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IMC512 Renal

Flashcards 6: Potassium, Calcium, and Phosphate

QuestionAnswerAdditional Information
Which class of diuretic can be used to lower plasma Ca2+? Loop diuretics Blocking NKCC lowers the electrical driving force for paracellular Ca2+ reabsorption.
What are the two means by which aldosterone can lower plasma K+? Stimulating K+ uptake into cell stores and stimulating K+ secretion by the collecting duct. Both mechanisms involve upregulation of Na/K-ATPase. Insulin also stimulates uptake into cell stores in this way.
In which three ways can plasma pH influence plasma Ca2+? Acidification encourages [1] bone demineralization, [2] release of Ca2+ from plasma proteins, and [3] inhibits Ca2+uptake by the distal tubule, raising plasma Ca2+. Acidosis inhibits TrpV5 in the distal tubule
In which cell type is the active form of vitamin D, calcitriol, synthesized? proximal tubule epithelia
In addition to calcitriol, which other hormone is useful for raising Ca2+ in hypocalemia? parathyroid hormone PTH and calcitriol both encourage bone resorption and renal Ca2+ reabsorption.
Which class of diuretic can be used to raise plasma Ca2+? Thiazide diuretics Blocking NCC increases the driving force for transcellular ca2+ reabsorption.
What is the role of the calcium sensing receptor in the thick ascending limb? Senses rise in Ca2+ and signals to inhibit Ca2+ reabsorption. CaSR causes lower activity of NKCC and ROMK, lowering electrical driving force for paracellular Ca2+ uptake. Thus, mutations that hyperactivate CaSr mimic Bartters.
What is the effect of PTH on renal phosphate handling? PTH encourages phosphate excretion. Calcitriol encourage both Ca2+ and Pi rebasorption, but PTH encourages Ca2+ reabsorption and Pi excretion.
Created by: IMC512
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