Functions of the Urinary System

  Kidneys – eliminate unwanted plasma constituents

Renal Physiology through the urine while conserving materials of value to
& the body
Fluid and Electrolyte Balance   Excrete nitrogenous waste – urea, uric acid, creatinine
  Regulate blood volumes – by regulating H2O balance and
release of erythropoietin
  Regulates blood pressure – releases renin which triggers
vasoconstriction and aldosterone secretion
Regulates chemical composition of the blood – regulating
Keri Muma  

ions and osmolarity

Bio 6   Stabilizes pH – balances acids and bases
  Converting Vitamin D into its active form

Anatomy of the Kidney Microscopic Anatomy

  Cortex – outer region   The functional unit of the kidney is the nephron
  Medulla – deep to the cortex   Composed of vascular and tubular components
  Renal pelvis – flat funnel shaped cavity   Responsible for the filtration of blood and urine
formation

Tubular Component Tubular Component

  Bowman’s capsule – cup surrounding the glomerulus, collects   Distal convoluted tubule – leads away from the
filtrate ascending loop of Henle to the collecting duct
  Proximal convoluted tubule – extends from the Bowman’s   Collecting duct – receives filtrate from DCT of
capsule numerous nephrons
  Loop of Henle – hairpin loop

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 Vascular Component
  Afferent arterioles – supply glomerulus
  Glomerulus – capillary knot
  Efferent arterioles – drains the glomerulus
  Peritubular capillaries – surround tubular portions of the
nephron in the cortex
  Vasa recta – surround tubular portions of the nephron in the
medulla
Types of Nephron
  Cortical nephron – majority of the nephron is within
the cortex with a short loop of Henle
  Juxtamedullary nephron – glomeruli is deep in the
cortex and have a long loop of Henle that extends
deep into the medulla

Juxtaglomerular Apparatus (JGA) Juxtaglomerular Apparatus (JGA)

  Region between the beginning of the DCT and the
afferent arteriole
  Contains cells that regulate the rate of filtration and
blood pressure
  Macula densa – in the DCT, contain osmoreceptors
that monitor solute concentration and flow rate of
filtrate
  Granular cells – smooth muscle cells in the afferent
arteriole, act as mechanoreceptors to monitor BP,
synthesize and secrete renin

Renal Processes" Renal Processes"

  The four basic processes of the nephrons are:"   Glomerular filtration is the
  glomerular filtration" first process. "
  Plasma is filtered from the
  tubular reabsorption"
glomerulus into the
  tubular secretion" Bowmanʼs capsule. "
  excretion"
  Solutes and fluid are forced
through the filtration
membrane by hydrostatic
pressure"
  Blood cells and plasma
proteins normally do not
enter the filtrate "

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 Glomerular Filtration Glomerular Filtration Rate (GFR)
  The glomerulus is more efficient at filtration than
other capillary beds because:
  Glomerular filtration rate - the total amount of
  Its filtration membrane is significantly more permeable
to solutes and water due to capillary pores filtrate formed per minute by the kidneys
  Glomerular blood pressure is higher due to a larger   125mL/min or 180L/day!
afferent arteriole than efferent arteriole
  Factors governing filtration rate at the
  It has a higher net filtration pressure
capillary bed are:
  Net filtration pressure
  Total surface area available for filtration
  Filtration membrane permeability

Forces Involved in Glomerular Filtration " Forces Involved in Glomerular Filtration "
  The glomerular capillary pressure (55 mm Hg) is the
  From the previous examples:"
result of the blood pressure pushing on the inside of   The net pressure = glomerular blood pressure -
the capillary wall " (plasma-colloid osmotic pressure + Bowmanʼs capsule
  The plasma-colloid osmotic pressure (30 mm Hg) is hydrostatic pressure)"
due to the retention of plasma proteins in the blood of   55 - (30 +15) = 10"
the glomerulus. "
  The net filtration pressure
  The concentration of water is higher in the capsule,
is 10 mm Hg by this
because proteins are absent there. Water tends to
return to the glomerulus by osmosis" example. "
  There is also a hydrostatic pressure (15 mm Hg)
tending to move fluid from the Bowmanʼs capsule into
the glomerulus"

