- The kidneys are said to be retroperitoneal

CHAPTER 13. THE URINARY SYSTEM because it is posterior to the peritoneum of

abdominal cavity.
- Consists of two kidneys, two ureters, one urinary
bladder, and one urethra. EXTERNAL ANATOMY OF KIDNEYS
- They filter blood and excrete them into fluid
called urine. - Typical adult kidney is about the side of bar of
bath soap.
FUNCTIONS OF THE KIDNEY - The concave medial border is an indentation
called renal hilum, through which ureter
- Does the major work in urinary system emerges from kidney along with blood vessels,
1. EXCRETION OF WASTE lymphatic vessel, and nerves.
- Help excrete wastes from body by forming urine
- Some wastes excreted through urine result from
metabolic reactions in body
- Urea and ammonia from deamination of amino
acid
- Creatinine from breakdown of creatine
phosphate
- Uric acid from catabolism of nucleic acid
- Urea, ammonia, creatinine, uric acid, urobilin
are known as nitrogenous wastes
2. REGULATION OF BLOOD IONIC
COMPOSITION
- Regulate blood level of ions (Na, K, Ca, Cl,
HPO)
- Kidney adjusts amount of ions excreted into
urine
3. REGULATION OF BLOOD PH
- Excrete amount of hydrogen ions into urine and
conserve bicarbonate ions, which is an
important buffer of H+ in blood
4. REGULATION OF BLOOD VOLUME
- Kidneys adjust blood volume by conserving or - Kidney has three layers of tissue:
eliminating water in the urine 1. RENAL CAPSULE
5. REGULATION OF BLOOD PRESSURE - Smooth, transparent sheet of dense
- Help regulate blood pressure by secreting the irregular connective tissue
enzyme renin, which activates renin-angiotensin - Serves as a barrier against trauma and
aldosterone pathway helps maintain ns the shape of kidney
6. MAINTENANCE OF BLOOD OSMOLARITY 2. ADIPOSE CAPSULE
- Regulating loss of water and loss of solutes in - Mass of fatty tissue surrounding the renal
the urine capsule
- Kidneys maintain a relatively constant blood - Protects kidney from trauma and holds it
osmolarity (concentration of chemical particles firmly in place within abdominal cavity
found in blood) 3. RENAL FASCIA
7. PRODUCTION OF HORMONES - Another thin layer of dense irregular
- Produces two hormones connective tissue
- Calcitriol, active form of vitamin D, regulates - Anchors the kidney to the surrounding
calcium homeostasis structures and to the abdominal wall
- Erythropoietin stimulates the production of red
blood cells
8. REGULATION OF BLOOD GLUCOSE LEVEL
- The kidneys can use the amino acid glutamine
in gluconeogenesis, the synthesis of glucose
molecules.

ANATOMY OF KIDNEYS

- Kidneys are reddish, kidney bean-shaped

organs located just above the waist between the
peritoneum and posterior wall of abdomen.
 INTERNAL ANATOMY OF KIDNEYS - Renal nerves originate in renal ganglion and
pass through renal plexus.
If cut, TWO regions can be seen: - Renal nerves are part of sympathetic division of
autonomic nervous system.
1. RENAL CORTEX
- Superficial, light red region PARTS OF A NEPHRON
2. RENAL MEDULLA
- Deep, darker reddish-brown inner region - Nephrons are the functional units of the kidneys
- Consists of multiple cone-shaped pyramids. - Consists of TWO parts:
- Has a base and apex 1. RENAL CORPUSCLE
- Apex of medulla is called a renal papilla - Where the blood plasma is filtered
- Portions in renal cortex that extend between - Has two parts:
renal pyramids are called renal columns. a. GLOMERULUS
- Capillary network of kidney
Renal cortex and pyramids form the PARENCHYMA or b. GLOMERULAR CAPSULE
the functional portion of kidney. - Also called Bowman’s capsule
- Epithelial cup that surrounds the
- Within the parenchyma are functional units of glomerulus
kidney called the nephrons. 2. RENAL TUBULE
- Filtrate formed by nephrons travel into the large - Where the filtrate passes
papillary duct and drain into cuplike structures - Has three main sections:
called minor and major calyces. a. PROXIMAL CONVOLUTED
- Each kidney has 8-18 minor calyces and 2 or 3 TUBULE
major calyces. - Connected to glomerular capsule
- Renal pelvis is a large cavity that is connected - Lie in renal cortex
to major calyces and ureter. - Convoluted, meaning tightly coiled
- Renal sinus contains part of renal pelvis, b. NEPHRON LOOP
calyces, and branches of blood vessels and - Extend to medulla and returns to
nerves. renal cortex
- Connects proximal and distal
BLOOD AND NERVE SUPPLY OF KIDNEYS convoluted tubule
- Begins in renal cortex and extends
Receives 20-25% cardiac output downward into medulla, this is
called descending limb of
Supplies to different segments of kidney nephron loop
- When the loop returns to renal
Branches that enter parenchyma and pass cortex and terminates at the distal
through renal columns
convoluted tubule and is known as
Branches that are found in bases of pyramids
ascending limb of nephron loop
c. DISTAL CONVOLUTED TUBULE
- Connected to collecting duct
Radiate outward and enter renal cortex
- Lie in renal cortex
- Convoluted
Branches that supplies one nephron - 80-85% of nephrons are cortical nephrons.
Renal corpuscles are in renal cortex, has short
Tangled, ball-shaped capillary network nephron loops that lie mainly on renal cortex and
penetrate outer layer of medulla.
Carry blood out of glomerulus
FLOW OF FLUID IN CORTICAL NEPHRON:
Surround tubular parts of nephron in the
renal cortex

