06 Renal Endocrine
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Renin
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JG (juxto glomerulus): modified smooth muscle cells of afferent arteriole. Sits between afferent/efferent, distal tubule and glomerulus
macula densa: DCT
macula densa: sense NaCl levels
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Ang: made by liver, in blood
renin finds Ang, convert to AI
Ang II
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increase Na/H2O
increase bicarb absorption in PCT
harder to get blood through whole system, thus lower RPF, FF goes up
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Hydrostatic effect:
less fluid go to peritubular because of constriction
low hydrostatic pressure in peritubular capillaries
result: water drawn out
Oncotic effect:
protein stay in efferent, increase oncotic pressure
high oncotic pressure
fluid out
AII activate Na/H antiporter
Na absorption, H2O absorption
Contraction alkalosis: more H+ out to lumen, combine with bicarb to form water, absorption
Aldosterone
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adrenal makes too much aldosterone
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ANP
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released by heart
opposite of renin
relax smooth muscle via cGMP to dilate afferent
PTH
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low Ca most important
alcoholics very low Mg
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increase Ca absorption in DCT
Vid D
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D2 less active, not important
25- OH longest half life
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renal failure: increase phosphate from unable to excrete
secondary hyper PTH from renal failure
EPO
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peritubular interstitial cells
acts in bone marrow
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association with increased mortality
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