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Human Anatomy and Physiology. Renal function. Functions. Regulation of water and electrolytes Maintain plasma volume Acid-base balance Eliminate metabolic wastes Hormone secretion. Kidney anatomy. Anatomy. Functional unit is the nephron Components Glomerulus Proximal tubule
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Human Anatomy and Physiology Renal function
Functions • Regulation of water and electrolytes • Maintain plasma volume • Acid-base balance • Eliminate metabolic wastes • Hormone secretion
Anatomy • Functional unit is the nephron • Components • Glomerulus • Proximal tubule • Loop of Henle • Distal tubule • Common Collecting duct
Nephron anatomy • Nephron types • Juxtamedullary • Cortical • Peritubular capillaries • Vasa recta
Renal processes • Filtration • Water and solutes • Protein (Not filtered) • Blood cells (No filtered) • Filtration based onsize and charge
Glomerular Filtration Size barrier Size barrier
Renal processes • Reabsorption • 99% of water & solutes • Passive - water • Active - sodium • Proximal tubule (65%)
Reabsorption at cell level • Sodium moves passively across the apical membrane and actively into the plasma
Renal processes • Secretion • Water and solutes (1%)
Secretion at cell level • Potassium is transported actively into the cell and passively into the tubular lumen
Urine formation • Volume of fluid into kidneys per day 1,640 L • Volume filtered into the glomeruli per day 180 L • Volume of fluid excreted/day ~ 1.5L • Hence 180 - 178.5 L = amount reabsorbed (~99%)
Blood supply • GFR will depend on blood supply • Blood pressure drop in the glomeruli
Glomerular filtration • Total amount of filtrate formed per minute • Influenced by: • Filtration surface area • Filtration membrane permeability • Net filtration pressure
Glomerular filtration • Measured by a marker • Characteristics • Freely filtered by the glomerulus • Not reabsorbed or secreted • Must not alter GFR
Glomerular filtration • Inulin • Renal clearance • GFR x P(In) = U(In) x V
Regulation of GFR • 3 mechanisms • Renal autoregulation • Neural control • Renin-angiotension system(JG apparatus)
Countercurrent multiplication 65% 14% 15% 5%
Urine concentration • Vasopressin: antidiuretic hormone (ADH) • Posterior pituitary, increases the number of aquaporin water channels in the CD
Vasa recta • Osmotic gradient not washed out • Blood supply sluggish • Medulla blood flow is 2% of that to the kidneys
Urine concentration • The urine to plasma osmolality ratio • [U]/[P] • Plasma osmolality from 285 - 295 mOsm • Example: [urine] = 1,200 mOsm, ratio = 4.0
Urine dilution • Atrial natriuretic peptide (ANP) • Atrium of the heart, decreases Na+ and water reabsorption ADH/ANP ADH/ANP
Diuretics • Action of Diuretics • Alcohol: inhibits ADH • Caffeine: promotes renal vasodilation, increasing GFR • Drugs: any that inhibit sodium reabsorption
Micturition • Mechanism of action • Contraction of detrusor muscle • Relaxation of sphincters