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Samenvatting Nieren en urinewegen E-lectures (Humane anatomie)

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Samenvatting van Nieren E-lectures (van Ravesloot)

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Nieren en urinewegen

1 Osmose
Osmose is de diffusie van water.
ICV = water in de cellen
ECV = water buiten de cellen (in het milieu intérieur)
Infuusvloeistof bestaat uit water en 0.9% NaCl, want
keukenzoutconcentratie in het bloed is 9 gram/L (155 mM).

Opgegeven Na+ concentratie bloedplasma = 145 mmol/liter
7% van het plasmavolume is eiwit
93% van het plasmavolume is water
De ‘echte’ Na+ concentratie bloedplasma
= 145 mmol/0,93 liter = 155 mmol/L

Wat is de osmotische druk van een 0,9% NaCl oplossing?
π = n ×[NaCl] × R× T met n = aantal ionsoorten, R = gasconstante en T =
temperatuur
π = 2 ×155 mol/m3 × 8,3 J/K mol × 310 K
π = 797,6 kPa

Deze druk is nodig om de kant met de hoge osmolaliteit niet omhoog te laten
gaan.
1 atmosfeer = 101 kPa of 760 mm Hg.

De osmotische druk in de ICV is gelijk aan de osmotische druk in de ECV.
Osmolaliteit: total number of solute particles per mass of solvent.
Eq = valentie × mol. Valentie: Na+ is eenwaardig, Ca2+ is tweewaardig.

Als de osmolaliteit omhoog gaat, stijgt de osmotische druk, wordt het kookpunt
verhoogd en het vriespunt verlaagd.
De osmolaliteit van plasma is 285-295 mOsm/kg H2O.
OsmolaLiteit = per kg solvent en osmolaRiteit = per L solvent.

Tijdens XTC gebruik hou je water vast, waardoor de ECV osmolaliteit daalt (tot
ongeveer 262 mOsm), waardoor er water in de hersencellen komt en dit kan
leiden tot een hersenoedeem.
Als de osmolaliteit langzaam stijgt, kunnen cellen erop anticiperen:

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