1. What are the functions of renal system?

• Answer: Excretory function:

 metabolic wastes are eliminated from the body (urea & creatinine*)
 drugs,
 Toxic substances &
 pathogenic bacteria
• Regulatory Function:
 water balance
Elecrolyte balance : Na+ in relation to H2O. Retains Na+ if osmolarity of body is
decreased and eliminate when osmolarity is increased
Acid base balance: Kidneys along with lungs and blood buffers. Sulphuric acid &
phosphoric acid (kidney)
Endocrine functions
 Erythropoetin: Peritubular capillaries in response to hypoxia , stimulates the bone marrow
& causes erythropoesis
 Renin: secreted from the Granular cells of JG apparatus of kidney. When released into the
blood the , the Angitensinogen is converted into Ag-1, this is converted into Ag-II in the lungs by
converting enzymes. Ag – II has three functions
a) Constriction of systemic arteries inc BP
b) Stimulates adrenal cortex to secrete Aldosterone causes retention of Na+ by kidneys by
increasing the tubular reabsorption of Na+
c) Helps to maintain the GFR
Prostaglandins: PGA2, PGE2
 causes fall in blood pressure by producing systemic vasodilation, diuresis and natriuresis.
 Kinins: Renal kinins convert alpha 2 globulin into bradykinin in the presence of enzyme
Kallilkrein.  Bradykinin is a vasodilator substance.

Metabolic Functions:

Cholecalciferol is converted to 25,hydroxicholecalceferol in the liver, later in the kidneys it is

converted to 1,25,di hydroxycholecalceferol (alpha 1 hydroxylase enxyme PCT) .This is activated
Vit D which plays imp role in the maintenance of bld Calcium level. It acts on the intestinal
epithelium and enhances absorption of calcium from intestine into blood.

Regulation of blood pressure :

a) By regulating the volume of ECF

b) Through Renin-Ag mechanism

Glucose synthesis: kidneys synthesis glucose from Amino Acids and other precursors during prolonged
fasting, a process is known as Gluconeogenesis.

The kidneys capacity to add glucose to the blood during prolonged fasting rivals that of the
Liver.
2. A. What is the basic mechanism of urine formation?

2. B. How are different substances handled by kidney?

3. What is the structure of glomerular capillary membrane?

has three major layers:
(1) capillary endothelium
(2) basement membrane, and
(3) a layer of epithelial cells (podocytes) surrounding the outer surface of the capillary basement
membrane.
 Together, these layers make up the filtration barrier, which, despite the three layers, filters
several hundred times as much water and solutes as the usual capillary membrane
The capillary endothelium is perforated by thousands of small holes called fenestrae.
The basement membrane, consists of a meshwork of collagen and proteoglycan fibrillae that
have large spaces through which large amounts of water and small solutes can filter.
It prevents filtration of plasma proteins, because of strong negative electrical charges associated
with the proteoglycans.
Epithelial cells line the outer surface of the glomerulus. These cells are not continuous but have
long footlike processes (podocytes) that encircle the outer surface of the capillaries.
The foot processes are separated by gaps called slit pores (25nm wide) through which the
glomerular filtrate moves.
• Mesangial cells: are located between the basal lamina and the endothelium.
• They are contractile and play a role in regulation of GF. They secrete the extracellular matrix,
take up immune complexes involved in progression of disease. Total area of Glomerular
capillary endothelium across which filteration occurs in human is about 0.8m2
4. What is GFR? What are the factors determining GFR?
Answer. The speed at which fluids are filtered thru this G Cap memb is GFR. Amount of filtrate
produced in the kidneys each minute. 125mL/min = 180L/day
• Factors that alter filtration pressure change GFR. These include:
– Increased renal blood flow -- Increased GFR
– Decreased plasma protein -- Increased GFR. Causes edema.
– Hemorrhage -- Decreased capillary BP -- Decreased GFR

• The GFR is determined by (1) the sum of the hydrostatic and colloid osmotic forces across the
glomerular membrane, which gives the net filtration pressure, and (2)the glomerular capillary
filtration coefficient, Kf. Expressed mathematically, the GFR equals the product of Kf and the
net filtration pressure: GFR = Kf х Net filtration pressure . The Kf is a measure of the product of
the hydraulic conductivity and surface area of the glomerular capillaries. Kf = GFR/Net filtration
pressure. The net filtration pressure represents the sum of the hydrostatic and colloid osmotic
forces that either favor or oppose filtration across the glomerular capillaries.

• These forces include: hydrostatic pressure inside the glomerular capillaries (glomerular
hydrostatic pressure, PG), which promotes filtration; the hydrostatic pressure in Bowman’s
capsule (PB) outside the capillaries, which opposes filtration; the colloid osmotic pressure of the
glomerular capillary plasma proteins (πG), which opposes filtration; and the colloid osmotic
pressure of the proteins in Bowman’s capsule (πB), which promotes filtration.

• The GFR can therefore be expressed as GFR = Kf х (PG – PB – πG + πB)

• Forces Favoring Filtration (mm Hg) Glomerular hydrostatic pressure = 60

• Bowman’s capsule colloid osmotic pr = 0

• Forces Opposing Filtration (mm Hg) Bowman’s capsule hydrostatic pr = 18

• Glomerular capillary colloid osmotic pressure = 32

• Net filtration pressure = 60 – 18 – 32 = +10 mm Hg .

• The Kf is a measure of the product of the hydraulic conductivity and surface area of the
glomerular capillaries. Kf = GFR/Net filtration pressure

Because total GFR for both kidneys is about 125 ml/ min and the net filtration pressure is 10 mm
Hg, the normal Kf is calculated to be about 12.5 ml/min/mm Hg of filtration pressure.

5. What is the mechanism of formation of concentrated urine? Explain Counter-Current

Multiplier?

The human kidney can produce 1200-1400 mosml/L conc urine. Basic requirment 1. A high level
of ADH. 2. A high osmolarity of renal medullary I.F which provides a conc gradient for H2O
reabsorption.

• The formation of Conc urine is by a mechanism called counter current mechanism depends
upon the special arrangement of LOH & V.R . The CCM has 2 components

1. CC Multiplier done by LOH

2. CC exchanger done by VR

The Counter-Current Mechanism Produces a Hyperosmotic Renal Medullary Interstitium

• Interstitial osmolarity = 300mosm/L. Osmolairty of Medullary int = 1200mosm/L is due to

accumulation of solutes. Major contributing factors

1. Active transport of Na ions & co transport of K , Cl and other ions out of the thick portion of the
ascend LOLH into the med inter.
2. Active transport of ions from the collecting ducts into the medullary inter
3. Passive diffusion of large amounts of urea from the inner med col duct into the med inter
4. Diffusuion of only small amount of H2O from the medullary tubules into the medullary
interstitium , far less than the reabsorption of solutes into the medullary interstitium.
Special characteristics of the LOH that causes solutes to be trapped in renal medulla
Active transport of Na & cotransport of K, Cl & other ions from LOH into interstitium . This
pump is capable of establishing 200mosm/L conc gradient b/w the tubular lumen and I.F. Thick
Asc LOLH is impermeable to H2O, the sol pumped out are not followed by osmotic flow of H2O
into interstitum.