> For the complete documentation index, see [llms.txt](https://thisispiggy.gitbook.io/my-wiki/llms.txt). Markdown versions of documentation pages are available by appending `.md` to page URLs; this page is available as [Markdown](https://thisispiggy.gitbook.io/my-wiki/01-step-1/renal/06-renal-endocrine.md).

# 06 Renal Endocrine

[\_](https://github.com/thisispiggy/my-wiki/tree/601ff771dc2fac1318ae8b59435ac8485628fd81/01%20Step%201/Renal/kidney%20releases%20what%20hormones.%20What%20hormones%20act%20on%20kidney)..

![](https://f001.backblazeb2.com/file/wikiFiles/WNlw2N3.jpg)

## Renin

[\_](https://github.com/thisispiggy/my-wiki/tree/601ff771dc2fac1318ae8b59435ac8485628fd81/01%20Step%201/Renal/JG%20apparatus%20structures,%20main%20function/README.md)..

![](https://f001.backblazeb2.com/file/wikiFiles/76oA0sK.jpg)

* JG (juxto glomerulus): modified **smooth muscle** cells of **afferent arteriole**. Sits between afferent/efferent, distal tubule and glomerulus
* macula densa: DCT

![](https://f001.backblazeb2.com/file/wikiFiles/9DcZQ5v.jpg)

* macula densa: sense NaCl levels

[\_](https://github.com/thisispiggy/my-wiki/tree/601ff771dc2fac1318ae8b59435ac8485628fd81/01%20Step%201/Renal/renin%20release%20stimulated%20how.%20Which%20cell%20responsible%20for%20what%20stimulation)..

![](https://f001.backblazeb2.com/file/wikiFiles/jHiJJWS.jpg)

[\_](https://github.com/thisispiggy/my-wiki/tree/601ff771dc2fac1318ae8b59435ac8485628fd81/01%20Step%201/Renal/RAS%20system%20pathway.%20A2%20functions)..

![](https://f001.backblazeb2.com/file/wikiFiles/49jmnsS.jpg)

* Ang: made by liver, in blood
* renin finds Ang, convert to AI

![](https://f001.backblazeb2.com/file/wikiFiles/DfAQZFy.jpg)

## Ang II

[\_](https://github.com/thisispiggy/my-wiki/tree/601ff771dc2fac1318ae8b59435ac8485628fd81/01%20Step%201/Renal/AII%20II%20kidney%20function,%20GFR,%20RPF,%20FF/README.md)..

![](https://f001.backblazeb2.com/file/wikiFiles/aplTGpj.jpg)

* **increase Na/H2O**
* **increase bicarb absorption in PCT**
* harder to get blood through whole system, thus lower RPF, FF goes up

[\_](https://github.com/thisispiggy/my-wiki/tree/601ff771dc2fac1318ae8b59435ac8485628fd81/01%20Step%201/Renal/AII%20Na,%20water,%20bicarb%20absorption%20how/README.md)..

![](https://f001.backblazeb2.com/file/wikiFiles/pZgkWPk.jpg)

![](https://f001.backblazeb2.com/file/wikiFiles/QxxJYav.jpg)

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

![](https://f001.backblazeb2.com/file/wikiFiles/c7hU49u.jpg)

* AII activate Na/H antiporter
* Na absorption, H2O absorption
* **Contraction alkalosis**: more H+ out to lumen, combine with bicarb to form water, absorption

## Aldosterone

[\_](https://github.com/thisispiggy/my-wiki/tree/601ff771dc2fac1318ae8b59435ac8485628fd81/01%20Step%201/Renal/primary%20aldosteronism%20case.%20Causes)..

![](https://f001.backblazeb2.com/file/wikiFiles/4lTSPxo.jpg)

* adrenal makes too much aldosterone

[\_](https://github.com/thisispiggy/my-wiki/tree/601ff771dc2fac1318ae8b59435ac8485628fd81/01%20Step%201/Renal/different%20RAA%20drugs,%20MOA/README.md)..