Regulation of Glomerular Filtration Regulation of Glomerular Filtration

  Uncontrolled shifts in the GFR can lead to fluid   Changes in GFR primarily result from changes
and electrolyte imbalances in glomerular capillary blood pressure
  If the GFR is too high:
  Needed substances cannot be reabsorbed quickly
  Three mechanisms control the GFR:
enough and are lost in the urine 1.  Renal autoregulation (intrinsic control)
  If the GFR is too low: 2.  Sympathetic NS (extrinsic control)
  Everything is reabsorbed, including wastes that are 3.  Hormonal mechanisms (the RAA system)
normally disposed of

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 Intrinsic Controls Intrinsic Controls
  Autoregulation - regulates the GFR by factors   Autoregulation entails two types of control:
within the kidneys. "   Myogenic – responds to changes in pressure in
  Under normal conditions, it prevents inappropriate the renal blood vessels
changes in the GFR   Tubuloglomerular feedback mechanism - senses
changes in flow rate in the nephronʼs tubular
component"

Autoregulation of the GFR" Autoregulation of GFR

  Tubuloglomerular feedback – involves the
  Myogenic mechanism – cells of the JGA
controlled by arteriole   Macula densa cells – detect change in flow-rate
smooth muscle cells and osmolarity
  If the arterial pressure   Increase in flow rate – releases vasoactive chemicals
increases, the afferent that cause vasoconstriction of afferent arteriole
arterioles constrict to lower   Decrease in flow rate – inhibits release of vasoactive
GFR." chemicals causing vasodilation of afferent arteriole
  If the arterial pressure
decreases the afferent
arterioles dilate to increase
GFR."

Tubuloglomerular Feedback Extrinsic Controls

  When the sympathetic nervous system is at rest
or low levels then autoregulation mechanisms
prevail and afferent arteriole is dilated
  However, the sympathetic nervous system can
override the autoregulatory mechanisms to carry
out long term adjustments for blood pressure if
blood volume drops"

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 Extrinsic control of the GFR"
  If arterial blood pressure severely drops, the
baroreceptor reflex triggers vasoconstriction
of systemic arterioles "
  The afferent arterioles constrict by
Extrinsic Controls
  The sympathetic nervous system also stimulates the
renin-angiotensin-aldosterone mechanism
  Renin release is triggered by the following:
  Reduced stretch of the granular cells

sympathetic innervation. Less blood flows   Stimulation of the granular cells by activated
through the glomeruli, lowering the blood macula densa cells
pressure in these capillaries. "   Direct stimulation of the granular cells via β1-
  The decrease in the GFR reduces urine adrenergic receptors by renal nerves
volume."
  This helps to conserve plasma volume,
increasing blood pressure. "

Renin-Angiotensin Mechanism Summary: Control of GFR

  Is triggered when the granular cells release renin
  Renin acts on angiotensinogen to produce
angiotensin I
  Angiotensin I is converted to angiotensin II
  Angiotensin II:
  Causes systemic arteriole vasoconstriction
  Stimulates the adrenal cortex to release aldosterone
  As a result, both systemic blood pressure and
blood volume increase

Figure 25.10

Tubular Reabsorption Tubular Reabsorption"

  Tubular Reabsorption - is the selective transfer
of substances needed by the body from the
filtrate back into the peritubular capillaries "
  Reabsorption rates are high: 124 of 125 ml of
filtered fluid per minute, 99% for water, 100% for
glucose, and 99.5% for Na+"
  By transepithelial transport a reabsorbed substance must
cross the tubule wall, enter the interstitial fluid, and pass
through the wall of the peritubular capillaries, entering the
blood."
  Epithelial cells of the nephron tubule have a luminal
membrane and a basolateral membrane"

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 Sodium Reabsorption
  Sodium reabsorption is mostly driven by active
transport
  Na+ enters the tubule cells at the luminal membrane by
diffusion
  Then it is actively transported out of the tubules by a Na
+-K+ pump at the basolateral membrane
Sodium reabsorption"
  67% of sodium reabsorption occurs in the
proximal tubule at a constant rate"
  The reabsorption of sodium in the loop of Henle
plays a role in the production of varying
concentrations and volumes of the urine"
  In the distal tubule, reabsorption of sodium is
variable and depends on aldosterone"
  More or less is reabsorbed, depending on the needs of
the body."

