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What’s Left of Physiology
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Normally, all14.31
filtered
Figure
bicarbonate is “reabsorbed”
Diagram respiratory response to:
a) Vomiting
b) Diarrhea.
Urinalysis Lab 2012
% Water Excreted
Category
Mean%
Excreted
St. Error
NaCl Excreted
N=
Difference
Category
Mean
Excreted
St. Error
N=
Difference
Dilute
Salt
77
17
14
B
Dilute
Salt
2.0 g
0.2
14
A, B
Strong
Salt
289
38
18
A
Strong
Salt
2.4 g
0.3
18
A
Water
104
9
28
B
Water
1.5 g
0.2
28
B
For 2012,
the winner of the
Peebody Award
produced
1845 ml of urine
from 800 ml of water.
And the winner is….
For 2012,
the winner of the
The Sahara Award
produced
a pitiful 0 ml of urine
after drinking the
“Strong Salt Solution”
And the winner is….
Filtration is controlled by aa and ea diameters!
Consider a substance that in filtered only, no reabsorption, no secretion.
Excretion of this substance = GFR
Clearance of this substance = GFR
• Clearance = volume of plasma from which a
substance is completely removed (cleared) by the
kidneys per unit time.
• Clearance of Inulin is 120 ml/min
• Cinulin or Ccreatinine = Glomerular Filtration Rate
Calculating clearance
Clearance of s = Urine concentration of s X Urine Volume
Plasma concentration of s
“24 hour urine catch” + blood sample
Special cases: Clearance of
•
Inulin and creatinine (filtered only; use to
measure Glomerular Filtration Rate.)
•
Para Amino Hippurate (filtered and completely
secreted, use to measure Renal Plasma Flow)
Renal Handling of Substances
Filtration +
complete Secretion
Ex: Para AminoHippurate (PAH)
Measure Renal Plasma Flow
Filtration + partial reabsorption
Filtration + 100 Reabsorption
Ex: Sodium
Ex: Water
Ex: Glucose
Ex: Amino Acids
• Clearance = volume of plasma from which a
substance is completely removed (cleared) by the
kidneys per unit time.
• Clearance of Inulin is 120 ml/min
• Cinulin or Ccreatinine = Glomerular Filtration Rate
• If C x is greater than GFR ( which is Cinulin) then that
substance undergoes NET TUBULAR SECRETION
• If C x is less than GFR ( which is Cinulin) then that
substance undergoes NET TUBULAR REABSORPTION
A little more on Clearance:
Clearance of glucose = 0 ml/min which means….
Clearance of X = 120 ml/min which means….
Clearance of antibiotic XXX = 500 ml/min which means…
Who Cares?
S 17
pp
X
P?
Fluid-filled cysts
Fig. 14.04
Polycystic
Kidney
Disease
Symptoms?
Genetics?
Prognosis &
Treament?
When Ccreatinine =
GFR becomes less
than 120 ml/min….?
The End?
“Reincarnation”
by Wallace McRae