urine takes place along the lower (distal) portion of nn a Production of Concentrated Urine, ihe “tubules whist “known ‘heulta absorption. This fraction amounts to 13 10 20% oF ountee Gees eaters reteg even ceetias es | ogg eee MErent Theory, osmotic pressure of urine, and it requires energy 7 Which is provided by the metabolic activity of the The production of concentrated hypertonic yg, ere eee ais) a complex process and is closely related wig The active distribution of the renal tubules an excretion of materials involves the diffusion of concentration of Na* in the interstitial mgt Sinerials from the capillary beds into the kidney different levels of the cortex and medulla of tissue fluid and then in metabolic transfer from the kidney (Fig. 4). cortex outer zone of medulla inner zone of medulla active passive sodium me urea me transport water ie. 4. Diagram illustrating the countercurrent mechanism as itis believed to operate im 9° lait long loop in the vasa reacta (represented on the right). The numbers represent hypottietlell © saenis talucs, No quantitative significance is to be attached to the number of arrows and only 172 are indicated,peoretion — a The loop of He, le wi essels descends fro, ‘© with its surrounding blood 2 d after taking a tu; m the cortex into the medulla a ™ again enters the cortex. This grrangement of the loop r F n esembles 1 is ‘The osmotic CONCentration of the a oc aa aa peritubular fluid increases towards the medulla. The glomerular filtrate has an osmotic concentration equal to that of plasma. In the proximal tubule about 80% of fluid is reabsorbed. Thus, the fluid entering the descending limb of the loop of Henle is isotonic and the surrounding interstitial or peritubular fluid is hypertonic. Therefore, sodium ions passively ijfuse into the tubular fluid and make it hypertonic. During the passage of fluid through the ascending limb of loop of Henle, sodium ions leave the tubular fluid and re-enter the peritubular fluid. The ascending limb is impermeable to water. ‘Thus, the fluid in the tubule becomes hypotonic as it enters into the distal convoluted tubule. ‘The permeability to water of the distal convoluted tubular epithelium is under the control of the antidiuretic hormone. Under the influence of this hormone, water is absorbed by the distal tubule resulting is an isotonic state of the fluid. As this isotonic fluid passes through the collecting tubule, it becomes again hypertonic due to the ionic and water exchange between the tubular fluid and in the interstitial fluid of medulla. ‘Thus, finally, a hypertonic urine is produced in the kidney. Sometimes, when body fluids are diluted, dilute urine has to be excreted by animals. The Volume of water osmotically transported from the collecting tubule into the peritubular fluids depends on the permeability of the collecting tubule. The Permeability of collecting tubule is controlled by antidiuretic hormone or vasopressin. In the absence of vasopressin the epithelium of the collecting ‘ubule is impermeable to water, and water cannot leave the tubules in response to the higher osmotic Concentration outside. Under these conditions, a dilute urine is produced and excess water is ©Xeretcd. When water conservation becomes Heeessary, the hypothalamo-hypophyseal system is activated and vasopressin is released. The Collecting tubular epithelial cells permeability to Water is increased, and water is absorbed resulting " concentrated urine production. ion The peritubular fluid remains hypertonic due (i) active transport of one or more solutes by the ascending loop of Henle, (ii) differences in the permeability to NaCl and water in the ascending and descending limbs of the loop of Henle, and (iii) the 'U’ shaped configuration of the loop of Henle resulting in a counter current of the tubular fluid. The ascending limb actively transports Na* and CI” but impermeable to water. The descending tubular cells are permeable to water and passive diffusion of NaCl, Thus, the descending and ascending limbs constitute a counter current flow system and the active and passive movements of, NaCl establish an osmotic gradient in the interstitial fluid. As extremely high concentrations of NaCl can be produced at the tip of the loop of Henle in the medulla, the system is known as counter current multiplier system. Vasa recta. The concentration of NaCl can also increase in the interstitial fluid of the medulla because of the counter current flow system of the vasa recta. Some of the peritubular capillaries arising from the efferent arteriole descend into the medulla along with the loops of Henle. The ‘osmotic concentration of the blood in the descending limb of vasa recta is about 320 m osm. During the passage of the tubule deep into the medulla, NaCI from the medullary fluid enters the flowing blood of the vasa recta through the very permeable walls. Thus, the osmotic concentration of the blood goes on increasing towards the top of the vasa recta, As the blood takes a turn in loop and flows upward in the ascending limb into the more dilute region of the medullary peritubular fluid, NaCl leaves the blood and diffuses into the medullary fluid. The counter current in the vasa recta and movement of NaCl help to maintain the osmotic concentration gradient of the interstitial fluid in the medulla. Very little quantity of NaCl is carried away by the blood and the osmotic concentration of the blood that enters and leaves the vasa recta is the same. Blood flow through the ‘vasa recta is very slow and it becomes still slower as the concentration becomes increased medullary region. alanee Role of Kidney in Acid-base Ba i e The hydrogen ion concentration of PE of maintained at pH ‘Daily about 40-H-ions are produced by the incomplete oxidation of fats and carbohydrates and by the oxidation of sulfur containing amino acids, In diabetes about 400 m eq of hydrogen ions are produced but there is only a slight fall in plasma pH. The kidney excretes acidic urine in acidaemia, and more alkaline urine in alkalaemia. The kidneys ability to vary the pH of urine is dependent upon the secretion of hydrogen ions in the proximal tubule and the production of ammonia in the distal and collecting tubules As the glomerular filtrate passes through the renal tubule, its pH decreases by 0.3 to 0.5 units in the proximal and distal tubule by 1 to 2 units in the collecting ducts. This is due to the small volume of fluid in the collecting ducts. The secretion of free hydrogen ions is accompanied by the reabsorption of sodium bicarbonate from the tubular fluid under the influence of carbonic anhydrase which increases the concentration of hydrogen ions in the tubular cell. The free H ions are exchanged for Na ions. H ions enter the tubular fluid while Na ions combine with intracellular bicarbonate sodium bicarbonate. From the tubular bicarbonate enters the plasma while j lumen H ions combine hieemaee pe carbonic acid which breaks into H,0 ang co, CO, diffuses into the tubular cell where Ge i utilized to form more H ions or enters the blog The net result is that all the bicarbonate of ge glomerular filtrate is reabsorbed and 11 jong W'S z= ions to form cell sodium exereted. The H' is either buffered by phophing combined with ammonia. The unr phosphate present in the glomerular filtrate eats with carbonic acid to form bicarbonate, HPO; +H,CO; == HPO; +HCO; The dihydrogen phosphate so formed i excreted while the bicarbonate is reabsorbed y supply base to plasma. Part of the hydrogen ios the tubular fluid combines with ammonia to fim ammonium (NH; ) ions which are acidic in mee The overall mechanism ,of excretion of H' 3 shown in figure 5 Sf Regulation of Kidney Function Changes in arterial blood pressure, though oe changes in urinary out put, produce relatively alterations in glomerular filtration rate 0 © " blood flow. The ability of glomerular filtration and renal blood flow to resist changes in blood pressure is known as autores Nervous system plays little role in this ne because denervated kidney maintains @ oy a level of glomerular filtration rate and renal flow indicating that the mechanism lies wit" kidney itself, io It is believed that the autores mechanism involves the _juxtaglomet apparatus Which is a complex structure in “silular components from the affarent and ¢