Renal Physiology

Functions
Excrete and remove
wastes
Nitrogen wastes

Elimination and
discharge of wastes
Regulation of blood
volume and solute
concentration
Water Balance
Salt (ion) Balance
pH Balance

Renal Phys: Chapter

26
Fluid/Acid Base
Balance: Chapter 27

Renal Anatomy
2 Kidneys
Performs excretory
functions
Produce urine

Urinary tract
Performs elimination
Contains
Ureters
Bladder
Urethra

The
Kidney
BloodFiltrateTubular Fluid
Urine
Filters blood

25% of total cardiac output!!!

Blood delivered to cortex and filtered
in glomerulus

Separates Wastes and Nutrients

Renal tubule reabsorbs nutrients,
and adjusts water content/pH
Deliver wastes through medulla as
urine
Urine collected centrally to pelvis
and sent to ureters

Renal Corpuscle
Glomerulus
Specialized blood vessels
Knot of capillaries
Fenestrated!

Fluid and solute filtration;

not gas exchange!
Blood enters via afferent
arteriole
Filtrate exits to capsule
Remaining blood exits to
efferent arteriole

Glomerular (Bowmans)
Capsule
First structure in renal
tubule

The Nephron
The Nephron
Functional unit of the kidney
Tube-like structure (aka
glomerular capsule plus renal
tubule)
Adjusts filtrate composition
Reabsorbs useful things
Water
Nutrients
Ions

Secrets wastes not already in

filtrate
Final result urine

Nephron Parts

Glomerular (Bowmans) capsule

Proximal convoluted tubule (PCT)
Loop of Henle (Nephron Loop)
Distal convoluted tubule (DCT)
To Collecting Duct

What
is
Filtrat
e?

Filtration membrane is semipermeable

Fenestrated capillaries
Filtration slits between pedicles of
podocytes

Net filtration pressure

Favors fluid diffusing from capillary to
Glomerular capsule
Blood fluids and solutes are forced out
Proteins and RBCs cannot leave capillary
(create osmotic pull back)

GFR
Glomerular Filtration Rate
Amount of filtrate produced
125 ml/min
180 L/day

Driven by blood pressure

and flow
How much blood do Kidneys
receive?
How much urine is
produced/day?
What happens in the
nephron?

Reabsorption Reabsorption
Reabsorption!
Proximal convoluted
tubule (PCT)
60% of filtrate is
reabsorbed in PCT!
60% Ions
Na+, K+
Bicarbonate (HCO3- )

60% Water ~108L

99% of nutrients
Glucose
Amino acids

Accomplished with
ion gradients and
protein transporters

the Loop of Henle

Loop is semi permeable

Thin descending loop
Water only

Thick ascending loop

Solutes (Na+ and Cl-) only

Countercurrent multiplication occurs in loop

Water follows salt!

Vasa Recta and Peritubular

Capillaries
Two types of Nephrons
Cortical
Juxtamedullary

Supporting vessels
Peritubular capillaries
Observed in both types
Normal capillary function
Accept reabsorbed filtrate
components
Vasa recta capillaries
Only with juxtamedullary
nephron loops
Specialized to concentrate
filtrate
Take away reabsorbed
substances and transport back
to circulation

Final Adjustments in the

DCT
Distal convoluted tubule
(DCT)

Only 15-20% of filtrate

volume left
Composition no longer
blood plasma like
Urea and wastes are now
main solutes

Secretion segment
Drugs (penicillin, atropine,
morphine ect. )
K+, H+ , ammonium ions,
H+ removal utilizes carbonic
anhydrase reaction Hormone
sensitive segment

Aldosterone stimulates
additional Na+ reabsoption
Antidiuretic hormone
additional water reabsorption

Figure 27-16 Responses to Metabolic Acidosis and Alkalosis

Responses to Metabolic Acidosis
Respiratory compensation:

Stimulation of arterial and CSF chemoreceptors results in increased

respiratory rate.

Increased
H ions

Renal compensation:
Metabolic Acidosis
Elevated H results
in a fall in plasma pH

H ions are secreted and HCO3 ions are

generated.

Combined Effects

Buffer systems accept H ions.

Decreased H and
increased HCO3
Decreased PCO

HOMEOSTASIS
DISTURBED

HOMEOSTASIS

Increased H production

Normal
acidbase
balance

or decreased H excretion

Metabolic acidosis can result from

increased acid production or
decreased acid excretion, leading to
a buildup of H in body fluids.

HOMEOSTASIS
RESTORED
Plasma pH
returns to normal

H+ removal/ conservation
Occurs in BOTH
DCT of nephron
Alveoli in lungs

Antidiuretic
Hormone
(ADH)
Fluid balance in DCT and
Collecting Duct

Minimum amount of water

needed to keep wastes
dissolved (obligatory water
loss)
Body can also adjust if
blood pressure is off
If blood pressure is low,
then blood volume is low
ADH acts to conserve
water and restore volume
and pressure

ADH Released by
hypothalamus
Acts on collecting duct
Cells insert aquaporins
Water channels allow
water to diffuse out of
collecting duct (remains in
body)

 *similar figures found

in Chapter 27 of Marti
and Nath text.

Whats left in Urine?

Excreted = Filtered-Reabsorbed
+Secreted
The 1%!
Urine
Nitrogen Waste
Urea-Most abundant
organic waste
Ammonium ions (NH4+ )
amino acid waste

Acids
Uric Acid, H+

Water
Some water loss always
occurs
Urea, uric acid, etc. must
be dissolved in water

Ion and nutrients

Some ion nutrient loss

How do we know
99% is reabsorbed?
Filtrate volume is 180 L
GFR 125mL/min

Urine volume is 1-2L

The Ureters and

Bladder
Ureter
Muscular tube
connecting kidney and
bladder

Bladder
Hollow muscular sac
Temporary urine storage
Can hold a maximum of ~1L

The Urethra
Extends from neck of urinary bladder
Controlled by involuntary and voluntary
sphincters
To the exterior of the body
Male=18-20cm
Female=3-5cm

Urinalysis
Analysis of urine sample
Calculate GFR
Could indicate renal failure
Too much urine (polyurea)
Not enough

Test for glycosuria

Glucose in urine
Old taste test method
Indicates diabetes
So much sugar in blood/filtrate
all is not reabsorbed
Transport maximum (Tm)
reached
Glucose detectable in
excreted urine

Assess ion concentrations

Na, K, Ca, Mg, Cl

Blood cells
Hematuria/pyuria
Should be very few
RBC and WBC!
RBC indicates
damage to kidneys
WBC indicates
infection! Dont
drink this urine!

Figure 26-16 Summary of Renal Function.