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