![](https://f001.backblazeb2.com/file/wikiFiles/EHOgAhP.jpg)

![](https://f001.backblazeb2.com/file/wikiFiles/MTYaRdM.jpg)

## ANP

[\_](https://github.com/thisispiggy/my-wiki/tree/601ff771dc2fac1318ae8b59435ac8485628fd81/01%20Step%201/Renal/ANP%20made%20where,%20stimulated%20how,%20effect,%20GFR,%20renin/README.md)..

![](https://f001.backblazeb2.com/file/wikiFiles/H4ybPB7.jpg)

* released by heart
* opposite of renin
* relax smooth muscle via cGMP to dilate afferent

## PTH

[\_](https://github.com/thisispiggy/my-wiki/tree/601ff771dc2fac1318ae8b59435ac8485628fd81/01%20Step%201/Renal/PTH%20function,%20made%20where,%20stimulation,%20Mg%20effect%20on%20PTH/README.md)..

![](https://f001.backblazeb2.com/file/wikiFiles/QwLSm29.jpg)

* low Ca most important
* alcoholics very low Mg

[\_](https://github.com/thisispiggy/my-wiki/tree/601ff771dc2fac1318ae8b59435ac8485628fd81/01%20Step%201/Renal/PTH%20Ca%20and%20phosphate%20net%20effect.%20Effects%20in%20kidney,%20bone,%20GI)..

![](https://f001.backblazeb2.com/file/wikiFiles/T6EqAo2.jpg)

![](https://f001.backblazeb2.com/file/wikiFiles/leGE3CO.jpg)

* increase Ca absorption in DCT

![](https://f001.backblazeb2.com/file/wikiFiles/GzidgVS.jpg)

![](https://f001.backblazeb2.com/file/wikiFiles/mQtW1fa.jpg)

## Vid D

[\_](https://github.com/thisispiggy/my-wiki/tree/601ff771dc2fac1318ae8b59435ac8485628fd81/01%20Step%201/Renal/Vit%20D%202%20versions,%20names,%202%20sources,%20activation/README.md)..

![](https://f001.backblazeb2.com/file/wikiFiles/iFJqNSk.jpg)

* D2 less active, not important

![](https://f001.backblazeb2.com/file/wikiFiles/Os4mpvP.jpg)

![](https://f001.backblazeb2.com/file/wikiFiles/Yr76O2w.jpg)

* 25- OH longest half life

[\_](https://github.com/thisispiggy/my-wiki/tree/601ff771dc2fac1318ae8b59435ac8485628fd81/01%20Step%201/Renal/vit%20D%20function/README.md)..

![](https://f001.backblazeb2.com/file/wikiFiles/L3fprEg.jpg)

[\_](https://github.com/thisispiggy/my-wiki/tree/601ff771dc2fac1318ae8b59435ac8485628fd81/01%20Step%201/Renal/PTH%20and%20vit%20D%20activation%20how/README.md)..

![](https://f001.backblazeb2.com/file/wikiFiles/B0RDToE.jpg)

[\_](https://github.com/thisispiggy/my-wiki/tree/601ff771dc2fac1318ae8b59435ac8485628fd81/01%20Step%201/Renal/renal%20failure%20effect%20on%20phosphate,%20Ca,%20PTH,%20Vit%20D/README.md)..

![](https://f001.backblazeb2.com/file/wikiFiles/LkBXUhS.jpg)

* renal failure: increase phosphate from unable to excrete
* secondary hyper PTH from renal failure

## EPO

[\_](https://github.com/thisispiggy/my-wiki/tree/601ff771dc2fac1318ae8b59435ac8485628fd81/01%20Step%201/Renal/EPO%20made%20where,%20stimulation,%20deficiency%20result/README.md)..

![](https://f001.backblazeb2.com/file/wikiFiles/uqlC8oc.jpg)

* **peritubular interstitial cells**
* acts in **bone marrow**

[\_](https://github.com/thisispiggy/my-wiki/tree/601ff771dc2fac1318ae8b59435ac8485628fd81/01%20Step%201/Renal/EPO%20drugs%20include,%20uses/README.md)..

![](https://f001.backblazeb2.com/file/wikiFiles/cpehsoB.jpg)

* association with increased mortality