Physiology of the kidney proff ahmed donia
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Physiology of the kidney
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Physiology of the kidney proff ahmed donia
- 1. PHYSIOLOGY OF THE KIDNEY Ahmed Donia, MD, MRCP (UK) Consultant of nephrology Urology and nephrology center Mansoura University, Egypt
- 10. RENAL BLOOD FLOW 21% CO 1200 ml/min
- 11. RENAL BLOOD FLOW RENAL PLASMA FLOW 21% CO 1200 ml/min
- 12. RENAL BLOOD FLOW RENAL PLASMA FLOW EFFECTIVE RENAL PLASMA FLOW 21% CO 1200 ml/min
- 13. PAH NON-PRACTICAL RENAL BLOOD FLOW RENAL PLASMA FLOW EFFECTIVE RENAL PLASMA FLOW 21% CO 1200 ml/min
- 14. PAH NON-PRACTICAL RENAL BLOOD FLOW RENAL PLASMA FLOW EFFECTIVE RENAL PLASMA FLOW 99mTc-MAG3 Renogram 21% CO 1200 ml/min
- 44. Glomerular filtrate GFR=125 ml/min GFR versus plasma clearance
- 45. Measurement Inulin clearance (impractical) Tc-99m DTPA renogram
- 48. Estimation Creatinine Variation in creatinine production Dietary intake (vegetarian diet, creatine supplements) Muscle mass (amputation, malnutrition, muscle wasting)
- 49. Estimation Creatinine Variation in creatinine secretion Early vs late disease
- 50. Estimation Creatinine Extrarenal creatinine excretion GIT in advanced renal disease
- 52. Estimation Creatinine clearance Tubular secretion vs overestimation of cr 24 hours urine collection Cimitidine (rarely used)
- 53. Cockcroft and Gault Equations Estimation MDRD CKD-EPI ↑ 10-40% >1 equation Underestimate normal or mild ↓GFR Better In normal GFR
- 56. Fanconi synsrome
- 60. Glycosuria Aminoaciduria Glomerular ptnuria PTH ↓P reabsorption Fanconi synsrome
- 61. Glycosuria Aminoaciduria Glomerular ptnuria PTH ↓P reabsorption RTA II Fanconi synsrome CAI ↓ HCO3
- 62. Glycosuria Aminoaciduria Glomerular ptnuria PTH ↓P reabsorption RTA II Obligarory water absorption 85% (ADH independent) Fanconi synsrome CAI ↓ HCO3
- 63. Glycosuria Aminoaciduria Glomerular ptnuria PTH ↓P reabsorption RTA II Obligarory water absorption 85% (ADH independent) PAH/diodrast secretion Fanconi synsrome CAI ↓ HCO3
- 64. Glycosuria Aminoaciduria Glomerular ptnuria ↑ uric acid Diuretic (↑ reabsorption) CKD(↓ GFR/tubular secretion) PTH ↓P reabsorption RTA II Obligarory water absorption 85% (ADH independent) PAH/diodrast secretion Fanconi synsrome CAI ↓ HCO3
- 69. Loop diuretic Bartter syndrome Ca 25% Na
- 72. Thiazide diuretic Gitleman syndrome Ca ↑Ca absorption 5% Na 25% Na
- 73. Aldosterone K-sparing diuretics Thiazide diuretic Gitleman syndrome Ca ↑Ca absorption 5% Na 25% Na
- 74. Aldosterone Free H Titratable acidity Ammonia Distal (I) RTA K-sparing diuretics Thiazide diuretic Gitleman syndrome Ca ↑Ca absorption 5% Na 25% Na
- 75. Aldosterone Free H Titratable acidity Ammonia Distal (I) RTA K-sparing diuretics Thiazide diuretic Gitleman syndrome Ca ↑Ca absorption 5% Na 25% Na Obligarory water absorption 85% (ADH independent) Fuculuative water absorption 15% (ADH dependent)
- 84. THANK YOU