artery

Afferent arteriole

Glomerular capillary

Efferent arteriole

Renal Physiology 2
Bowmans space Peritubular capillary

vein tubule

Basic Renal Processing

General strategy
Everything but cells and protein gets filtered into Bowmans space (called glomerular filtrate) Flitrate has the same substances at same concentrations as plasma Further along tubule, substances are added (secretion) or removed (reabsorption)

Steps in urine formation

1. Filtration 2. Secretion 3. Reabsorption 4. Excretion (urine)

2 3

Amount excreted = amount filtered + amount secreted amount reabsorbed

1. Filtered and secreted; not reabsorbed

3. Filtered and completely reabsorbed

2. Filtered and some reabsorbed

Glomerular Filtration
For each substance in plasma
there is some combination of filtration, reabsorption and secretion

For many substances (eg, Na+, Ca++, water) these processes are under physiological control

Capillary Fenestra allow movement from plasma to Bowmans space

Glomerular Filtration
A bulk flow process

PGC

GC BS

PBs

Glomerular Filtration Pressure GFP= ((PGC-PBS)-(GC- BS))

Usually 0

Glomerular Filtration Rate (GFR)

Function of:
1. Filtration pressure 2. Permeability of substance

GFR = filtration pressure x Kf

Kf is the filtration coefficient

GFP=(60-15)-(29) = 16 mmHg
Positive pressure indicates filtration

70 kg person
GFR water = 180 L/day (125 ml/min)

Role of hydrostatic pressure in controlling GFP

1. PBC primarily a function of the tubules & ureters; movement of fluid through the system keeps PBC low 2. PGC a function of blood volume in glomerular capillary
Afferent and efferent arterioles may be regulated independently Function of Reff / Raff Constriction of afferent flow into glomerular capillary therefore PGC Constriction of efferent flow out of glomerular capillary therefore PGC Opposites for dilation

Assessing kidney function by measuring plasma clearance & GFR

Total entering= [plasma] x renal blood flow

To estimate plasma clearance

plasma clearancesubstance X =
Amount filtered = [plasma] x GFR

[urine]substance x urine vol [plasma]substance

If substance is completely filtered and not reabsorbed nor secreted plasma clearance = GFR
Amount in urine = [urine] x urine volume

Inulin is a small sugar that is completely filtered and is not reabsorbed or secreted 1. Inject a small amount of inulin into blood and measure [inulin]plasma 2. Measure [inulin]urine and urine volume [inulin]plasma= 4mg/L Urine volume = 0.1 L/hour [inulin]urine = 300 mg/L Inulin excretion = 0.1 L/h x 300 mg/L = 30 mg/h
Plasma clearanceinulin = 300 x 0.1 4

Plasma clearanceinulin = 7.5 L/h = GFR

Steps in urine formation

For any substance: If plasma clearance <GFR there must be reabsorption If plasma clearance >GFR there must be secretion

1. Filtration 2. Secretion 3. Reabsorption 4. Excretion (urine)

2 3

Distal tubule

Tubular Reabsorption
180 L of glomerular filtrate, only 1 L of urine 99% of all water is reabsorbed 1800g/day of NaCl in glomerular filtrate, only 10g/day in urine 99% of NaCl is reabsorbed Glucose 100% reabsorption
Collecting duct Proximal tubule

Descending LofH

Ascending LofH - thick Ascending LofH - thin

paracellular Tubular fluid transcellular

capillary

Tight junction

Na+ Na+ K+ K+ ATP Na+ ATP

 Na+,K+ pump establishes Na+ gradient In the proximal tubule Na+ transport
Antiport with H+ Symport with glucose

Water movement is secondary to Na+ transport

1. Na+ 2a. osmolarity Na+ H+ Na+ glucose K+ glucose Na+ ATP H2O 3. osmosis K+

Na+ ATP 2b. osmolarity H2O 4. Bulk flow

Na+,K+ pump establishes Na+ gradient In the distal tubule Na+ transport
Symport with Cl

H20 Proximal tubule Descending LofH Ascending LofH High High Low

Na+ Active transport Low Active transport

Na+ ClK+ Na+ ATP

Distal Tubule & Collecting Duct

Variable Active transport due to hormones

Formation of urine
1. Dilute 2. Concentrated

Excretion of dilute urine occurs with low levels of ADH/vasopressin

300 150 100 300 80 375 400 350 500 Active transport of solutes 65 Low permeability to water

700

700

To form dilute urine:

Reabsorb solute from tubular fluid, while leaving water in the distal tubules. Occurs only in the absence of ADH/vasopressin