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RAAS System: Renin-Angiotensin-Aldosterone System
Causes vasoconstriction
Increases blood pressure and sodium reabsorption
Regulates GFR
ANP and BNP: Natriuretic Peptides
Causes vasodilation
Decreases blood pressure and blood volume
Inhibits sodium/water absorption and the RAAS system
Urodilatin
Causes vasodilation and diuretic effects
Increases renal blood flow
Secreted by the distal convoluted tubule and collecting ducts
Vitamin D
Necessary for absorption of calcium and phosphate
Erythropoietin (Epoietin Alfa): Uses
Anemia due to chronic renal failure, chemotherapy, surgery
HIV patients on zidovudine
Athletes use recreationally for enhanced performance
Erythropoietin (Epoietin Alfa): Adverse Effects
Cardiovascular events, especially in renal failure
Ex: Cardiac arrest, hypertension, heart failure, stroke, MI
Can overshoot the HGB goal and lead to polycythemia that causes increased blood
viscosity
Can accelerate tumor progression
HGB should not exceed
12
Relationship between BUN/Creatinine and GFR
Inverse
Increased GFR = Decreased BUN/Creatinine
Decreased GFR = Increased BUN/Creatinine
Acute Glomerulonephritis
Inflammation of the glomerulus
Strep infection occurs somewhere else in the body causing antibodies to produce
against the organism that cross-react with the glomerular endothelial cells leading to
activation of complement and an immune response in the glomerulus
Inflammation causes decreased GFR, scarring, and thickening
Acute Glomerulonephritis: Symptoms
Hematuria with RBC casts
Proteinuria with albumin
Anasarca
Chronic Glomerulonephritis: Causes