Peritubular capillaries reunite to form this

Blood drains to arcuate vein to interlobar - 15-20% of nephrons are juxtamedullary

vein between pyramids
nephrons. Renal corpuscles lie in deep cortex,
has long nephron loops that extend to deep
medulla, has two portions of ascending limb: 1)
This vein exits through renal hilum and thin ascending limb, followed by 2) thick
carries blood to IVC
ascending limb.
FLOW IN JUXTAMEDULLARY NEPPRON: - Descending limb and thin ascending limb are
composed of simple squamous epithelium
- The thick ascending limb, composed of simple
cuboidal to low columnar epithelium, makes
contact with the afferent arteriole.
- The columnar tubule cells in the region of
contact are crowded together and are known as
macula densa.
- The wall of afferent arterioles contain smooth
muscle fibers called juxtaglomerular cells.
Together with macula densa, they make
juxtaglomerular apparatus. This apparatus
helps with regulating blood pressure.
- In the last part of distal convoluted tubule and
collecting duct, there are TWO types of cells:
1. PRINCIPAL CELLS
- Have receptors for antidiuretic hormones
and aldosterone; most present cell
2. INTERCALATED CELLS
- Play a role in homeostasis of blood pH;
smaller in number
- The number of nephron is constant from birth.

HISTOLOGY OF NEPHRON AND COLLECTING OVERVIEW OF RENAL PHYSIOLOGY

DUCT - To produce urine, nephrons and collecting duct
perform three basic processes:
- Single layer of epithelial cells forms the entire 1. GLOMERULAR FILTRATION
wall of glomerular capsule, renal tubule, and - Water and most solutes in blood plasma
ducts. move across the wall of glomerular
capillaries, they are filtered and
GLOMERULAR CAPSULE transported into glomerular capsule and
then into the renal tubule.
- Consists of visceral and parietal layer 2. TUBULAR REABSORPTION
- VISCERAL LAYER: consists of modified simple - As filtered fluid flows through renal tubule
squamous epithelial cells called podocytes, and through the collecting ducts, tubule
which have footlike projections that wrap around cells reabsorb 99% of the filtered water
a single layer of epithelial cells and form the and useful solutes. These substances
inner wall of capsule. return to the blood as it flows in the
- PARIETAL LAYER: consists of squamous peritubular capillaries and vasa recta.
epithelium, forms outer wall of capsule 3. TUBULAR SECRETION
- Capsular space is the space between the two - As filtered fluid flows through the renal
layers of glomerular capsule. tubules and collecting ducts, the renal
tubule and duct cells secrete wastes,
drugs, and excess ions into the fluid.
- Solutes that drain into the minor and major
calyces and renal pelvis are already urine and
are excreted.
- By filtering, reabsorbing, and secreting,
nephrons help maintain homeostasis of the
blood’s volume and composition.

GLOMERULAR FILTRATION

- Fluid that enters the capsular space is called

glomerular filtrate.
RENAL TUBULE AND COLLECTING DUCT
FILTRATION MEMBRANE
- In the proximal convoluted tubule, cells are
simple cuboidal epithelial cells with a prominent - Glomerular capillaries and podocytes form this
border of microvilli on their apical surface. This - Filtration membrane is a leaky barrier that
increases the surface area for reabsorption and permits filtration of water and small solutes but
secretion.
 prevents filtration of most plasma proteins and HORMONAL REGULATION OF GFR
blood cells.
- Substances filtered from blood cross THREE - TWO hormones contribute to regulation of GFR
filtration barrier: 1. ANGIOTENSIN II
1. GLOMERULAR ENDOTHELIAL CELLS - Potent vasoconstrictor that narrows
- Leaky because they have large both afferent and efferent arterioles and
fenestrations (pores) reduces renal blood flow
- Permits all solutes in blood plasma to - DECREASES GFR
exit glomerular capillaries but prevent 2. ATRIAL NATRIURETIC PEPTIDE (ANP)
filtration of blood cells. - Cells in atria secrete ANP through
- Has mesangial cells that contract and contraction
help regulate filtration. - By relaxing the mesangial cells, ANP
2. BASEMENT MEMBRANE increases capillary surface area for
- Layer of acellular material between filtration
endothelium and podocytes - INCREASES GFR as surface area rises
- Allows water and most small solutes to
pass through PRINCIPLES OF TUBULAR REABSORPTION AND
3. FILTRATION SLIT
- These are spaces between pedicels SECRETION
- Has slit membrane that extends across
which permits passage of small - Reabsorption is the return of most of the filtered
molecules such as water, glucose, water and many of the filtered solutes to the
vitamins, amino acids, very small bloodstream
plasma proteins, ammonia, urea, and - Reabsorption is the second basic function of
ions. nephron and collecting duct.

