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NP2 Nephrology
Acronyms
Toronto Notes 2019
Acronyms
ACEI angiotensin converting enzyme inhibitor
ACR albumin to creatinine ratio ADH antidiuretic hormone
AG anion gap
AIN acute interstitial nephritis AKI acute kidney injury
ANA antinuclear antibody
ARB angiotensin receptor blocker ASA acetylsalicylic acid
ASOT anti-streptolysin-O titer ATN acute tubular necrosis
AVM arteriovenous malformation c-ANCA cytoplasmic antineutrophil
cytoplasmic antibody C&S culture and sensitivity
CHF CKD Cr
CrCl D5W DCT DDAVP DI
DIC DKA DM ECF eGFR ESR ESRD FF
congestive heart failure
chronic kidney disease
creatinine
creatinine clearance
5% dextrose in water
distal convoluted tubule 1-desamino-8-d-arginine vasopressin diabetes insipidus
disseminated intravascular coagulation diabetic ketoacidosis
diabetes mellitus
extracellular fluid
estimated glomerular filtration rate erythrocyte sedimentation rate end-stage renal disease
filtration fraction
FSGS focal segmental glomerulosclerosis PTH GBM glomerular basement membrane R&M GFR glomerular filtration rate RAAS GN glomerulonephritis RBF HCTZ hydrochlorothiazide RCC HPF high power field RPF HSP Henoch-Schönlein purpura RPGN HTN hypertension RRT HUS hemolytic uremic syndrome RTA IVP intravenous pyelogram SIADH LOC level of consciousness
MDRD modification of diet in renal disease SLE NS normal saline TBW p-ANCA perinuclear anti-neutrophil cytoplasmic TIN
antibody TTP PCKD polycystic kidney disease UAG
parathyroid hormone
routine and microscopy renin-angiotensin-aldosterone system renal blood flow
renal cell carcinoma
renal plasma flow
rapidly progressive glomerulonephritis renal replacement therapy
renal tubular acidosis
syndrome of inappropriate antidiuretic hormone
systemic lupus erythematosis
total body water
tubulointerstitial nephritis
thrombotic thrombocytopenic purpura urine anion gap
• •
• •
mesodermicorigin pronephros(fromnephrogeniccordgrowingcaudallytowardscloaca)developsattheendofweek3 and then degenerates along with adjacent pronephric duct mesonephrosdevelopsin4thweek,degenerates,andtheremnantsformthemesonephric(Wolffian) duct of the male reproductive system metanephrosdevelopsinthe5thweekfromtheuretericbudinthemesonephricductintothe metanephric (mesoderm-derived) mass
■ uretertic bud → ureters, renal pelvis, calyces, collecting ducts
■ metanephric mass → nephrons (from glomeruli to the DCT)
■ kidneys ascend from sacral segments into abdomen, rotating medially while ascending, and gaining
a blood supply from the aorta as they ascend
Renal Structure and Function
Basic Anatomy Review
Embryology of the Kidney
UTI urinary tract infection
The Nephron
• basicstructuralandfunctionalunitofthekidney,approximately1millionperkidney
• 2maincomponents:glomerulusandattachedrenaltubule
• directionofbloodflow:afferentarteriole→glomerularcapillaries→efferentarteriole→vasarecta(the
capillaries surrounding the tubules) → renal venules
Table 1. Major Kidney Functions
Function
1. Waste Excretion
2. Electrolyte Balance and Osmoregulation
3. Hormonal Synthesis
Mechanism
Glomerular filtration Tubular secretion Tubular catabolism
Tubular NaCl and water reabsorption
Tubular K+ secretion
Tubular H+ secretion
HCO3– synthesis and reabsorption Tubular Ca2+, Mg2+, PO43- transport Synthesize osmolytes
Erythropoietin production (cortex)
Vitamin D activation: 25(OH)VitD converted to 1,25(OH)2VitD (proximal tubule)
Affected Elements
Excretion of nitrogenous products of protein metabolism (urea, Cr)
Excretion of organic acids (urate) and organic bases (Cr)
Breakdown and excretion of drugs (antibiotics, diuretics) and peptide hormones (most pituitary hormones, insulin, glucagon)
Controls volume status and osmolar balance
Controls potassium concentration
Acid-base balance
Acid-base balance
Alters Ca2+, Mg2+, PO43- homeostasis
Increase osmolality of medullary cytoplasm to match medullary concentration gradient
Red blood cell production Calcium homeostasis