Download - Basic Processes Of Kidney
![Page 1: Basic Processes Of Kidney](https://reader034.vdocuments.net/reader034/viewer/2022042714/556ba555d8b42a207e8b49d3/html5/thumbnails/1.jpg)
04/12/23
THREE BASIC RENAL PROCESSES
Glomerular Filtration: Filtering of blood into tubule forming the primitive urine
Tubular Reabsorption: Absorption of substances needed by body from tubule to blood
Tubular Secretion: Secretion of substances to be eliminated from the body into the tubule from the blood
www.freelivedoctor.com
![Page 2: Basic Processes Of Kidney](https://reader034.vdocuments.net/reader034/viewer/2022042714/556ba555d8b42a207e8b49d3/html5/thumbnails/2.jpg)
04/12/23
BASIC RENAL PROCESSES
GF
TR
TA
Urine Excreted
Efferent ArterioleAfferentArteriole
Glomerulus
KidneyTubule
Peritubular Capillary
www.freelivedoctor.com
![Page 3: Basic Processes Of Kidney](https://reader034.vdocuments.net/reader034/viewer/2022042714/556ba555d8b42a207e8b49d3/html5/thumbnails/3.jpg)
04/12/23
Glomerular Filtration
First step in urine formation180 liters/day filteredEntire plasma volume filtered 65
times/dayProteins not filtered
www.freelivedoctor.com
![Page 4: Basic Processes Of Kidney](https://reader034.vdocuments.net/reader034/viewer/2022042714/556ba555d8b42a207e8b49d3/html5/thumbnails/4.jpg)
04/12/23
Forces Involved inGlomerular Filtration
Glomerular CapillaryBlood Pressure + 55
Plasma Colloid Osmotic Pressure
-30
15
10
Bowman’s CapsuleHydrostatic Pressure
-
Net Filtration Pressure +
www.freelivedoctor.com
![Page 5: Basic Processes Of Kidney](https://reader034.vdocuments.net/reader034/viewer/2022042714/556ba555d8b42a207e8b49d3/html5/thumbnails/5.jpg)
04/12/23
Tubular Reabsorption
Water: 99% reabsorbed
Sodium: 99.5% reabsorbed
Urea: 50% reabsobed
Phenol: 0% reabsorbed
www.freelivedoctor.com
![Page 6: Basic Processes Of Kidney](https://reader034.vdocuments.net/reader034/viewer/2022042714/556ba555d8b42a207e8b49d3/html5/thumbnails/6.jpg)
04/12/23
Tubular Reabsorption
By passive diffusion
By primary active transport: Sodium
By secondary active transport: Sugars and Amino Acids
www.freelivedoctor.com
![Page 7: Basic Processes Of Kidney](https://reader034.vdocuments.net/reader034/viewer/2022042714/556ba555d8b42a207e8b49d3/html5/thumbnails/7.jpg)
04/12/23
Tubular Reabsorption is a Function of the Epithelial Cells Making up the Tubule
Lumen
Plasma
Cells
www.freelivedoctor.com
![Page 8: Basic Processes Of Kidney](https://reader034.vdocuments.net/reader034/viewer/2022042714/556ba555d8b42a207e8b49d3/html5/thumbnails/8.jpg)
04/12/23
Sodium Reabsorption
Lumen
Plasma
Cells
PUMP: Na/K ATPase
Sodium
Potassium
Chloride
Water
www.freelivedoctor.com
![Page 9: Basic Processes Of Kidney](https://reader034.vdocuments.net/reader034/viewer/2022042714/556ba555d8b42a207e8b49d3/html5/thumbnails/9.jpg)
04/12/23
Rennin-Angiotensin-Aldosterone System
Stimulates Sodium Reabsorption in distal and collecting tubules
Naturetic peptide inhibitsIn absence of Aldosterone, 20mg of
sodium/day may be excretedAldosterone can cause 99.5%
retention
www.freelivedoctor.com
![Page 10: Basic Processes Of Kidney](https://reader034.vdocuments.net/reader034/viewer/2022042714/556ba555d8b42a207e8b49d3/html5/thumbnails/10.jpg)
04/12/23
Rennin-Angiotensin-Aldosterone System
Fall in NaCl, extracellular fluid volume, arterial blood pressure
JuxtaglomerularApparatus
ReninLiver
Angiotensin
+
Angiotensin Angiotensin Aldosterone
Lungs
ConvertingEnzyme
AdrenalCortex
IncreasedSodiumReabsorption
HelpsCorrect
www.freelivedoctor.com
![Page 11: Basic Processes Of Kidney](https://reader034.vdocuments.net/reader034/viewer/2022042714/556ba555d8b42a207e8b49d3/html5/thumbnails/11.jpg)
