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Summary Renal Physiology
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Summary of the different functions of the kidney and how drugs can be cleared. Includes specific examples.
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Renal PhysiologyFunctions of the kidney
Homeostasis
Body’s ability to maintain a stable and constant internal environment.
Despite changes.
This includes:
o Regulation of blood volume
o Regulation of blood pressure
o Regulate osmolarity (ion levels)
o Acid-base balance
Excretion
Remove metabolites.
E.g., urea which is a product of protein metabolism
Excretes chemicals and therapeutic drugs.
Endocrine System
The kidneys also play a part in the endocrine system and the production of new red
blood cells.
Known as erythropoietin.
The kidneys produce erythropoietin (EPO)
This stimulates the bone marrow to produce new red blood cells.
Low oxygen means the kidneys secrete more EPO.
When blood pressure drops, renin is secreted by the kidneys.
This acts on angiotensin to form angiotensin II.
This is a vasoconstrictor.
To increase blood pressure.
Renal Function
Vasa rector: capillaries after the bowmans capsule
Refer to diuretics lecture.
Drugs and renal Physiology
Drugs are highly bound to plasma proteins.
Making it unlikely to be filtered effectively.
So, remains in the bloodstream and lasts longer in the body.
GFR and creatinine clearance
Glomerular filtration rate
The rate at which kidneys filter the plasma.
Indicates kidney health.
Can be estimated using eGFR by measuring blood creatinine levels.
Muscles use creatinine as a energy source
Creatine is converted to creatinine.
And creatinine is removed from the body by the kidneys.
This is usually constant and the rate it is cleared depends on kidney function.
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