lec 14 mineralocorticoids.pptx

lec 14 mineralocorticoids.pptx - Mineralocorticoids...

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Page 1 Mineralocorticoids 24 Nephron H2O, ADH, CD glucose, PCT, Tm JGA, renin, Ag II, vasoconstriction, thirst, aldosterone, kinins, vasodilation, Na, ZG, DCT, ANP, BNP, CNP endothelin, adrenomedullin Introduction concepts to remember: a) water, glucose, mineral metabolism; b) adrenal in stress and blood pressure Renin - angiotensin (RAS) and kallikrein - kinin (KKS) systems: synthesis, secretion receptors, mechanism of action, effects Mineralocorticoids: aldosterone synthesis, secretion, receptors, mechanism of action, hormonal effects Peptide hormones and paracrine factors: ANP, BNP, CNP, ET, adrenomedullin Integration: response to hemorrage and to dehydration Pathophysiology: RAS & KKS involvement in hypertension and in hyperaldosteronism Introduction aldosterone and its “story lines” ALDO renin Ag II
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Page 2 Body Water and Electrolytes Introduction RAS & KKS Aldosterone ANP, ET, adre- nomedullin Integration Pathologies Distribution of body water and principal electrolytes. Note that water and electrolytes equilibrate freely between plasma and interstitial fluid, but only water equilibrates between the intracellular and extracellular compartments. The electrochemical gradient for sodium is maintained by the activity of the sodium / potassium ATPase. The Kidney’s Nephron Introduction RAS & KKS Aldosterone ANP, ET, adre- nomedullin Integration Pathologies Schematic representation of renal tubules and their component parts. (Modified from Kriz, W. (1988) A standard nomenclature for structures of the kidney. Am. J. Physiol. 254: F1–F8.)
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Page 3 Countercurrent Mechanism Introduction RAS & KKS Aldosterone ANP, ET, adre- nomedullin Integration Pathologies The countercurrent multiplier in the loop of Henle. Selective permeability of the tubular epithelium and active transport of sodium by the thick ascending limb create osmotic gradients. Tubular to interstitial flow of water concentrates sodium in the descending limb. Sodium movement across the water impermeable ascending limb creates the osmotic gradient in the interstitium. Yellow arrows indicate the direction of flow. Note that active sodium transport in the thick ascending limb creates the gradient in the interstitium and makes the tubular fluid hypoosmotic by the time it emerges from Henle’s loop. Pituitary and H2O metabolism AVP released from the PP controls water permeability in the DCT and collecting ducts of the kidney AVP Introduction RAS & KKS Aldosterone ANP, ET, adre- nomedullin Integration Pathologies
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Page 4 Pituitary and H2O metabolism Introduction RAS & KKS Aldosterone ANP, ET, adre- nomedullin Integration Pathologies The V1 receptor mediates the pressor actions of AVP/ADH, and the V2 receptor mediates the water conservation effects.
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lec 14 mineralocorticoids.pptx - Mineralocorticoids...

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