Tutorial kidney ageing
19 important questions on Tutorial kidney ageing
Where is the nephron located?
What is not a function of the kidneys?
- regulate acid homeostasis
- regulate blood pressure
- filter waste products
- serving as a calcium pool for the body
- converting vitamin D into its active form
Which molecules can pass the membranes between the arteriole and the tubule cells?
- Amino acids
- Glucose
- Ions
NIET protein, white blood cells, red blood cells
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Why is urea partly reabsorbed from the collecting tubule in the medulla?
Can you explain the term 'counter current multiplication?
Many older adults are falsely diagnosed with CKD
- True, as based on literature, often only eGFR is used to define CKD (<60 ml/min/1.73m2)
- False, as a single measurement of eGFR is sufficient to estimate kidney function and should therefore be used to define CKD(<60 ml/min/1.73m2)
- True, because serum creatinine alone is used to define CKD (<60 ml/min/1.73m2)
- True, as based on literature, often only eGFR is used to define CKD (<60 ml/min/1.73m2)
Ageing is related to the following changes in kidney structure:
- Decrease in cortical volume
- Increase in medullary volume
Albumin is not normally lost in urine, but in older people we do observe albuminuria. What is a cause for albuminuria?
During ageing, Bowman's space gradually fills with a matrix-like hyaline material, most likely due to disrupted balance between formation and breakdown of the extracellular matrix in the glomerulus. What is a consequence?
True/False Nephron hypertrophy is more related to ageing than to lifestyle factors?
Nephrosclerosis does not associate with:
- glomerular filtration rate
- albuminuria
- blood pressure
- glomerular filtration rate
True/False Older individuals should not donate a kidney
What can be concluded from Micheal Lustgarten's experiment? (more options)
- people who eat more vegetables have a better kidney function
- Lustergarten's kidney function was probably higher on days without meat intake than on days with meat intake
- sardine consumption leads to improved kidney function, due to its omega-3 content
- food intake can have an acute effect on kidney function
4. food intake can have an acute effect on kidney function
We have now learned that it is indeed possible to prevent age-related kidney function decline by means
of nutrition. But which foods can be consumed ‘safely’ and which are better to avoid?
What can be concluded from Micheal Lustgarten's experiment? (more options)
- people who eat more vegetables have a better kidney function
- Lustergarten's kidney function was probably higher on days without meat intake than on days with meat intake
- sardine consumption leads to improved kidney function, due to its omega-3 content
- food intake can have an acute effect on kidney function
4. food intake can have an acute effect on kidney function
We have now learned that it is indeed possible to prevent age-related kidney function decline by means
of nutrition. But which foods can be consumed ‘safely’ and which are better to avoid?
Take a look at figure 1 of the paper written by van Westing et al., in which associations between commonly consumed foods and incident CKD are depicted. Is the following statement true or false? Based on Figure 1, it is likely that a high protein intake decreases kidney function.
Figure 1. Under vegetables, a subcategory of nitrate-containing vegetables is made. Why would nitrate be especially interesting?
Figure 2 shows the risk between beverage intake and CKD incidence. Three studies looked at the influence of coffee intake on CKD risk. Gain et al. Found a trend for an increased risk in an Iranian population, while the other two studies in USA and Korea found significant protective associations for coffee intake. What could be the reason for the increased risk in Iran?
What are the functions of de kidney's
- Filtration
- Collection
- Homeostasis
- pH
- blood pressure (when lots of salt is taken in)
- osmolarity
- excretion of waste products --> urea
functions = unit = nephron [filtration and collection] --> located between cortex and medulla
How can you improve the eGFR? With nutrition
- A high total vegetable intake is correlated with high eGFR
- dairy, nuts+seeds (SFA, MUFA, PUFA(O3, O6)), total vegetables, fruit (berries), sardines, beef, eggs were entered into a backward elimination regression model
- variables are sequentially removed until the best performing regression model remains
- higher intake of sardines and vegetables, lower beef is correlated with higher eGFR
- Fiber, omega-3 and protein intake are significantly correlated with eGFR
- higher intake of fiber and O3, but a lower protein intake is correlated with higher eGFR
- higher fiber --> increased gut bacterial production of butyrate --> better kidney function
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