If a patient has renal artery stenosis (narrowing of the renal artery) due to atherosclerosis, what...

If a patient has renal artery stenosis (narrowing of the renal artery) due to atherosclerosis, what is the impact of this on GFR? Specifically, be sure to discuss the impact on the afferent and/or efferent arterioles as well as effects on hydrostatic and/or oncotic pressure.

Expert Solution

When there is renal artery stenosis there may be stenosis of afferent renal arteriole or efferent renal arteriole or both. Usually when there is stenosis the GFR levels are regulated through auto regulation mechanism. When the involvement of lumen is >50%then GFR is altered.

Oncotic pressure depends on the plasma protein concentration. Hydrostatic pressure depends on the flow rate to the kidney.

When the afferent arteriole constrict there is decreased flow to the glomerulus.. Which leads to decreased GFR.

But if the efferent arteriole is constricted then as the blood reached to glomerulus from afferent arteriole will take somewhat more time to enter into efferent arteriole due to its construction.. As the time of presence increase there will be more filtration of blood... Which leads to increased GFR.

During constriction there will be no effect on Oncotic pressure.. In afferent arteriole constriction hydrostatic pressure decreases and in efferent arteriole constriction hydrostatic pressure increases.

Nightingale answered 2 years ago

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