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Kidney

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jay acharya

on 29 April 2010

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Transcript of Kidney

Kidney
Erythropoietin 1 25 diOH vit D3
Renin Regulates Insulin
GH
Glucogon
Prolactin
Vasopressin
Atrial natriuretic factor

corticosteroids
sex harmones
thyroid harmones
catecholamines
Nephron is endocrine target for PTH
Vasopressin
Atrial natriuretic factor
Angiotensin II
Insulin
IGF1
GH
Calcitonin
Aldosterone
Catecholamines
Thyroid harmones
It is a cytokine for erythrocyte (red blood cell) precursors in the bone marrow.
Produced by the peritubular capillary endothelial cells in the kidney,
Other functions - wound healing and possible role in brain's response to neuronal injury.
Erythropoietin Anemia of chronic renal discease
Erythropoietin deficiency
Reduced RBC life span
Chronic blood loss from GI tract
Folic acid dificiency
Uremic toxins suppressing erythropoiesis Renin also known as angiotensinogenase
granular cells of the juxtaglomerular apparatus
Stimulated by -A decrease in arterial blood pressure
A decrease in sodium chloride levels in the ultra-filtrate of the nephron
Sympathetic nervous system activity,
1,25-dihydroxyvitamin D3 is the hormonally active form of vitamin D
increasing the uptake of calcium from the gut into the blood
decreasing the transfer of calcium from blood to the urine
also release of calcium into the blood from bone(effect seen in dietery calcium defiency
or interstinal malabsorption

Calcitriol is produced in the cells of the proximal tubule of the nephron
in the kidneys by the action of 25-hydroxyvitamin D3 1-alpha-hydroxylase

The activity of the enzyme is stimulated by PTH




Vit D Skin-7dehydrocholesterol converted to cholecalciferol (vit D3)
by UV light 290-330nm ( age, skin pigmentation,intensity clothing angle of exposure)

Ergocaciferol is derived from animal /plant source (vit D2)
Both D2 and D3 25 hydroxylated at liver by P450 --Regulated by Ca , Phosphate and PTH

1 25 hydroxylation at kidney to calcitriol

The vitamin D receptor belongs to the nuclear receptor superfamily of steroid/thyroid hormone receptors, and VDRs are expressed by cells in most organs, including the brain, heart, skin, gonads, prostate, and breast.

VDR activation in the intestine, bone, kidney, and parathyroid gland cells leads to the maintenance of calcium and phosphorus levels in the blood (with the assistance of parathyroid hormone and calcitonin) and to the maintenance of bone content Rickets a childhood disease
Osteomalacia, a bone-thinning disorder characterized by proximal muscle weakness and bone fragility

hypervitaminosis D.
In healthy adults, sustained intake of 1250 micrograms/day (50,000 IU) can produce overt toxicity within months


Other possible Health effects

Immune system-VDR ligands have been shown to increase the activity of natural killer cells,
Cancer-vitamin D receptors expressed in cancer cells, ?association with ovarian and brest cancer
CVS-A National Health and Nutrition Examination Survey (NHANES) involving nearly 5,000 participants found that low levels of vitamin D were associated with an increased risk of peripheral artery disease (PAD). The incidence of PAD was 80% higher in participants with the lowest vitamin D levels (<17.8 ng/mL).

Mortality
Using information from the National Health and Nutrition Examination Survey a group of researchers concluded that having low levels of vitamin D (<17.8 ng/ml) was independently associated with an increase in all-cause mortality in the general population










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