Verfügbarkeit: Principles of renal physiology

Principles of renal physiology:

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1. Verfasser:	Lote, Christopher J. (VerfasserIn)
Format:	Buch
Sprache:	English
Veröffentlicht:	New York, NY [u.a.] Springer 2012
Ausgabe:	5. ed.
Schlagworte:	Kidney > physiology > Examination Questions Kidneys > Physiology Renal Circulation > physiology > Examination Questions Niere Physiologie
Online-Zugang:	Inhaltsverzeichnis
Beschreibung:	XV, 204 S. Ill., graph. Darst.
ISBN:	9781461437840

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Datensatz im Suchindex

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adam_text	Contents 1 The Body Fluids ...................................................................................... 1 Introduction ............................................................................................... 1 Body Water ............................................................................................... 2 Body Fluid Osmolality .............................................................................. 2 Units of Osmotic Measurement ............................................................ 2 Isotonicity and Isosmoticity .................................................................. 5 Normal Body Fluid Osmolality ............................................................ 6 Distribution of Ions Across Biological Membranes .................................. 6 Fluid Exchanges Between Body Compartments ....................................... 8 Exchanges Between Interstitial Fluid and Intracellular Fluid ............... 8 Exchanges Between the Plasma and Interstitial Fluid .......................... 8 Lymphatic System ................................................................................. 10 Fluid Exchanges Between the Body and the External Environment .............................................................................................. 10 Water Intake .......................................................................................... 11 Water Output ......................................................................................... 11 Ionic Composition of the Body Fluids ...................................................... 12 Extracellular Fluid ................................................................................ 13 Intracellular Fluid .................................................................................. 13 Ion Exchanges Between the Body and the External Environment ........... 13 Body Fluid Compartments: Methods of Measurement ............................. 14 Measurement of Plasma Volume, Red Cell Volume and Blood Volume ................................................................................. 16 Extracellular Fluid Volume ................................................................... 17 Interstitial Fluid Volume ....................................................................... 17 Total Body Water .................................................................................. 17 Transcellular Fluid Volume ................................................................... 18 Problems ................................................................................................... 18 Further Reading ........................................................................................ 19 í Contents 2 Essential Anatomy of the Kidney ........................................................... 21 Introduction ............................................................................................... 21 General Morphology and Cellular Organization ...................................... 21 TheNephron ......................................................................................... 22 Glomerulus ............................................................................................ 24 Proximal Tubules .................................................................................. 25 Loop of Henle and Distal Tubule .......................................................... 25 Collecting Duct ..................................................................................... 27 Blood Supply and Vascular Structure Within the Kidney ......................... 27 Function of the Renal Blood Supply ..................................................... 28 Renal Lymphatic Drainage ....................................................................... 29 Juxtaglomerular Apparatus ....................................................................... 29 Erythropoietin ....................................................................................... 30 Bladder and Micturition ........................................................................ 30 3 Glomerular Filtration ............................................................................. 33 The Filter ................................................................................................... 33 Functions of the Components of the Glomerular Filter ........................ 34 Mesangial Cells ..................................................................................... 37 Glomerular Filtration Process ................................................................... 37 Glomerular Capillary Permeability ....................................................... 41 Composition of the Glomerular Filtrate .................................................... 41 Filtration Fraction ..................................................................................... 42 Glomerular Filtration Pressure as a Force for Tubular Flow ................ 42 Tubulo-Glomerular Feedback ................................................................... 42 Problems ................................................................................................... 43 Further Reading ........................................................................................ 44 4 Tubular Transport ................................................................................... 45 Introduction ............................................................................................... 45 Primary and Secondary Active Transport ................................................. 46 Ion Channels, Uniporters and Facilitated Diffusion ............................. 48 Paracellular Movement ......................................................................... 49 Water Absorption .................................................................................. 49 Fractional Excretion and Fractional Reabsorption ............................... 50 Further Reading ........................................................................................ 50 5 The Proximal Tubule .............................................................................. 51 Morphology of Proximal Tubule Cells ..................................................... 51 Proximal Tubular Handling of Sodium ..................................................... 51 Sodium Entry ........................................................................................ 52 Sodium Extrusion .................................................................................. 52 Chloride Reabsorption .......................................................................... 52 Water Reabsorption ............................................................................... 54 Contents Uptake of NaCl and Water into Peritubular Capillaries ............................ 54 Relationship of Proximal Tubular Reabsorption to Glomerular Filtration Rate ........................................................................................... 55 Proximal Tubular Reabsorption of Other Solutes ..................................... 56 Glucose ................................................................................................. 56 Relationship of Glucose Reabsorption to Sodium Reabsorption .......... 58 Amino Acids ......................................................................................... 59 Phosphate .............................................................................................. 60 Urea ....................................................................................................... 60 Bicarbonate ........................................................................................... 61 Sulphate ................................................................................................ 62 Potassium .............................................................................................. 63 Albumin ................................................................................................ 63 Secretory Processes in the Proximal Tubule ............................................. 