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Michael Fill, PhD Department of Molecular Biophysics and Physiology mfill@rush.edu 312-942-6434
Resource Material:
1. These Lecture Notes 2. Suggested Readings a. Principles of Physiology, 4th Ed., Berne & Levy, Chapters 36-40 b. Vanders Renal Physiology, 5th or 6th Edition
Learning Objectives:
1) Define renal blood flow (RBF), renal plasma flow (RPF) and glomerular filteration rate (GFR) and give normal values of each. 2) Describe the forces (hydrostatic & oncontic pressures) and factors (hydraulic permeability & surface area) that determine the rate at which the glomerular filtrate is formed. 3) Define the terms net filtration pressure (NFP) and filtration coefficient. 4) Describe autoregulation of RBF (and GFR) and two mechanisms of autoregulation (myogenic & tubuloglomerular feedback). 5) Define the term clearance and list what information is needed to calculate the clearance of a solute also be able to calculate clearance if given the needed information. 6) Describe why clearance of inulin or creatinine can be used to access GFR. This includes explaining why inulin clearance is more accurate as well as why creatinine clearance is more practical (although less accurate). 7) Describe why clearance of para-aminohippurate (PAH) can be used to access RPF.
units
Na Cl HCO3 Glucose
Think of filtration as the kidneys default mode of handling solutes. Any substance that is just filtered (not reabsorbed or secreted) will be excreted in precisely the amount that is filtered. If the substance is not water, then it will end up concentrated in urine (relative to plasma) because of the extensive water reabsorption along the renal tubules. The advantage of filtration is that no specific transport system is needed for something to be eliminated from the body - just allow it to be filtered and do not reabsorb it. The disadvantage of essentially nonselective filtration is that the body must expend considerable energy to reabsorb filtered substances that it needs to retain. Table 2.1 lists some filtered substances (including water) that are almost completely (~99%) reabsorbed into the peritubular capillaries. This filtered then almost completely reabsorbed scenario is certainly not the case for all solutes. Indeed, different substances are handled very differently by nephrons.