Sodium reabsorption" Action of Aldosterone

  Aldosterone increases Na+ absorption in
the DCT and collecting ducts by promoting
the insertion of:"
  Additional Na+ channels in the luminal
membrane "
  Additional Na-K+ pumps into the basolateral
membranes"
  About 8% of the filtered Na+ is dependent on
aldosterone for reabsorption"
  If aldosterone is absent it is lost in the urine"

Atrial Natriuretic Peptide Activity ANP

  ANP inhibits Na+ reabsorption which:

  Decreases blood volume
  Lowers blood pressure
  ANP lowers blood volume and pressure by:
  Acting directly on collecting ducts to inhibit Na+
reabsorption
  Inhibits RAA pathway
  Dilates afferent arteriole triggering an increase in
GFR which reducing water and sodium
reabsorption

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 Reabsorption by PCT Cells Tubular Reabsorption of Water
  The reabsorption of water, glucose, amino acids, and   The accumulation of sodium in the lateral spaces produces
anions is linked to the active reabsorption of Na+" an osmotic gradient and hydrostatic pressure that drives the
  Active pumping of Na+ drives reabsorption of: water into the peritubular capillaries."
  Water by osmosis, aided by water-filled pores called aquaporins
  Anions follow by diffusion, down electrochemical gradient
  Glucose and amino acids by secondary active transport

Tubular Reabsorption of Water Role of ADH on Water Reabsorption

  ADH works on tubule cells through a cyclic AMP mechanism "
  Promotes the insertion of aquaporins on the luminal membrane
  80% of water reabsorption is obligatory in the thus increasing water reabsorption"
proximal tubule and loop of Henle"   Produces concentrated urine"
  Occurs by osmosis, no control"
  20% of water reabsorption is facultative in the
distal tubule and collecting duct "
  Based on the secretion of ADH, depends on bodyʼs
needs"

Tubular Reabsorption Nonreabsorbed Substances

  Glucose and amino acids are reabsorbed by
  A transport maximum (Tm):
secondary active transport and cotransported
  Reflects the number of carriers in the renal tubules available
with sodium on the luminal membrane"
  Exists for nearly every substance that is actively reabsorbed
  When the carriers are saturated, excess of that
substance is excreted

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Nonreabsorbed Substances Renal Processes"

  Substances are not reabsorbed if they:   Tubular secretion is a

  Lack carriers selective process by
  Are not lipid soluble which substances from
the peritubular capillaries
  Are too large to pass through membrane pores
enter the lumen of the
  Urea, creatinine, uric acid and other nitrogen nephron tubule. "
containing wastes are usually excreted   Provides a mechanism to
speed up the elimination
of substances from the
blood"

Tubular Secretion Tubular Secretion of K+"

  Tubular secretion is important for:
  Disposing of substances not already in the filtrate
  Eliminating undesirable substances such as urea
and uric acid
  Ridding the body of excess potassium ions
  K+ is almost completely reabsorbed in the proximal tubule"
  Aldosterone stimulates the tubular cells to secrete potassium if
plasma levels are elevated"
  K+ secretion occurs in the distal tubule"
  As the basolateral pump transports sodium into the lateral spaces,
it pumps potassium into the tubular cells where it diffuses into the
lumen for elimination. "

  Controlling blood pH

Role of Acid-Base Balance

Aldosterone   Concentration of hydrogen ions is regulated
sequentially by:
  Chemical buffer systems – act within seconds
  The respiratory center in the brain stem – acts
within 1-3 minutes
  Renal mechanisms – require hours to days to
effect pH changes

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 Renal Mechanisms of Acid-Base Balance Summary of Renal Response to
Acidosis & Alkalosis
  The most important renal mechanisms for
regulating acid-base balance are:
  Conserving (reabsorbing) or generating new
bicarbonate ions
  Excreting bicarbonate ions
  Losing a bicarbonate ion is the same as gaining a
hydrogen ion; reabsorbing a bicarbonate ion is the
same as losing a hydrogen ion