64 Hydrogen Secretion .............................................................................. 65 Problem ..................................................................................................... 65 Further Reading ........................................................................................ 66 The Loop of Henle, Distal Tubule and Collecting Duct ....................... 67 Introduction ............................................................................................... 67 The Loop of Henle .................................................................................... 67 Counter Current Multiplication Mechanism ......................................... 67 Collecting Tubules/Ducts .......................................................................... 73 Importance of Urea in Counter Current Multiplication ............................ 73 Further Requirements of the Counter Current Multiplication Mechanism: The Vasa Recta ..................................................................... 75 Long and Short Loops of Henle ................................................................ 76 Regulation of Urine Concentration ........................................................... 76 Maximal ADH: The Production of Concentrated Urine ....................... 77 No Circulating ADH: The Production of Dilute Urine ......................... 77 Other Hormones Affecting Distal Nephron Transport Processes ............. 78 Further Reading ........................................................................................ 81 Renal Blood Flow and Glomerular Filtration Rate ............................. 83 Measurement of Renal Blood Flow and Glomerular Filtration Rate ........ 83 Inulin Clearance: The Measurement of Glomerular Filtration Rate ....................................................................................... 84 Clearance Ratios ................................................................................... 86 PAH Clearance: Measurement of Renal Plasma Flow .......................... 86 Filtration Fraction ................................................................................. 87 Regulation of Renal Blood Flow and Glomerular Filtration Rate ............ 88 Problem ..................................................................................................... 92 Further Reading ........................................................................................ 92 ■j Contents 8 Regulation of Body Fluid Osmolality .................................................... 93 Introduction ............................................................................................... 93 Osmoreceptors .......................................................................................... 94 Sensitivity of the Osmoreceptors to Osmotic Changes Caused by Different Solutes .............................................................................. 94 Synthesis and Storage of ADH ............................................................. 95 Structure of ADH .................................................................................. 97 Cellular Actions of ADH on Water Permeability .................................. 97 Removal of ADH from the Blood ......................................................... 99 Drags Affecting ADH Release .............................................................. 99 Regulation of Water Excretion and Water Reabsorption .......................... 99 Effect of Solute Output on Urine Volume ............................................. 101 Adrenal Steroids and the Renal Response to ADH ............................... 102 Further Reading ........................................................................................ 103 9 Regulation of Body Fluid Volume .......................................................... 105 Introduction ............................................................................................... 105 Effective Circulating Volume ................................................................ 105 Aldosterone ............................................................................................... 106 Control of Aldosterone Release ............................................................ 107 Renin and Angiotensin, and Their Relationship to Aldosterone ........... 108 Actions of Angiotensin II ...................................................................... 109 Starling Forces and Proximal Tubular Sodium Reabsorption ................... Ill Renal Nerves ............................................................................................. 112 Prostaglandins and Other Arachidonate Metabolites ................................ 113 Atrial Natriuretic Peptide and Urodilatin .................................................. 114 Other Factors Which May Be Involved in Regulating Sodium Excretion ................................................................................................... 115 Dopamine .............................................................................................. 115 Kinins .................................................................................................... 115 Nitric Oxide .......................................................................................... 116 Adrenomedullin .................................................................................... 116 Endothelin ............................................................................................. 116 Natriuretic Hormone ............................................................................. 116 ADH and the Relationship Between Osmotic Regulation and Volume Regulation ............................................................................. 117 Overall Scheme of Body Fluid Volume Regulation .................................. 118 Further Reading ........................................................................................ 119 10 Renal Regulation of Body Fluid pH...................................................... 121 Introduction ............................................................................................... 121 Physiological Buffers ................................................................................ 121 pK Values and Equilibrium Constants .................................................. 122 Contents xiii Renal Regulation of Plasma Bicarbonate Concentration .......................... 124 Conversion of Alkaline Phosphate to Acid Phosphate .......................... 127 Ammonia Secretion .............................................................................. 128 Summary ............................................................................................... 130 Regulation of H+ Secretion According to Acid-Base Balance Requirements ............................................................................................ 131 Compensation Versus Correction in Acid-Base Disturbances ............. 131 Respiratory Acidosis ............................................................................. 133 Respiratory Alkalosis ............................................................................ 134 Metabolic Acidosis ................................................................................ 136 Metabolic Alkalosis .............................................................................. 138 Problem ..................................................................................................... 139 Further Reading ........................................................................................ 140 11 Renal Control of Body Fluid Potassium Content ................................. 141 Importance of K+ in the Body ................................................................... 141 Regulation of Body К ............................................................................... 142 Renal К Handling ................................................................................. 142 Aldosterone ........................................................................................... 143 Hypokalaemia ........................................................................................... 144 Renal Function in Hypokalaemia .......................................................... 145 Hyperkalaemia .......................................................................................... 146 Further Reading ........................................................................................ 147 12 Renal Regulation of Body Calcium, Magnesium and Phosphate ......................................................................................... 149 Introduction ............................................................................................... 