/$ &( /#$ 1447 45

$(1$ +8:-&(2 8( &(+*$8-$ &( *$83-4*7/&4( 45 -4'&:0 8(' +#14*&'$ &4(- &( /#$ 8-+$('&(2 1447 45 #$(1$ 8(' /#$*$3) *$':+&(2

4(+$(/*8/&4( 45 -4'&:0 8(' +#14*&'$ +4(+$(/*8/&4( &( /:*( &(&/&8/$- 8 -&2(81 5*40 /#$ 08+:18 '$(-8 /#8/ #8- D $55$+/-\ JAL &/

$+*$8-$- *$-&-/8(+$ 45 /#$ 855$*$(/ 8*/$*&41$9 6#&+# *8&-$- 2140$*:18* #)'*4-/8/&+ 7*$--:*$ 8(' #$17- /4 *$/:*( [?= /468*' (4*081

(' JDL &/ &(+*$8-$- *$(&( *$1$8-$ 5*40 /#$ ]:./82140$*:18* +$11- 45 /#$ 855$*$(/ 8(' $55$*$(/ 8*/$*&41$-9 6#&+# 8*$ 08]4* -/4*82$

/$- 54* *$(&(; =$(&( *$1$8-$' 5*40 /#$-$ +$11- /#$( 5:(+/&4(- 8- 8( $(^)0$ /4 &(+*$8-$ /#$ 54*08/&4( 45 H(2


7/13

\\a 96+-+0(+F-826+,-+ "&$8,26'8+6C 96+-+ -, '6&6(,6$ -+28 B&(,*( $%6 28C

! &8< [D@ 7( 8' &8< [DM! ,E*B(2)62-> J$%6 28 )EB826+,-8+N! (446'6+2 B'6,,%'6 J)EB826+,-8+N

96+-+ (>2, 8+ (+F-826+,-+8F6+ "+F-826+,-+ \ "+F-826+,-+ >8+A6'2-+F 6+5E*6 J"D[NC "+F-826+,-+ \ (+F-826+,-+ \\ "+F-826+,-+ \\ (>2 8+ ($'6+(& >8'26L (&$8,26'8+6 ,6>'62-8+ 7( '6(#,8'B2-8+ -+ $-,2(&

d >8&&6>2-+F $%>2 84 +6B)'8+

H (+$ ; ,6>'62-8+ -+ 6L>)(+F6 48' 7(

\\\a 12)6' H8'*8+(& 96F%&(28' 84 ]@9CSa "$'6+(&-+6` +8'($'6+(&-+6 (446'6+2 A(,8>8+,2'->2-8+ ]@9

Xa "+F-826+,-+ \\ M(,8>8+,2'->2-8+ 84 6446'6+2 ]@9

ea G'8,2(F&(+$-+,` #'($E3-+-+ (446'6+2 A(,8$-&(28' ]@9


8/13

Renal Clearance:

" .)6 M8&%*6 84 G&(,*( 2)(2 -, >8*B&626&E >&6('6$ 84 (+E ,%#,2(+>6 #E 2)6 ;-$+6E, B6' *-+%26-, >(&&6$ 2)6 >&6('(+>6 84 2)(2 B('2->%&('

,%#,2(+>6

" D&6('(+>6 6/%(2-8+! D, I JiKj, L MNOiGj, I *&O*-+

" 96+(& >&6('(+>6 48' $-446'6+2 ,%#,2(+>6, A('-8%, #62'626$ J6aFa \+%&-+N! "&& 2)6 ,%#,2(+>6


9/13


10/13

Inulin clearance & GFR:

" SXQ *&O*-+", -+%&-+ -, 4'66&E 4-&26'6$ +82 ,6>'626$ 8'

96(#,8'#6$

\+%&-+ >&6('(+>6 I ]@9

Creatinine clearance &GFR:

# D'6(2-+-+6 -, (+ 6+$8F6+8%, ,%#,2(+>6 %,6$ '8%2-+6&E

28 *6(,%'6 ]@9

# D8*B&626&E 4-&26'6$` #%2 ,6>'626$ -+ ,*(&& /%(+2-2E

# \+A6',6 '6&(2-8+,)-B #62'6(2-+-+6

# @8' 6L(*B&6C '6(,6 2)6 B&(,*(

>'6(2-+-+6 -, $6>'6(,6$ (+$ A-6, A6',(a


11/13

Inulin clearance vs. clearance of othersubstance

# DL I -+%&-+ >&6('(+>6 J]@9N f%#,2(+>6 L -, 4-&26'6$ #%2 +82 (#,8'#6$ 8' ,6>'626$I]@9# DE l -+%&-+ >&6('(+>6 J]@9N f%#,2(+>6 E -, 4-&26'6$ (+$ B('2-(&&E (#,8'#6$ l ]@9# D5 m -+%&-+ >&6('(+>6 J]@9N f%#,2(+>6 5 -, 4-&26'6$ (+$ ,6>'626$ m]@9

Glucose & urea clearance:

96+(& >&6('(+>6 84 F&%>8,6I56'8

@-&26'6$` >8*B&626&E (#,8'#6$` +8 F&%>8,6 -+ %'-+6

iKjF L M I 56'8

K'6( >&6('(+>6 I TQ *&O*-+` %'6( 4-&26'6$` B('2-(&&E '6(#,8'#6$


12/13

#8(2$-&( 8,$*82$ +4(+$(/*8/&4( 45 '&55$*$(/

:3-/8(+$- 8/ '&55$*$(/ 74&(/- &( /#$ /:3:18*

)-/$0 *$18/&,$ /4 /#$ +4(+$(/*8/&4( 45 $8+#

:3-/8(+$ &( /#$ 2140$*:18* 5&1/*8/$; H ,81:$ A;N

('&+8/$- /#8/ +4(+$(/*8/&4( 45 /#$ -:3-/8(+$ &(

#$ /:3:18* 51:&' &- /#$ -80$ 8- /#$ +4(+$(/*8/&4(

5 /#8/ -:3-/8(+$ &( /#$ 2140$*:18* 5&1/*8/$;

V81:$- 3$146 A;N &('&+8/$ /#8/ /#$ -:3-/8(+$ &-$83-4*3$' 04*$ 8,&'1) /#8( 68/$*9 6#$*$8-

81:$- 834,$ A;N &('&+8/$ /#8/ /#$ -:3-/8(+$ &-

$83-4*3$' /4 8 1$--$* $./$(/ /#8/ 68/$*;


13/13

Indicate wither in of the following factors would (A) increase (B) decreasethe GFR:

__1.Tubuloglomerular feedback response to decreased salt delivery to the

distal tubule

__2.Affernt arteriole vasoconctriction

__3.A dramatic fall in arterial pressure following sever hemorrhage (

3rd lecture - renal clearance

Documents