Reabsorption of Bicarbonate Generating New Bicarbonate Ions

  Secreted hydrogen ions form carbonic acid with filtered
bicarbonate
  Carbonic acid dissociates to release carbon dioxide and
water
  Carbon dioxide then diffuses into tubule cells, triggering
further hydrogen ion secretion and bicarbonate reabsorption
  Thus, bicarbonate disappears from filtrate at the same rate it
is reabsorbed
  Dietary hydrogen ions must be counteracted
by generating new bicarbonate
  Two mechanisms generate new bicarbonate
ions:
  Both involve renal excretion of acid via secretion
and excretion of hydrogen ions or ammonium ions
(NH4+)
  The excreted hydrogen ions must bind to
buffers in the urine (phosphate buffer system)

Figure 26.12

Hydrogen Ion Excretion Ammonium Ion Excretion

  Another response to
  In response to acidosis: acidosis:
  Kidneys generate   This method uses

bicarbonate ions and ammonium ions produced

add them to the blood by the metabolism of
glutamine in PCT cells
  An equal amount of
  Each glutamine
hydrogen ions are
metabolized produces two
added to the urine ammonium ions and two
  H+ binds with buffers in new bicarbonate ions
the filtrate   Bicarbonate moves to the

(monohydrogen blood and ammonium ions

phosphate) are excreted in urine

Figure 26.13

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 Bicarbonate Ion Secretion Varying Urine Concentration
  When the body is in
alkalosis, type B   Kidneys excrete varying concentrations and
cells: volumes of urine depending on the body’s
  Exhibit bicarbonate needs
ion secretion   Can produce urine ranging from 0.3ml/min at
  Reclaim hydrogen 1200 mosm/L to 25 ml/min at 100 mosm/L
ions and acidify the
blood

Varying Urine Concentration" Varying Urine Concentration

  Countercurrent – the movement in opposite
  This variation in reabsorption
is made possible by a large, directions of filtrate through the ascending
vertical osmotic gradient in and descending limbs of the loop of Henle
the interstitial fluid of the   Also applies to the flow of blood through the vasa
medulla " recta
  From 300 to 1200 mosm/liter"
  This increase follows the
juxtamedullary nephronʼs loop
of Henle deeper and deeper
into the medulla."
  The gradient is established by
means of the countercurrent
system"

Countercurrent Mechanism Countercurrent Multiplier

  Countercurrent multiplier – refers to the ability to   The ascending limb actively
increase the osmolarity of the interstitial fluid transports NaCl out of the
tubular lumen into the
  Due to the properties in the two limbs of the loop: surrounding interstitial fluid.
  The descending loop of Henle: It is impermeable to water.
  Is relatively impermeable to solutes Therefore, water does not
follow the salt by osmosis."
  Is permeable to water
  The ascending limb produces
  The ascending loop of Henle: an interstitial fluid that
  Is permeable to solutes becomes hypertonic to the
  Is impermeable to water descending limb. This
attracts the water by osmosis
for reabsorption. !

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 Countercurrent Mechanism
  Countercurrent exchanger - The hairpin structure of the
vasa recta allows the blood of the vasa recta to
equilibrate with the interstitial fluid
  Prevents the dissipation of the medullary osmotic gradient
  Blood is isotonic when it enters and when it leaves the
medulla
Formation of Concentrated Urine
  ADH is the signal to produce concentrated urine
  Allowing the distal and collecting ducts to become
permeable to water
  In the presence of ADH, 99% of the water in filtrate is
reabsorbed

Diuretics Renal Processes"

  Osmotic diuretics include:   Urine Excretion –

  High glucose levels – carries water out with the elimination of what
glucose remains in the tubular
  Alcohol – inhibits the release of ADH lumen"
  Caffeine and most diuretic drugs – inhibit sodium   The unwanted filtrate
ion reabsorption material"
  Lasix and Diuril – inhibit Na+-associated
symporters

Transport and Storage of Urine Micturition Reflex

  Urine is transported from the kidney to the
bladder by the ureters
  Due to gravity or peristaltic waves
  The bladder temporarily stores urine
  Micturition – act of emptying the bladder
  The filling of the bladder activates stretch receptors
which trigger reflex contractions of the bladder and
relaxation of the internal sphincter
  Urine is forced past the internal sphincter
  Must voluntary relax external sphincter to void the
bladder of urine

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Micturition Reflex

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