149 Calcium ..................................................................................................... 149 Maintenance of Calcium Balance ......................................................... 150 Calcium Handling by the Kidney ......................................................... 151 Phosphate .................................................................................................. 152 Maintenance of Phosphate Balance ...................................................... 153 Calcium and Phosphate Homeostasis ....................................................... 153 Disturbances of Calcium and Phosphate Homeostasis ......................... 155 Magnesium ................................................................................................ 156 Magnesium Homeostasis ...................................................................... 157 Renal Reabsorption of Magnesium ....................................................... 157 Regulation of Magnesium Balance ....................................................... 158 Disorders of Magnesium Balance ......................................................... 159 Further Reading ........................................................................................ 159 13 Summary of the Principal Reabsorptive and Secretory Processes in the Nephron Segments ...................................................... 161 Introduction ............................................................................................... 161 Sodium ...................................................................................................... 161 Water ......................................................................................................... 161 xjv Contents Potassium .................................................................................................. 163 Hydrogen Ions and Bicarbonate ............................................................ 163 Phosphate .................................................................................................. 163 Calcium ..................................................................................................... 163 Glucose ..................................................................................................... 164 Urea, Ammonia and Other Nitrogenous Waste Products .......................... 164 14 Disease Conditions Which Alter Renal Sodium and Water Reabsorption ........................................................................ 167 Introduction ............................................................................................... 167 Oedema ................................................................................................. 167 Congestive Heart Failure ...................................................................... 169 Hypovolemia and Shock ........................................................................... 170 Hypovolemic Shock .............................................................................. 171 Cardiogenic Shock ................................................................................ 171 Haemorrhage ......................................................................................... 172 Effect of Haemorrhage on Body Fluid Volume and Composition, and Renal Function ...................................................... 174 Additional Problems of Severe Haemorrhage (Hypovolemic Shock) ........................................................................... 176 Measures to Prevent Irreversible Renal Damage .................................. 176 Hypertension ............................................................................................. 176 Secondary Hypertension ........................................................................... 177 Renovascular Hypertension .................................................................. 177 Renal Hypertension ............................................................................... 177 Primary Hyperaldosteronism ................................................................ 177 Essential (Primary) Hypertension ............................................................. 177 Treatment of Hypertension ....................................................................... 179 ACE Inhibitors/Angiotensin Receptor Blockers................................... 179 Calcium Channel Blockers................................................................... 179 Diuretics ................................................................................................ 179 Malignant Hypertension ........................................................................ 180 Liver Disease ............................................................................................ 180 Nephrotic Syndrome ............................................................................. 183 Further Reading ........................................................................................ 183 15 Use of Diuretics ........................................................................................ 185 Introduction ............................................................................................... 185 Osmotic Diuretics ..................................................................................... 185 Loop Diuretics .......................................................................................... 186 Banter s Syndrome ............................................................................... 187 Thiazides ................................................................................................... 187 Guelman s Syndrome ............................................................................ 188 Aldosterone Antagonists ........................................................................... 188 Na Channel Blockers................................................................................ 189 Contents xv Carbonic Anhydrase Inhibitors ................................................................. 189 Clinical Use of Diuretics ........................................................................... 189 Acid-Base and Electrolyte Disturbances .............................................. 190 Calcium Homeostasis and Diuretic Treatment ..................................... 191 Azotaemia and Hyperuricaemia ............................................................ 191 Further Reading ........................................................................................ 191 Answers to Problems ...................................................................................... 193 Index ................................................................................................................. 197
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discipline	Biologie Medizin
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spelling	Lote, Christopher J. Verfasser (DE-588)142940194 aut Principles of renal physiology Christopher J. Lote 5. ed. New York, NY [u.a.] Springer 2012 XV, 204 S. Ill., graph. Darst. txt rdacontent n rdamedia nc rdacarrier Kidney physiology Examination Questions Kidneys Physiology Renal Circulation physiology Examination Questions Niere (DE-588)4042270-7 gnd rswk-swf Physiologie (DE-588)4045981-0 gnd rswk-swf Niere (DE-588)4042270-7 s Physiologie (DE-588)4045981-0 s DE-604 Erscheint auch als Online-Ausgabe 978-1-4614-3785-7 Digitalisierung UB Regensburg application/pdf http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=025109915&sequence=000002&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA Inhaltsverzeichnis
spellingShingle	Lote, Christopher J. Principles of renal physiology Kidney physiology Examination Questions Kidneys Physiology Renal Circulation physiology Examination Questions Niere (DE-588)4042270-7 gnd Physiologie (DE-588)4045981-0 gnd
subject_GND	(DE-588)4042270-7 (DE-588)4045981-0
title	Principles of renal physiology
title_auth	Principles of renal physiology
title_exact_search	Principles of renal physiology
title_full	Principles of renal physiology Christopher J. Lote
title_fullStr	Principles of renal physiology Christopher J. Lote
title_full_unstemmed	Principles of renal physiology Christopher J. Lote
title_short	Principles of renal physiology
title_sort	principles of renal physiology
topic	Kidney physiology Examination Questions Kidneys Physiology Renal Circulation physiology Examination Questions Niere (DE-588)4042270-7 gnd Physiologie (DE-588)4045981-0 gnd
topic_facet	Kidney physiology Examination Questions Kidneys Physiology Renal Circulation physiology Examination Questions Niere Physiologie
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