Fisiologia Renal de Vander – Ebook download as PDF File .pdf) or read book online. Conciso e didático, este livro explora os aspectos fundamentais da fisiologia renal que são essenciais para o bom entendimento da medicina clínica. : FISIOLOGIA RENAL DE VANDER 6TA. EDIC. by EATON DOUGLAS C. () by Douglas C. Eaton and a great selection of similar.
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Fisiologia Renal de Vander – Free Download PDF
In the present review article, we explain in detail the characteristics of the creatinine, urea, uric acid, sodium, water, and potassium renal handling in the very old healthy people taking the younger group years as a parameter. Anatomical changes in the aging kidney. Rejal procurement of a ratio between the CC and the CCWC allows for the evaluation of the net tubular handling of this renzl Renal reserve in the oldest old.
Abstract Renal physiology in the healthy oldest old has the following characteristics, in comparison with the renal physiology in the young: On the other hand, serum uric acid level and fractional excretion of uric acid FEUAc do not differ between very old healthy people in comparison with healthy young ones.
TTKG in basal situation, does not show any significant difference between the very old group and the young one, despite the existence of lower glomerular filtration in the very old, which ultimately accounts for the relatively reduced cation excretion in the very old, since it is known that the potassium excretion tends to increase paralelly to the reduction of glomerular filtration: As regards the maximum tubular dilution capacity, another of the parameters which Chaimowitz test can evaluate, it has been reported that such dilution is significantly reduced in the very old in comparison with the young: The observed difference in the creatinine filtration between the studied age groups could be justified as a consequence of the decrease in the number of glomerular units secondary to their obliteration due to the glomeruloscrerosis which accompanies ageing[ 3 – 5 ].
Furosemide intravenous infusion furosemide test shows that fractional excretion of sodium FENa post-furosemide infusion is significantly lower in the very old group in comparison with the young one: Cimetidine improves the reliability of creatinine as a marker of glomerular filtration.
In this test, it is observed that the basal fractional excretion of potassium FEK before furosemide infusion is not significantly different in the young and the very old group, whereas the highest FEK post-infusion of furosemide is significantly lower in the very old group in comparison with the young one: Begins with the basics and works up to advanced principles Focuses on the logic of renal processes Includes the most current research on the molecular and genetic principles underlying renal physiology Explains the relationship between blood pressure and renal function Presents the normal functions of the kidney with clinical correlations to disease states Includes study questions with an answer key at the end of each chapter Features learning aids such as flow charts, diagrams, key concept clinical examples, boxed statements to emphasize major points, learning objectives, and review questions with answers and explanations About the Authors Doug Eaton is the Distinguished Professor and Chairman of Physiology at Emory University.
Fisiología renal de Vander – Douglas C. Eaton, John P. Pooler – Google Books
Renal handling of many substances creatinine, urea, sodium, water, potassium significantly differs between very old healthy people and young one, while there is no change in uric acid renal handling between these groups. To examine these signaling mechanisms, he uses contemporary methods of cellular and molecular biology including patch voltage clamp methods and expression of cloned signaling molecules in Xenopus oocytes and other expression systems.
Even though, the vanderrs mentioned creatinine renal filtration difference between the age groups, there is no significant difference regarding their serum creatinine value between them. Fractional excretion of K, Na and Cl following furosemide infusion in healthy, young and very old people.
The aging kidney in health and disease. Renal physiology in the oldest old: It could be hypothesized that the phenomenon of net creatinine tubular reabsorption documented on very old people could be explained due to the senile structural tubular changes atrophy, etc.
The collecting tubules are the nephronal segment where potassium secretion, and sodium and water reabsorption take place[ genal ]. Renal handling of uric acid, magnesium, phosphorus, calcium, and acid base in the elderly. This article has been cited by other articles in PMC. From the clinical point of view, the above mentioned reduction in the tubular capacity to reabsorb sodium fosters sodium depletion and its clinical consequences: Additionally, it is important to point out that there are no significant physiological differences related to gender in both age populations.
Aldosterone bioactivity in this segment is studied using the furosemide test, which ultimately generates a discrete hypovolemia that stimulates the release of this hormone, which in turn stimulates the secretion of potassium in the collecting tubules.
Renal handling of sodium in old people: National Center for Biotechnology InformationU. Additionally, the high urea urinary excretion documented in the very old could be one of the factors which explains the senile medullar hypotonicity reduced urea medullar content and the nocturia urea osmotic diuresis usually found fisillogia the very old patients[ 1516 ].
The lower reabsorption of sodium in TALH is translated into a lower medullar concentration of sodium, which fisiiologia senile medullar hypotonicity and as a consequence to a reduction in the urinary concentration capacity, which can be the cause of dehydration in the old in situations of high loss of water or eenal intake[ 13 ]. Something similar was documented in the newborns but in this case it was attributed to tubular immaturity since this finding disappeared as they grew older[ 89 ].
Rev Esp Geriatr Gerontol. Physiology of the healthy ageing kidney.
Fisiologia Renal de Vander
The previously described physiological alterations also show that the characteristic senile sodium urinary loss depends not only on the reduced sodium reabsorbed in the TALH but also in the collecting tubules[ 24 ].
This has been attributed to the senile medullar hypotonicity[ 324 ].
Besides, it has been documented that free water clearance a marker of TALH function is considerably lower in the very old in comparison with the young: Since uric acid is mainly handled in the proximal tubule, a segment that suffers practically no functional changes with ageing, perhaps this could explain the above mentioned phenomenon[ 14 ].
This phenomenon can be explained as the decrease in the creatine levels due to the senile diminution in lean body mass tissues from where creatinine comes [ 6 ]. All physiological changes of the aged kidney are the same in both genders. Renal senescence in Studies in old rats have documented a significant reduction in the number of co-transporters NKCC2 in comparison with young ones.
Creatinine, urea, uric acid, water and electrolytes renal handling in the healthy oldest old
Geriatric nephrology and the ‘nephrogeriatric giants’. Journal List World J Nephrol v. Regarding tubular sodium handling in the oldest old, it has been documented that the selective reabsorption of sodium at the proximal tubule, evaluated using the Chaimowitz test, shows that it remains in remal normal range: Additionally, it has also been documented a decrease in sodium reabsorption in the thick ascending loop of Henle in very old healthy people[ 20 ].