04/12/23
DIURETICS
ACE Inhibitors (Angiotensin Converting Enzyme): Cause loss of salt---> water follows
Atrial Naturetic Peptide (ANP) also inhibits sodium reabsorption
Osmotic diuretics: Are not reabsorbed
www.freelivedoctor.com
![Page 12: Basic Processes Of Kidney](https://reader034.vdocuments.net/reader034/viewer/2022042714/556ba555d8b42a207e8b49d3/html5/thumbnails/12.jpg)
04/12/23
Glucose and Amino Acids are reabsorbed by secondary active transport
They are actively transported across the apical cell membranes of the epithelial cells
Their active transport depends on the sodium gradient across this membrane
All other steps are passive
www.freelivedoctor.com
![Page 13: Basic Processes Of Kidney](https://reader034.vdocuments.net/reader034/viewer/2022042714/556ba555d8b42a207e8b49d3/html5/thumbnails/13.jpg)
04/12/23
GLUCOSE REABSORPTION HAS A TUBULAR MAXIMUM
Renal threshold (300mg/100 ml)
Plasma Concentration of Glucose
GlucoseReabsorbedmg/min
Filtered Excreted
Reabsorbed
www.freelivedoctor.com
![Page 14: Basic Processes Of Kidney](https://reader034.vdocuments.net/reader034/viewer/2022042714/556ba555d8b42a207e8b49d3/html5/thumbnails/14.jpg)
04/12/23
Tubular Secretion
Protons (acid/base balance)
Potassium
Organic ions
www.freelivedoctor.com
![Page 15: Basic Processes Of Kidney](https://reader034.vdocuments.net/reader034/viewer/2022042714/556ba555d8b42a207e8b49d3/html5/thumbnails/15.jpg)
04/12/23
Potassium Secretion
Lumen
Plasma
Cells
PUMP: Na/K ATPase
Sodium
Potassium
Chloride
Water
www.freelivedoctor.com
![Page 16: Basic Processes Of Kidney](https://reader034.vdocuments.net/reader034/viewer/2022042714/556ba555d8b42a207e8b49d3/html5/thumbnails/16.jpg)
04/12/23
DUAL CONTROL OF ALDOSTERONE SECRETION
Fall in sodium
ECF Volume
Blood Pressure
Increased PlasmaPotassium
Increased Aldosterone secretion
Increased TubularPotassium Secretion
Increased UrinaryPotassium Secretion
Increased TubularSodium Reabsorption
Fall in Urinary
Sodium Excretion
www.freelivedoctor.com
![Page 17: Basic Processes Of Kidney](https://reader034.vdocuments.net/reader034/viewer/2022042714/556ba555d8b42a207e8b49d3/html5/thumbnails/17.jpg)
04/12/23
Reabsorption in Proximal Tubule (Summary)
Glucose and Amino Acids67% of Filtered SodiumOther Electrolytes65% of Filtered Water50% of Filtered UreaAll Filtered Potassium
www.freelivedoctor.com
![Page 18: Basic Processes Of Kidney](https://reader034.vdocuments.net/reader034/viewer/2022042714/556ba555d8b42a207e8b49d3/html5/thumbnails/18.jpg)
04/12/23
Secretion in Proximal Tubule (Summary)
Variable Proton secretion for acid/base regulation
Organic Ion secretion
www.freelivedoctor.com
![Page 19: Basic Processes Of Kidney](https://reader034.vdocuments.net/reader034/viewer/2022042714/556ba555d8b42a207e8b49d3/html5/thumbnails/19.jpg)
04/12/23
Reabsorption in Distal Tubule (Summary)
Variable Sodium controlled by Aldosterone
Chloride follows passively
Variable water controlled by vasopressin
www.freelivedoctor.com
![Page 20: Basic Processes Of Kidney](https://reader034.vdocuments.net/reader034/viewer/2022042714/556ba555d8b42a207e8b49d3/html5/thumbnails/20.jpg)
04/12/23
Secretion in Distal Tubule (Summary)
Variable Proton for acid/base regulation
Variable Potassium controlled by aldosterone
www.freelivedoctor.com
![Page 21: Basic Processes Of Kidney](https://reader034.vdocuments.net/reader034/viewer/2022042714/556ba555d8b42a207e8b49d3/html5/thumbnails/21.jpg)
04/12/23
Collecting Duct (Summary)
Variable water reabsorption controlled by vasopressin
Variable Proton secretion for acid/base balance
www.freelivedoctor.com
