Urinary System
P.954 Every day kidneys filter nearly
200 liters of fluid from the blood
stream, allowing toxins, metabolic
wastes, excess ions to leave as urine
while returning the needed substances
99% of the filtrate is reabsorbed, only
1.5 to 2 L pass as urine
Kidneys are the major excretory organs
P.955 Renin- an enzyme, helps to
regulate blood pressure
Erythropoietin – an hormone, stimulates
RBC production
Metabolize vitamin D to its active form
Gluconeogenesis during prolonged
fasting
Kidney Anatomy
Bean shaped, lie retroperitoneally
Lateral surface is convex
Medial surface is concave, has a vertical
cleft called renal hilus, that leads
within the kidney called renal sinus,
contains ureters, blood vessels,
lymphatics, and nerves
Adrenal gland – sits atop each kidney
Kidney Anatomy
Renal (fibrous) capsule –
Adipose tissue –
Renal fascia –
P.956 Renal cortex, medulla, and pelvis
Renal pyramids – broad base faces
toward the cortex; its apex is papilla
Minor calyces, major calyces, renal
pelvis
Nephrons
P.957 Renal arteries and renal veins –
P.958 Nephrons are the structural &
functional units of the kidneys
Each kidney contains over 1 million of
these tiny blood-processing units; carry
out these processes and form urine
Each nephron consists of a glomerulus
and a renal tubule
Glomerular capsule (or Bowman’s
capsule) – surrounds the glomerulus
Renal corpuscle – glomerular capsule
and the enclosed glomerulus
Glomerular endothelium is fenestrated
(penetrated by many pores which
makes these capillaries extremely
porous
Filtrate – contains everything from
blood except protein and blood cells
Parietal layer of the glomerular capsule
P.960 Visceral layer clings to the
glomerulus, consists of highly modified
epithelial cells called podocytes
Proximal convoluted tubule (PCT) –
Loop of Henle -
Distal convoluted tubule (DCT) –
Collecting ducts –
Papillary ducts – deliver urine into the
minor calyces
Walls of the PCT are cuboidal epithelial
U-shaped loop of Henle has descending
and ascending limbs; has thin and thick
segments
Nephron Capillary Beds
Glomerulus and peritubular capillaries
P.962 Glomerulus, a tuft of capillaries,
is specialized for filtration
It is both fed and drained by arterioles -
affarent and efferent arterioles
Arterioles are high resistance vessels
Affarent arteriole has a larger diameter
than the efferent, makes the BP high
Cortical nephrons – 85%, only small
parts of the loop of the Henle dip into
the outer medulla
Juxtamedullary nephrons – are at
the cortico-medullary junction; play an
important role in the kidney’s ability to
produce concentrated urine; their loops
of Henle invade deep into the medulla
Most of this filtrate (99%) is reabsorbed
by the renal tubule cells and returned to
blood by the peritubular capillaries
Peritubular capillaries, arise from
the efferent arterioles, cling closely to
the renal tubule and empty into venules
Vasa recta – bundles of long straight
vessels in the loop of Henle
The first capillary bed (glomerulus)
produces filtrate
The second (peritubular capillaries)
reclaims most of the filtrate
Juxtaglomerular Complex (JGC) –
lies at the juncture of DCT and afferent
arteriole
P.963 Granular or Juxtaglomerular
(JG) cells – secrete renin, act as
mechanoreceptors that sense the
pressure in the affarent arteriole
Macula densa cells – closely packed
DCT cells lies adjacent to JG cells; are
chemoreceptors (osmoreceptors) that
respond changes in the solute content
Mechanism of Urine Formation
Involve three processes :
Glomerular filtration -
Tubular reabsorption -
Tubular secretion -
About 1200 ml of blood passes through
the glomeruli each minute; 650 ml is
plasma, and 1/5 of this (120 – 125 ml)
is forced into the renal tubules
Filtrate and urine are quite different
Filtrate contains everything found in
blood plasma except proteins
Mostly metabolic wastes
