• Pair of kidneys – produce urine (fluid containing water, salt, ions, & small solute compounds) • Ureters – paired tubes that conduct urine to urinary bladder Urinary • Urinary bladder – muscular organ – temporarily stores urine tract • Urethra – tube that eliminates urine to the exterior (urination/ micturition) Key functions of the excretory system 1. Excretion – removal of organic waste 2. Elimination – discharge of waste into the environment 3. Homeostasis – regulation of fluid volume and solute concentration in blood plasma • ~ 200 l of fluid are filtered from the bloodstream/ day • Regulates the conc. of blood Na+, K+, Cl-, Ca2+ etc. • Maintains pH of blood – regulating conc of H+ & HCO3- • Eliminates metabolic nitrogenous wastes (ammonia & uric acid), retains valuable nutrients • Assists liver in detoxification process Other functions are: 1. Secretion of erythropoietin – control RBC production 2. Activation of Vit D 3. Maintain blood volume and pressure – secretion of renin 4. Carries out gluconeogenesis during extended fasting Position of the kidney
• 2 Kidneys – either sides of vertebral
column (between T12 & L3) • Right kidney – slightly lower that left (because of liver) • Adrenal glands superior to each kidney • Kidneys – in retroperitoneal cavity Coverings of the kidney • Kidneys are enclosed by renal capsule (fibrous/ collagenous) • Perinephric fat • Renal fascia – collagen fibrous outermost capsule which fuses with the surrounding muscular wall Anatomy of the kidney lobe
• Each: 10 cm long, 5.5 cm wide, 3 cm
thick, 150 g • Hilus – point of entry for renal artery, renal nerves, exit for ureter, renal veins • Renal cortex – next to capsule, reddish- brown, granular (due to nephrons) • Renal medulla – 6-18 triangular renal pyramids • Renal columns – cortex extends between pyramids; granular Discharged via Renal papilla Minor calyx renal ducts
Ureter Renal pelvis Major calyx
lobe
Renal columns Renal papilla Blood supply to the kidney • Renal arteries – supply 20-25% of total cardiac Segmental output (1200 mL/min) artery • Branch off as interlobular arteries • Further branch to finally afferent arterioles – supply the nephrons • Cortical radiate veins – converge into interlobular veins Arcuate artery Renal vein – joins inferior vena cava Nervous supply to the kidney • Innervated by sympathetic post ganglionic fibers • Renal nerve – enters through hilus • Follows branches of arteries & reaches each nephron • Sympathetic innervations influence rate of urine formation by changing blood flow • Influence urine composition by stimulating release of hormones (renin) Structure of the Nephron
Podocytes Have foot processes and narrow gaps/filtration slits (6-9 nm) Filtration membrane between adjacent foot • Fenestrated capillary processes • Basement Membrane • During filtration blood pressure forces water & small • foot process of podocyte dissolved solutes out of capillaries into the capsular space. • Larger solutes do not pass. • Filtrate is protein-free • Structures that regulate blood pressure & filtration • Have chemo & baroreceptors • Smooth muscle & epithelial cells Extraglomerular mesangial cell Histology of the Nephron Cortex
- tubules
Medulla
Thick & thin refer to
height of epithelium Histology of the Nephron Cortex
Towards renal pelvis Urine formation 1. Glomerular filtration – • Water moves out • Solutes: based on particle size • Water carries small solutes 2. Tubular reabsorption – • selective process (diffusion/ carrier mediated transport) • reabsorption into interstitial fluid -> reabsorbed into blood • Water reabsorption by passive osmosis 3. Tubular secretion – • active process of secretion • Backup for the glomerular filtration • Ensures toxin, drugs etc. are excreted Glomerular filtration • Hydrostatic pressure • 3 barriers for movement across the glomerulus • Water crosses all barriers • Pores in capillaries allow mostly solutes • BM – selectively permeable • Foot processes – finest filters • Hydrostatic & colloidal osmotic pressure (capillaries) capsular hydrostatic pressure => net hydrostatic pressure
Regulation of urine formation
• Autoregulation – mainly BP inside arteries & arterioles, myogenic mechanisms • Hormonal regulation – renin-angiotensin aldosterone system (RAAS) • Autonomic regulation – sympathetic system Tubular reabsorption Useful substances such as glucose, free fatty acids, amino acids, vitamins, and other solutes enter the capsular space, in addition to metabolic wastes and excess ions
Renal tubule: 1. Reabsorbs all useful organic nutrients 2. Reabsorbs > 90% of water 3. Secretes any residual waste
Reabsorption & secretion take place in every segment of the tubule
Relative importance varies Collectively alters urine composition Mechanisms of transport Carrier mediated transport: 1. Facilitated diffusion 2. Active transport 3. Co-transport 4. Counter transport Urine composition
Formation of Urine Kidney disease Kidney stones/renal calculi Glomerulonephritis Pink or cola-colored urine from RBC in your urine (hematuria) Foamy or bubbly urine due to excess protein in the urine (proteinuria) High blood pressure (hypertension) Fluid retention (edema) with swelling evident in your face, hands, feet and abdomen Urinating less than usual Nausea and vomiting Nephropathy/ diabetic nephropathy Chronic kidney disease Urinary tract infections Common in women Infection of any part of the urinary system Involvement of kidneys is dangerous Symptoms - UTIs don't always cause symptoms. When they do, they may include: •A strong urge to urinate that doesn't go away •A burning feeling when urinating •Urinating often, and passing small amounts of urine •Urine that looks cloudy •Urine that appears red, bright pink or cola-colored — signs of blood in the urine •Strong-smelling urine •Pelvic pain, in women — especially in the center of the pelvis and around the area of the pubic bone Urinary tract infections – diagnosis & treatment Urinalysis Microbiological test CT or MRI Cytoscopy Treatment: antibiotics Testing of kidney function Pyelogram 1. Urinalysis 2. BUN 3. Creatinine clearance test 4. Culture/microbiology