![Page 22: Basic Processes Of Kidney](https://reader034.vdocuments.net/reader034/viewer/2022042714/556ba555d8b42a207e8b49d3/html5/thumbnails/22.jpg)
04/12/23
REGULATION OF URINE CONCENTRATION
Medullary countercurrent system
Vasopressin
www.freelivedoctor.com
![Page 23: Basic Processes Of Kidney](https://reader034.vdocuments.net/reader034/viewer/2022042714/556ba555d8b42a207e8b49d3/html5/thumbnails/23.jpg)
04/12/23
Medullary countercurrent system
Osmotic gradient established by long loops of Henle
Descending limb
Ascending limb
www.freelivedoctor.com
![Page 24: Basic Processes Of Kidney](https://reader034.vdocuments.net/reader034/viewer/2022042714/556ba555d8b42a207e8b49d3/html5/thumbnails/24.jpg)
04/12/23
Descending limb
Highly permeable to water
No active sodium transport
www.freelivedoctor.com
![Page 25: Basic Processes Of Kidney](https://reader034.vdocuments.net/reader034/viewer/2022042714/556ba555d8b42a207e8b49d3/html5/thumbnails/25.jpg)
04/12/23
Ascending limb
Actively pumps sodium out of tubule to surrounding interstitial fluid
Impermeable to water
www.freelivedoctor.com
![Page 26: Basic Processes Of Kidney](https://reader034.vdocuments.net/reader034/viewer/2022042714/556ba555d8b42a207e8b49d3/html5/thumbnails/26.jpg)
04/12/23
COUNTERCURRENT MAKESTHE OSMOTIC GRADIENT
300
450
600
750
900
1050
1200
1200
From ProximalTubule
To DistalTubule
Cortex
Medulla300
450
600
750
900
1050
1200
1200
100
250
400
550
700
850
1000
1000
ActiveSodiumTransport
PassiveWaterTransport
Long Loopof Henle
www.freelivedoctor.com
![Page 27: Basic Processes Of Kidney](https://reader034.vdocuments.net/reader034/viewer/2022042714/556ba555d8b42a207e8b49d3/html5/thumbnails/27.jpg)
04/12/23
THE OSMOTIC GRADIENT CONCENTRATES THE URINE WHEN VASOPRESSIN (ANTI DIURETIC HORMONE [ADH]) IS PRESENT
From DistalTubule
Cortex
Medulla300
450
600
750
900
1050
1200
1200
300
400
550
700
850
1000
1100
1200
Interstitial Fluid
CollectingDuct
PoresOpen
Passive Water Flow
www.freelivedoctor.com
![Page 28: Basic Processes Of Kidney](https://reader034.vdocuments.net/reader034/viewer/2022042714/556ba555d8b42a207e8b49d3/html5/thumbnails/28.jpg)
04/12/23
WHEN VASOPRESSIN (ANTI DIURETIC HORMONE [ADH]) IS ABSENT A DILUTE URINE IS PRODUCE
From DistalTubule
Cortex
Medulla300
450
600
750
900
1050
1200
1200
100
100
100
100
100
100
100
100
Interstitial Fluid
CollectingDuct
PoresClosed
No Water FlowOut of Duct
www.freelivedoctor.com
![Page 29: Basic Processes Of Kidney](https://reader034.vdocuments.net/reader034/viewer/2022042714/556ba555d8b42a207e8b49d3/html5/thumbnails/29.jpg)
04/12/23
Renal Failure
Acute: Sudden onset, rapid reduction in urine output - usually reversible
Chronic: Progressive, not reversible
Up to 75% function can be lost before it is noticeable
www.freelivedoctor.com
![Page 30: Basic Processes Of Kidney](https://reader034.vdocuments.net/reader034/viewer/2022042714/556ba555d8b42a207e8b49d3/html5/thumbnails/30.jpg)
04/12/23
THE URINARY BLADDER STORES THE URINE
Gravity and peristaltic contractions propel the urine along the ureter
Parasympathetic stimulation contracts the bladder and micturition results if the sphincters (internal and external urethral sphincters) relax
The external sphincter is under voluntary control
www.freelivedoctor.com
![Page 31: Basic Processes Of Kidney](https://reader034.vdocuments.net/reader034/viewer/2022042714/556ba555d8b42a207e8b49d3/html5/thumbnails/31.jpg)
04/12/23
Reflex and Voluntary Control of Micturition
Bladder filling reflexively contracts the bladder
Internal Sphincter mechanically opens
Stretch receptors in bladder send inhibitory impulses to external sphincter
Voluntary signals from cortex can override the reflex or allow it to take place
www.freelivedoctor.com