Lecture 3 Renal

Lecture 3 Renal - NPB113 Renal 3 -1 Regulation of...

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1 March 2, 10 NPB113 Renal 3 -1 Regulation of Extracellular Fluid Volume through Regulation of Na Excretion and Reabsorption Overview: 1. Plasma Osmolarity Regulated through ADH 2. Plasma or Vascular Volume Regulated through Changes in Na Reabsorption and Excretion with Water and, to lesser extent, Changes in ADH Secretion . Conservation of vascular volume occurs through decrease Na excretion and increase in ADH Secretion . Reduction of vascular volume occurs through increase Na excretion and decrease in ADH Secretio n. 3. Variation in Fluid and Na Intake Produces Changes in Vascular Volume Changes vascular volume changes in blood pressure, Changes in vascular volume changes in protein oncotic pressure changes in Filtration Fraction Changes in blood pressure reflex sympathetic induced changes in afferent and efferent arteriolar resistance Renal Plasma Flow, GFR, Filtration Fraction and Protein Oncotic Pressure in peritubular capillaries and space, Changes in vascular volume and changes in blood pressure changes in rate of Na and fluid delivery to distal tubules and macula densa of JGA renin secretion & changes in the activation of R-A-A system.
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NPB113 Renal 3 -2 Regulation of Extracellular Fluid Volume through Regulation of Na Excretion and Reabsorption Primary Effects of Changes in Vascular Volume changes protein oncotic pressure and blood pressure. 1. Effect on protein oncotic pressure and blood pressure Increases in vascular volume (fluid intake) decrease in protein oncotic pressure & increase blood pressure. Decreases in vascular volume (dehydration or blood loss) increase protein oncotic pressure with dehydration & decrease protein oncotic pressure with blood loss (consequence of transfer water from cellular compartment to vascular compartment) & decrease in blood pressure. 2. Blood pressure changes reflex changes in sympathetic activity to kidneys & to changes in ADH secretion Reflex changes in sympathetic activity with small changes in blood pressure affect efferent arteriolar resistance more than afferent. (large changes in blood pressure affect afferent more than efferent arteriolar resistance) Changes in osmolality of plasma affect ADH secretion. Changes in vascular volume affect volume dependent inhibition of ADH secretion through volume receptors pulmonary veins & left atrium. 2 March 2, 10
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NPB113 Renal 3 -3 Regulation of Extracellular Fluid Volume through Regulation of Na Excretion and Reabsorption Secondary Effects of Small Changes in Blood Pressure and Sympathetic Activity on RPF, FF, Activation of R-A-A System 1. Increase sympathetic activity from decreases in volume Decreases RPF
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Lecture 3 Renal - NPB113 Renal 3 -1 Regulation of...

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