By the time filtrate has reached into the
collecting duct most of its water,
nutrients, and ions; remains now urine
Contains mostly water and unneeded
substances
Kidneys process about 180 L of fluid
daily. Of this amount, only about 1%
(1.8 L) actually leaves the body as urine
Filtration Membrane
P.965 Lies between blood and visceral
layer of glomerular capsule
Porous membrane that allows free
passage of water and solutes smaller
than plasma proteins
Fenestrated endothelium of glomerular
capillaries
Podocytes in the visceral membrane
Step 1: Glomerular Filtration
Glomerular filtration by the glomeruli
Tubular reabsorption and secretion in
the renal tubules
Glomerular filtration – a passive process
A more efficient filter than are other
capillary beds, because
Its filtration membrane has a large
surface area and is thousands of times
More permeable to water and solutes
Glomerular blood pressure is much
higher than that in other capillary beds
(55 mm Hg as opposed to 18 mm Hg)
resulting in a much higher net filtration
pressure;as a result of these differences
Kidneys produce about 180 L of filtrate
daily, as opposed 2 to 4 L daily by other
capillary beds of the body combined
Net Filtration Pressure (NFP)
P.965 Glomerular hydrostatic
pressure (HPgc) – chief force pushing
water and solutes out of the blood and
across the filtration membrane
HPg is opposed by two forces:
P.966 Colloid osmotic pressure of
blood (OPgc) –
Capsular hydrostatic pressure(HPcs
NFP = HPgc – (OPgc + HPcs)
= 55 – (30 + 15)
= 10 mm Hg
Glomerular filtration rate (GFR) – is
the volume of filtrate formed each
minute by the combined activity of 2
million glomeruli of the kidneys
Factors governing the filtration rate are:
(1) total suface area available for
filtration
(2) filtration membrane permeabilty
(3)Net filtration pressure (NFP)
Normal GFR is 120 – 125 ml/min
GFR is directly proportional to the NFP,
any change in any of the pressures
would change both the NFP and GFR
Renin-angiotensin mechanism
P.968 is triggered when various stimuli
cause the JG cells to release renin
Renin acts angiotesinogen, made by
the liver, to make angiotensin I,
which is converted to angiotensin II
by angiotensin converting enzyme
(ACE), a potent vasoconstrictor
It also stimulates the adrenal cortex to
release aldosterone, which causes renal
tubule to reclaim more sodium ions
from the filtrate
As water follows sodium osmotically
blood volume and blood pressure rise
Angio II causes efferent arterioles to
constrict to a greater extent and
thereby increasing HPg
Step 2: Tubular Reabsorbtion
P.968 It begins as soon as the filtrate
enters the proximal tubules
To reach the blood, substances move
through three membrane barriers – the
luminal and basolateral membranes of
the tubule cells and the endothelium of
the peritubular capillaries
Virtually all organic nutrients such as
glucose and amino acids are completely
reabsorbed
On the other hand, water and many
ions are continuously regulated and
adjusted in response to as needed
The reabsorption process is either
passive or active
Sodium Reabsorption
Na+ - passive, active, and passive
P.970 Transport maximum (Tm) – for
nearly every substances that is actively
reabsorbed; it reflects the number of
carriers in the renal tubules available to
ferry each particular substance
When the transporters are saturated –
the excess is excreted in urine
As plasma levels of glucose exceed 180mg/dl,
the glucose Tm is exceeded and large
amounts of glucose will be lost in the urine
even though the renal tubules are functioning
normally
H20 - “obliged” to follow salt, called
obligatory water reabsorption
Nonabsorbed substances – either not
reabsorbed or reabsorbed incompletely: urea,
uric acid, creatinine
Absorptive Capabilities of the
Renal Tubules and Collecting
Ducts
P.970 Proximal Convoluted Tubule
– the entire renal tubule is involved in
