How and by what mechanism is glomerular filtration rate (GFR) affected by obstruction of the ureteropelvic junction...

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Medical Sciences

How and by what mechanism is glomerular filtration rate (GFR)affected by
obstruction of the ureteropelvic junction by a stone?
stimulation of the splanchnic nerve?
a marathon run?
severing the post-glanglionic sympathetic fibers to thekidney

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Ureteropelvic junction UPJ obstructionstone is a blockage in the renal pelvis of the kidney The renal pelvis is located at the upper end of each ureter tube that drains urine from the kidneys to the bladder The renal pelvis which is shaped like a funnel collects urineIn UPJ obstruction the flow of urine is slowed or stopped completely GFR will decreasedThis raises the risk of kidney damage In most cases of UPJ obstruction only one of the kidneys is affected Machanismureteropelvic obstruction there is a progressive fall in glomerular filtration rate GFR due to a reduction in single nephron glomerular filtration rate SNGFR and a reduced number of filtering nephrons Renal plasma flow also declines after a transient prostaglandindependent increase due to afferent and efferent arteriolar vasoconstriction The vasoactive hormones thromboxane A2 and angiotensin II are implicated in the pathogenesis of the vasoconstriction following ureteral obstruction and they also reduce the glomerular ultrafiltration coefficient by causing mesangial contraction Ureteropelvic obstructiona also leads to profound changes in renal tubular cell function These include altered sodium and water handling resulting in a postobstructive diuresis and natriuresis and a failure to dilute or concentrate the urine Potassium and divalent cation exchange is also affected as is urinary acidification Furthermore the response of the tubule to hormones such as antidiuretic hormone and parathyroid hormone is impaired The See Answer

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