FISIOLOGIA RENAL VANDERS PDF
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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Dysfunction of the thick loop fisiologis Henle and senescence: This article has been cited by other articles in PMC. Written in a clear, concise, logical style, this trusted text reviews the fundamental principles of the structure, function and pathologies of the human kidney that are essential for an understanding of rneal medicine.
Since furosemide stimulates sodium loss due to the inhibition of its reabsorption at the level of the TALH, the lower increase in soduria after furosemide infusion in the very old in comparison with the young could be explained by the functional reduction in the TALH furosemide blocking site due to the senescence process[ 23 – 25 ].
Fisiología renal de Vander – Douglas C. Eaton, John P. Pooler – Google Books
The normal ageing kidney—morphology and physiology. Abstract Renal physiology in the healthy oldest old has the following characteristics, in comparison with the renal physiology in the young: Even though, the above mentioned creatinine renal filtration difference between the age groups, there is no significant difference regarding their serum creatinine value between them.
The goal of his research is to examine the cellular signaling mechanisms which control all aspects of cellular function including cell growth, division, and responses to external stimuli. Rev Esp Geriatr Gerontol.
These finding could be interpreted as the fact that the dehydration over expresses the habitual senile creatinine back-filtration.
Renal reserve in the oldest old. Fractional excretion of K, Na and Cl following furosemide infusion in healthy, young and very old people.
Due to the fact that a reduction in the number of urea channels UT1 has been documented in the collecting tubules of very old rats, it could be suggested that the senile increase in urea excretion may be the consequence of a lower reabsorption of urea at the distal tubules[ 17 ]. Renal handling of sodium in old people: It is already known that there is a significant difference between urea and uric acid renal handling in very old healthy people.
The information obtained by means of the furosemide test senile hyposecretion of potassium explains why the tubular handling of potassium measured as FEK and transtubular potassium gradient: Inhibition of renal reserve in chronic renal disease. Fractional excretion of urea in severely dehydrated elderly with dementia. 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.
The procurement of a ratio between the CC and the CCWC allows for the evaluation of the net tubular handling of this substance: Journal List World J Nephrol v. 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 ].
The collecting tubules are the nephronal segment where potassium secretion, and sodium and water reabsorption take place[ 9 ].
Creatinine, urea, uric acid, water and electrolytes renal handling in the healthy oldest old
Aging and physiological changes of the kidneys including changes rrnal glomerular filtration rate. 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: 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.
All authors contributed to this manuscript. 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.
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.
Renal physiology in the oldest old: The aging kidney in health and disease. 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 Canders post-infusion of furosemide is significantly lower in the very old group in comparison with the young one: Rennke Vnders, Denker B.
Since uric acid is mainly handled in the proximal tubule, a segment that suffers practically no functional changes with ageing, perhaps this vandesr explain the above mentioned phenomenon[ 14 ].
Physiology of the healthy ageing kidney. Regarding tubular sodium handling eenal 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 the 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 ].
Fisiologia Renal de Vander – Douglas C. Eaton | John P. Pooler – Google Books
Combining the latest research with a fully integrated teaching approach, the eighth edition of Vander’s Renal Physiology features revised sections that explain how the kidneys affect other body systems and how they in turn are affected by these systems.
On one hand, it has been documented that fractional excretion of urea, in volume contraction as well as fisiolgoia volume expansion, was significantly higher than the one reached by the young: 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 fusiologia the collecting tubules[ 24 ]. The lower reabsorption of sodium in TALH is translated into a lower medullar concentration vandfrs sodium, which causes 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 low intake[ 13 ].
It could be vwnders 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. Author information Article notes Copyright and License information Disclaimer. Biology, functions and diseases. Creatinine clearance measured without CC or with cimetidine CCWCwhich is almost the same as inuline clearance due to the blocking effect that cimetidine has on the proximal tubular secretion of creatinine, has proved to be significantly lower in the very old healthy people in comparison to that documented on the younger population[ 12 ]: Even nowadays the limits that separate the changes considered typical of the normal ageing process of those patients who suffer from high prevalent illnesses characteristic of this period are not clear.
From the clinical point of view, the above mentioned reduction in the tubular capacity to reabsorb sodium fosters sodium depletion and its clinical consequences: Renal physiology in the healthy oldest old has the following characteristics, in comparison with the renal physiology in the young: This has been attributed to the senile medullar hypotonicity[ 324 ].
Additionally, the high urea urinary excretion documented in the very old could be one of the factors which explains the senile medullar ernal reduced urea medullar content and the fisoilogia urea osmotic diuresis usually found in the very old patients[ 1516 ]. Tel 91 99 99 Fax 91 21 Cimetidine improves the reliability of creatinine as a marker of glomerular filtration. 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.
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 ].