LATE FILTRATE

PROCESSING

 The final processing of filtrate in the late

distal convoluted tubule and collecting
ducts comes under direct physiological
control.
In this region, membrane permeabilities
and cellular activities are altered in
response to the body's need to retain or
excrete specific substances.

 The bulk of reabsorption occurs in the

early tubular segments. In these regions
the rates of both reabsorption and
secretion are relatively constant, because
the membrane permeabilities are relatively
fixed.
In the later tubular segments the
membrane permeabilities change in
response to changing physiological
conditions and hormone levels. This
variability provides a mechanism for
precisely regulating the final balance of
fluid and solutes returned to the blood.

Filtrate Processing in the

DCT & CCD
The Late Distal Tubule & CCT are
composed of principal cells & intercalated
cells
Intercalated cells secrete hydrogen ions
into filtrate
Principals cells perform hormonally
regulated water & sodium reabsorption &
potassium secretion

Role of Aldosteron
Principal cells are permeable to
sodium ions and water only in the
presence of Aldosterone & ADH
Low level of Aldosterone result in
little basolateral sodium/potassium
ATPase ion pump activity & few
luminal sodium & potassium channel

 Aldosteron increases the number of

basolateral Na/K pump and luminal Na & K
channels
Since there are no basolateral K channel, K
ion are secreted into the instead of
returning to the interstitium
Without an increase in water permeability,
the interstitial osmolarity increases

Role of ADH
Principals cells are permeable to
water only on the presence of ADH

Dehydration
Perspiration causes loss of water &
sodium ions
The body responds by increasing
blood level of Aldosteron & ADH
Body fluid is conserved & urine
volume decreases

Overhydration
Overhydration triggers a decrease in
ADH & Aldosteron
Reduced membrane permeability
decreases reabsorption of water and
sodium ions increases fluid volume
entering the medullary collecting
duct. Urine volume increases

Progressive change in
filtrate osmolarity
The high permeability of PCT allows
the filtrate & interstitium equilibrate
The osmolarity of both filtrate &
interstitium approximate 300mOsm
Filtrate volume is reduced by 65%

 The descending limb loop of henle are

permeable to water but not to solute
Filtrate volume is reduced by an
additional 15%
Filtrate becomes more concentrated
as it descends

 The ascending limb loop of henle are

permeable to solute but not to water
As it ascends, the filtrate loses
solute & so becomes less
concentrated
The filtrate volume remains
relatively unchanged

 The opposing flow and opposite

activities of descending & ascending
segments of loop of henle is called
the countercurrent multiplier
mechanism

 In the DCT & CCT, the reabsorption of

water and sodium ions is regulated by
aldosteron & ADH respectively
In normal hydration condition, the
hormones promote both sodium & water
reabsorption
The low osmolarity of the filtrate is
maintained, while its volume reduced, an
additional 15%

Urine concentration;
Medullary Collecting
Duct
Final concentration occurs in the medulary
collecting duct
Of the 125 ml/min of glomerular filtrate,
6 ml/min (5%) remain
ADH regulates final volume of water
reabsorbed in the collecting duct
The medullary osmotic gradient is
necessary or this process

Conditions affecting the

final concentration urine
The osmotic gradients concentrates the
urine by drawing water from the filtrate
as it travels trough the medullary
collecting duct
The degree of concentration is reguated
by ADH
ADH levels vary to the individual hydration
status

 With normal hydration, normal ADH

results in few water channel
ADH facilitates the diffusion of urea out
of medullary collecting duct
Urea is responsible for up to 40% of the
interstitial osmolarity
Urea circulates back into the loop of henle
and returns to the collecting duct

 Urine is concentrated to about twice

normal body osmolarity (600mOsm)

 With dehydration, the high level of ADH

increases the permeability of the
medullary collecting duct to urea & water
The filtrate equilibrate with each region
increase in osmolarity
In severe dehydration, the low volume of
urine excreted may be concentrated to
about 1400 mOsm

 With overhydration, ADH levels are very

low or absent, and the duct cells remain
impermeable to water and urea
Filtrate does not equilibrate with any
regional change in osmolarity
Urine is very dilute and high in volume
Final volume may have osmolarity as low as
100 mOsm

Ureter
Merupakan saluran yang menghubungkan
ginjal ke kandung kemih, yang merupakan
lanjutan renal pelvis.
Panjang 10-12 inchi.
Ureter memasuki kandung kemih melalui
bagian posterior dengan cara menembus
otot detrusor didaerah trigonum kandung
kemih

 Dinding ureter terdiri dari otot polos &

dipersarafi oleh saraf simpatis & parasimpatis.
Kontraksi peristaltik pada ureter ditingkatkan
oleh perangsangan parasimpatis & dihambat
oleh perangsangan simpatis.
Peristalsis dibantu gaya gravitasi akan
memindahkan urine dari ureter ke kandung
kemih.

Kandung Kemih
(Vesica Urinaria)
Berfungsi menampung/menyimpan urine
sementara.
Terdiri atas :
1. Badan (corpus) = bagian utama kandung
kemih dimana urine terkumpul.
2. Leher (kollum) = lanjutan dari badan yang
berbentk corong, berjalan secara inferior
dan anterior ke dalam daerah segitiga
urogenital & berhubungan dengan urethra.

Dinding kandung kemih :

3 lapisan otot polos (detrusor muscle)
Mucosa : transitional epithellium
Dinding : tebal &
berlipat saat
kandung kemih kosong.
Trigone tiga
pembukaan :
Dua dari ureter
Satu ke urethra

Persarafan
N. pelvikus yang berhubungan dengan medulla
spinalis melalui pleksus sakralis (S2 dan S3).
Saraf sensorik = regangan dinding kandung
kemih refleks berkemih.
Saraf motorik = parasimpatis berakhir pada
sel ganglion yang terletak dalam dinding
kandung
kemih untuk mensarafi otot
detrusor.

Urethra
Saluran berdinding tipis yang
memindahkan urine dari kandung kemih
ke luar tubuh degan gerak peristalsis.
Panjang : pria=8 inchi, wanita=1 inchi.
Pengeluaran urine diatur oleh dua katup
(sphincters)
Internal urethral sphincter (tanpa
sadari/involuntary)
External urethral sphincter
(disadari/voluntary)

Berkemih (Micturition/Voiding)
Kedua katup (sphincter) otot harus
terbuka agar dapat berkemih
Internal urethral sphincter : direlakskan
setelah peregangan kandung kemih
Pengkatifan ini berasal dari impulse
dikirim ke spinal cord dan kemudian
balik melalui saraf pelvic splanchnic
External urethral sphincter : harus
direlakskan secara sadar
Copyright2003PearsonEducation,Inc.publishingasBenjaminCummings

MICTURITION REFLEX
Bladder fills

+
Stretch receptors
Spinal Cord

Parasympathetic
nerve
Bladder contracts

Internal urethral
sphincter opens

Only the external urethral sphincter is controlled voluntarily