Epithelial cells along the renal tubule and duct carry out
GLOMERULAR FILTRATION RATE
the reabsorption, but PCT makes the largest
contribution.
- Amount of filtrate formed in all renal corpuscles
of both kidneys each minute - Some of the solutes that are reabsorbed include
- Averages 125 mL/min in males, 105 mL/min in Na, K, Ca, Cl, HCO, and HPO
females - The third function of nephron and collecting duct
- GFR is directly related to the pressures that is tubular secretion.
determine net filtration pressure; any changes in - Secretion is the transfer of materials from blood
net filtration pressure will affect GFR and tubule cells into glomerular filtrate.
- Has TWO important outcomes:
EXAMPLE: Severe blood loss reduces mean arterial blood
1. Helps control blood pH
pressure and decreases the glomerular blood hydrostatic
2. Helps eliminate substances through urine
pressure.
Certain substances pass from blood into urine and may be
- TWO mechanisms that regulate GFR:
detected in URINALYSIS. Urine tests are used to detect
1. Adjusting blood flow into and out of the
the presence of alcohol and illegal drugs. \
glomerulus
2. Altering glomerular capillary surface area
available for filtration REABSORPTION ROUTES
- GFR increases when blood flow into the
glomerular capillaries increases. - Substance being reabsorbed can take one of
the TWO routes before entering peritubular
cavity:
NEURAL REGULATION OF GFR
1. Move between adjacent tubule cells
2. Through an individual tubule cell
- Kidneys are supplied by sympathetic ANS fibers
- Tight junctions surround and join neighboring
that release norepinephrine, which causes
tubule cells together
vasoconstriction by activation of a1 receptors.
- APICAL membrane contacts the tubular fluid
- In exercise or a case of hemorrhage,
- BASOLATERAL membrane contacts interstitial
sympathetic stimulation increases and
fluid at the base and sides of cell.
vasoconstriction of afferent arteriole happens.
As a result, blood flow in glomerular capillaries TWO REABSORPTION ROUTES
decrease and GFR drops.
- Lowering of renal blood flow has two 1. PARACELLULAR REABSORPTION
consequences: 1) reduces urine output, 2) - Fluid leaks between the cells (through passive
permits greater blood flow to other body tissues. process)
 - Tight juctions between cells in PCT are
permeable to some substances and transport
them into peritubular capillaries
2. TRANSCELLULAR REABSORPTION
- Passes from the fluid in tubular lumen through
apical membrane of the cell, across cytosol, and
through the basolateral membrane to the
interstitial fluid.

TRANSPORT MECHANISMS

- When renal cells transport solutes, they move

specific substances in one direction only.
- Different transport proteins are present in the
apical and basolateral membranes.
- Cells lining the renal tubules have low
concentration of Na in their cytosol due to the
Na-K pumps located in the basolateral
membrane.
- The absence of Na-K pump in apical membrane
ensures that reabsorption of Na is a one-way
process.
- TRANSPORT OF MATERIALS ACROSS
MEMBRANES MAY BE ACTIVE OR PASSIVE
- Symporters are membrane proteins that move
two or more substance in the same direction
across a membrane.
- Antiporters move two or more substances in
opposite directions across a membrane.
- Each type of transporter has an upper limit,
called transport maximum, on how fast it can
work.

TWO TYPES OF WATER REABSORPTION:

1. OBLIGATORY WATER REABSORPTION

- Water reabsorbed with solutes in tubular fluid
- Water is obliged to follow solute when
reabsorbed
- Occurs in PCT and descending limb of nephron
loop
2. FACULTATIVE WATER REABSORPTION
- Reabsorption of final 10% of water
- Regulated by antidiuretic hormone
- Occurs in collecting ducts

*filtered fluid becomes tubular fluid once it becomes it

enters proximal convoluted tubule but changes once it
enters nephron tubule and collecting duct (due to
reabsorption and secretion)

*fluid that drains from papillary ducts into renal pelvis is

called urine.

REABSORPTION AND SECRETION IN THE PCT