Académique Documents
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Kf = 12.4
Glomerulotubular Balance
• It is an intrinsic ability of the tubules to increase
their reabsorption rate in response to increased
tubular load.
• It stimulates Sodium-potassium
ATPase pump on the
basolateral side of the cortical
collecting tubule membrane.
• Conn’s syndrome :
– Excess aldosterone
– Causes Sodium retention (Hypernatremia)
– Causes Potassium depletion (Hypokalemia)
Angiotensin II
• It is the most powerful sodium-retaining
hormone in human body.
• Produced by RAAS.
1. Stimulates aldosterone.
2. Constricts efferent arterioles.
– Efferent arteriolar constriction reduces peritubular capillary hydrostatic
pressure, which increases net tubular reabsorption.
– Efferent arteriolar constriction, increases the time for plasma to stay in
glomerulus , raises filtration fraction, & increases osmotic pressure in
the peritubular capillaries; this increases the reabsorption of sodium
and water.
• Produced by Hypothalamus.
• Inulin
• Creatinine
• PAH
Inulin
• Inulin Clearance Can Be Used to Estimate GFR
(eGFR)
• Inulin is :
– Freely filtered
– Neither reabsorbed
– Nor secreted
• Effect of reducing
(GRF) by 50 per cent
on serum creatinine
concentration
Creatinine
• It is not practical to measure urine
creatinine level to estimate GFR, so many
scientist has given many ways to calculate
GFR by being based upon only blood
creatinine.
• Widely accepted is :
Creatinine
• Approximate relationship
between GFR and
plasma creatinine
concentration.
• Decreasing GFR by 50
per cent will increase
plasma creatinine to
twice normal if creatinine
production by the body
remains constant.
PAH
• PAH Clearance Can Be Used to Estimate Renal Plasma
Flow.