reabsorption to some degree, the PCT
cells are by far the most active
“reabsorbers”
Reabsorbs all of the glucose, lactate,
and amino acids; 65% Na and H20,
55% K, 60% Cl, 80% bicarbonate
P.971 Nephron Loop – water
reabsorption is not coupled to solute
reabsorption; water can leave the
descending limb of the loop of Henle
but not the ascending limb
These permeability differences play a
vital role in the kidney’s ability to form
dilute and concentrated urine
P.972 Distal Convoluted Tubule
and Collecting Duct – By the time the
DCT is reached, only 10% of the filtered
NaCl and 25% of the water is there
Effect of aldosterone – Na+ reabsorbed,
water follows, and excrete K+
Atrial natriuretic peptide (ANP) –
Excrete Na+, water follows
Step 3: Tubular Secretion
Substances such as H+, K+, NH4+,
Creatinine, and certain organic
substances move from the tubule cells
into the filtrate
Disposing certain drugs
Eliminating undesirable substances
Controlling blood pH
Regulation of Urine
Concentration and Volume
P.973 Osmolality – is the number of
solute particles dissolved in one liter of
water
Milliosmol – 1/1000 or 0.001 osmol
300 mOsm, the osmotic concentration
of the blood plasma; kidneys play a
great role to maintain it
Countercurrent mechanism -
The term countercurrent means that
something flows in opposite direction
through adjacent channels
Osmolality increases from 300 to about
1200 mOsm in the deepest part of the
medulla
Countercurrent Multiplier
1. The descending limb of the loop of
the Henle is relatively impermeable to
solutes and freely permeable to water
2. The ascending limb is permeable to
solutes but not to water – filtrate in the
ascending limb becomes increasingly
dilute until, 100 mOsm at the DCT, it is
hypotonic to blood plasma
3. The collecting ducts in the medullary
regions are permeable to urea –
P.976 Formation of Dilute Urine –
when ADH is not released by the
posterior pituitary
Collecting duct remain impermeable to
water, no further water reabsorption
Formation of Concentrated Urine –
ADH inhibits diuresis or urine output;
water passes through the principals
cells of the collecting ducts
Summary of nephron functions
(a) Proximal tubules – nearly all
nutrients and 65% Na are absorbed; Cl-
and water follows
(b) Descending limb – is freely
permeable to water but not to NaCl
(c) Ascending limb – is impermeable
to water but permeable to Na+ and Cl-
(d) Distal tubule – more Na+ is
reabsorbed in the presence of
aldosterone; water permeability is
extremely low
(e) Collecting duct – is more
permeable to urea and is made more so
by the presence of ADH
In absence of ADH it is nearly
impermeable to water, and the dilute
urine passes out
In presence of ADH,water is reabsorbed
and concentrated urine is excreted
Renal Clearance
P.978 refers to the volume of plasma
that is cleared of a particular substance
in a given time, usually 1 minute
Tests are done to determine the GFR,
provides information about the amount
of functioning renal tissue
Renal Clearance (RC) = UV/P
U = conc. of the substance in urine
V = flow rate of urine formation
P = conc. of the substance in plasma
Inulin, a polysaccharide, is often used
as the standard to determine GFR, it is
not reabsorbed, secreted, or stored
Urine
Color – clear and pale to deep yellow is
due to urochrome, a pigment that
results from the body’s destruction of
hemoglobin via bilirubin
Odor –slightly aromatic, develops an
ammonia odor on standing; diabetic
urine is smells fruity due to acetone
pH – slightly acidic (around pH 6)
Specific Gravity – 1.002 to 1.035
Micturition
P.982 Voiding or urination – act of
emptying the bladder; distension of the
bladder walls activates stretch receptors
Visceral afferents activate the
micturition center, parasympathetic
outflow stimulate contraction of
detrusor muscle and relaxation of
internal and external sphincters
