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Managing Kidney Failure and Regulating Water Content

Learn about the treatment options for kidney failure, such as kidney transplant, dialysis, and peritoneal dialysis, as well as the importance of regulating water content in the body. Explore the structure and functions of the urinary system and the role of the kidneys in osmoregulation.

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Managing Kidney Failure and Regulating Water Content

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  1. When the kidneys fail People with kidney failure (腎衰竭) must be treated immediately.

  2. When the kidneys fail They can either undergo a kidney transplant (移植). transplanted kidney

  3. When the kidneys fail They can either use a kidney machine (洗腎機).

  4. When the kidneys fail They can either undergo peritoneal dialysis (腹膜透析). dialysis fluid in 4 hours later dialysis fluid out

  5. When the kidneys fail They also have to make some changes in their diet. e.g. avoid taking too much fluid and high-protein food.

  6. 1.1 Importance of regulating water content water intake water loss balanced

  7. Water Balance in the Body • Figure 20-2

  8. Water • balance in a • kangaroo rat • (2 mL/day) • Water • balance in • a human • (2,500 mL/day) • Ingested • in food • (750 mL) • Ingested • in liquid • (1,500 mL) • Ingested • in food (0.2 mL) • Water • gain • Derived from • metabolism (1.8 mL) • Derived from • metabolism (250 mL) • Urine • (1,500 mL) • Feces (100 mL) • Feces (0.09 mL) • Urine • (0.45 mL) • Water • loss • Evaporation (900 mL) • Evaporation (1.46 mL) • Land animals manage water budgets by drinking and eating moist foods and using metabolic water

  9. 1.1 Importance of regulating water content • if water intake  water loss  affects water content in blood  affects water potential of tissue fluid  water enters or leaves cells by osmosis  cells do not function properly or even die

  10. 1.1 Importance of regulating water content control of the water content in the body osmoregulation (滲透調節) done by kidneys of urinary system (泌尿系統)

  11. 1.1 Importance of regulating water content 1 keeps the water potential of the tissue fluid and hence the water potential of the cells stable, so that cells can function properly to sustain life. Osmoregulation

  12. 1.1 Importance of regulating water content 2 The of the system are the major organs for osmoregulation. kidneys urinary

  13. 1.2 The human urinary system (dorsal aorta) (posterior vena cava) (renal artery) (renal vein) • Despite their small size, the two kidneys receive an enormous blood flow — about 1.2 litres/min /2000 litres per day in an adult — which is a quarter of the total output of the heart (5 litres/min). female

  14. 1.2 The human urinary system kidneys ureters urinary bladder female

  15. 1.2 The human urinary system control urination sphincter muscles female

  16. 1.2 The human urinary system male female urethra

  17. 1.2 The human urinary system ureters urinary bladder (vas deferens) urethra male (penis)

  18. 1.2 The human urinary system Structure of the kidney 3D model cortex (皮質) medulla (髓) renal vein pelvis (腎盂) renal artery ureter

  19. 1.2 The human urinary system Structure of the kidney

  20. 1.2 The human urinary system Structure of the kidney cortex medulla

  21. 1.2 The human urinary system Structure of the kidney branch from renal artery branch from renal vein

  22. 1.2 The human urinary system Structure of the kidney nephron (腎元)

  23. Key functions of most excretory systems: • Filtration: pressure-filtering of body fluids • Reabsorption: reclaiming valuable solutes • Secretion: adding toxins and other solutes from the body fluids to the filtrate • Capillary • Filtration • Excretory • tubule • Filtrate • Reabsorption • Secretion • Urine • Excretion

  24. 1.2 The human urinary system Structure of the kidney proximal convoluted tubule distal convoluted tubule Bowman’s capsule kidney tubule loope of Henle collecting duct

  25. 1.2 The human urinary system Structure of the kidney proximal convoluted tubule distal convoluted tubule flow of urine Bowman’s capsule from another nephron loop of Henle collecting duct

  26. 1.2 The human urinary system Structure of the kidney glomerulus Bowman’s capsule kidney tubule

  27. Capillary Beds of the Nephron • Every nephron has two capillary beds • Glomerulus • Peritubular capillaries • Each glomerulus is: • Fed by an afferent arteriole • Drained by an efferent arteriole

  28. 1.2 The human urinary system Blood supply of a nephron efferent arteriole glomerulus afferent arteriole Peritubular capillary branch from renal artery branch from renal vein

  29. 1.2 The human urinary system 1.2 Examination of the mammalian kidney 1 Put a fresh pig’s kidney on a dissection tray. 2 Examine whether there are tubes coming from the kidney. Remove any fatty tissues and identify the tubes.

  30. 1.2 The human urinary system 1.2 3 Cut the kidney longitudinally.

  31. 1.2 The human urinary system 1.2 4 Identify various structures of the kidney. 5 Draw a labelled diagram of the longitudinal section of the kidney.

  32. 1.2 The human urinary system 1 Kidneys Ureters

  33. 1.2 The human urinary system 1 Urinary bladder Urethra

  34. 1.2 The human urinary system 2 Structure of a nephron: a A nephron consists of the , the Bowman’s capsule , proximal convoluted tubule the distal convoluted tubule and the . collecting duct

  35. 1.2 The human urinary system 2 Structure of a nephron: b The Bowman’s capsule encloses a network of capillaries called the glomerulus . The kidney tubule is surrounded by another network of capillaries which is continuous with the glomerulus.

  36. 1.3 Functioning of a nephron • urine is formed by mainly two processes: ultrafiltration (超濾) reabsorption (重吸收)

  37. 1.3 Functioning of a nephron • and: ultrafiltration reabsorption Active secretion

  38. Mechanism of Urine Formation • Urine formation and adjustment of blood composition involve three major processes • Glomerular filtration • Tubular reabsorption • Active Secretion • Figure 24.9

  39. 1.3 Functioning of a nephron 1 Ultrafiltration Bowman’s capsule • blood is under high hydrostatic pressure • capillary wall is differentially permeable • forces small molecules through the thin walls glomerulus

  40. 1.3 Functioning of a nephron 1 Ultrafiltration urea salts glucose water amino acids

  41. 1.3 Functioning of a nephron 1 Ultrafiltration • fluid filtered into the Bowman’s capsule: glomerular filtrate to proximal convoluted tubule

  42. 1.3 Functioning of a nephron 1 Ultrafiltration • composition similar to plasma plasma proteins water  glucose amino acids salts urea to proximal convoluted tubule

  43. Net Filtration Pressure (NFP) _ref only • The pressure responsible for filtrate formation • NFP equals the glomerular hydrostatic pressure (HPg) minus the osmotic pressure of glomerular blood (OPg) combined with the capsular hydrostatic pressure (HPc) NFP = HPg – (OPg + HPc)

  44. Glomerular Filtration Rate (GFR) NFP = HPg – (OPg + HPc) • Figure 24.10

  45. 1.3 Functioning of a nephron 2 Reabsorption • absorption of useful substances and most of the water from the filtrate to the blood • Your kidneys filter approximately 200L of plasma/day • 99% of the filtrate gets reabsorbed, leaving 1 -2 L of urine per day

  46. 1.3 Functioning of a nephron 2 Reabsorption to renal vein flow of urine from renal artery

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