LECTURE OBJECTIVES 24.docx

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LECTURE OBJECTIVES 24 1. List 10 consequences of kidney failure. a. Fluid overload b. Hypertension, edema (peripheral, pulmonary) c. Hyperkalemia d. Acidosis e. Anemia (lack of erythropoietin) f. Altered medication metabolism g. Cardiovascular disease h. Hyperparathyroidism i. Mineral and bone disorders j. Vascular calcification 2. List from memory the hormones that target the kidneys and what they do. a. Atrial natriuretic factor (ANF), affects Na+ b. Antidiuretic hormone (ADH, vasopressin), affects water c. Aldosterone, part of the renin-angiotensin system, affects Na+ and water (aldosterone also affects K+) d. Parathyroid hormone (PTH), affects Ca++ 3. List, describe and explain in detail the role of the kidney in the maintenance of volume, ionic composition and osmotic pressure of body fluids a. Water balance – kidneys control the amount of water excreted by the body regulate the volume of blood in the cardiovascular system, and the volumes of extracellular and intracellular fluid in the body. b. Ionic balance – by controlling the excretion of various ions such as Na+, K+, Ca+ +, and Cl- in the urine, the kidneys regulate the concentrations of these cations and anions in the extracellular fluids. c. The renin-angiotensin-aldosterone is activated by the kidneys – system is involved in both fluid and salt balance, component of various systems that regulate blood pressure. i. Low blood pressure sympathetic stimulation via baroreceptor reflex ii. Sympathetic activation stimulates a group of cells in the kidney (juxtaglomerular cells) to secrete renin into the circulation. iii. Renin angiotensin to angiotensin I angiotensin II by angiotensin enzyme (found in the pulmonary capillaries). Angiotensin II is a vasoconstrictor, which raises total peripheral resistance. iv. Angiotensin II acts on the adrenal cortex which stimulating it to secrete aldosterone stimulates the kidney to absorb sodium and water from the fluid destined to become urine generates more concentrated urine and conserves the body’s water.
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