Renal Physiology
Dereck Salisbury, PhD
Thousands of metabolic processes in myriad body cells
produce hundreds of waste products. The urinary
system removes them by filtering and cleansing the
blood as it passes through the kidneys. Another vital
function is the regulation fo the volume, acidity,
salinity, concentration, and chemical composition of
the blood, lymph, and other body fluids. Under
hormonal control, the kidneys continually monitor
what they release into the urine to maintain a healthy
chemical balance. Disorders of the system can be
subtle, so urination related symptoms should be
reported promptly.
Outline
• Review the function, the gross macro and micro
anatomy of urinary system.
• Describe the parts of the renal nephron and the
Starlings forces in the glomerulus and Bowman's
capsule.
• Discuss the autoregulatory, sympathetic and
hormonal means of regulating the GFR
• Describe the major transport mechanisms in the
renal tubules for water, glucose, amino acids,
hydrogen, bicarbonate, sodium and potassium
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Outline
• Describe the regulation of the renin-angiogensin-
aldosterone system and the influence of these
substances on renal function.
• Describe the regulation of antidiuretic hormone
(ADH) and the countercurrent mechanism
• Define renal clearance and glomerular filtration rate.
• Discuss the expected changes in blood and urine
values with renal dysfunction.
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Part I: Renal Structures and Flow
Renal Functions
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Structure of the Urinary System
• Ureters: transport urine from
kidneys to bladder
• Bladder: store urine until
voided from body
• Urethra: carry urine from
bladder to the outside of the
body
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Structure of the Kidneys
• Nephrons are the structural and
functional units of the kidney. Each kidney
has over 1 million of these units.
• Each nephron consists of a glomerulus,
which is a tuft of capillaries and a renal
tubule.
• The tubule forms a cup shape around the
glomerulus called the glomerular capsule
(Bowman’s capsule).
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Capillaries Associated with Nephrons
• Nephrons are associated with 2 sets of
capillaries: glomerular and peritubular.
• The glomerular capillaries are specialized
for filtration. These are the only capillaries
in the body that are fed and drained by an
arteriole (afferent and efferent).
• This allows the blood pressure in the
capillary bed to be very high and it forces
fluid and solute out of the blood into the
glomerular capsule.
• Most of the filtrate is reabsorbed in the
renal tubule cells and returns to the blood
through the peritubular capillaries.
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Flow through the Nephron
Basic Renal Processes
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Juxtaglomerular Apparatus
• In the arteriole wall the granular cells
(juxtaglomerular cells (JG)) are enlarged smooth
muscle cells that have secretory granules which
contain the hormone renin (part of the renin-
angiotensin system (RAS).
• The JG cells are mechanoreceptors (they sense
blood pressure) in the afferent arteriole .
• The macula densa is a group of tall, closely-
packed cells that are adjacent to the granular JG
cells.
• The macula densa cells are chemoreceptors that
respond to changes in the NaCl content of the
filtrate.
• These cells work in tandem and are critical
regulators of blood pressure.
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Glomerulus
• Associate with Filtration!
• The capillaries of the glomerulus
are fenestrated, which allows
large amounts of solute-rich fluid
to pass, except proteins.
• The inner layer of the glomerular
capsule contains highly modified
branching epithelial cells called
podocytes.
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Cortical vs. Juxtamedullary Nephrons
• Juxtamedullary Nephrons:
– Long loop of Henle
– Involved in the concentration of urine
– Found at the border between the cortex and medulla
– About 15% of all nephrons are in this category
• Cortical Nephrons:
– Most nephrons are in this category
– Short loop of Henle
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Capillaries Associated with Nephrons
• Nephrons are associated with 2 sets of capillaries:
glomerular and peritubular.
• The glomerular capillaries are specialized for filtration.
These are the only capillaries in the body that are fed and
drained by an arteriole (afferent and efferent).
• This allows the blood pressure in the capillary bed to be
very high and it forces fluid and solute out of the blood into
the glomerular capsule.
• Most of the filtrate is reabsorbed in the renal tubule cells
and returns to the blood through the peritubular
capillaries.
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Basic Structure of a Nephron
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Group Activity
• Describe the flow of unfiltered blood through the kidney vs
flow of filtrate to the ureter
• Describe the functions of the various structures of the
glomerulus: juxtaglomerulur apparatus, juxtaglomerulus
cells, macula densa, bowman capsule
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Questions?
