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URINARY SYSTEM
Physiology 2
Presented by: Dr. Shaimaa Nasr Amin
Lecturer of Medical Physiology
General Education Program
Tubular processing of the
Glomerular Filtration
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As glomerular filtrate enters the renal
tubule (now called tubular fluid), it flows
through the proximal tubule, loop of
Henle ,distal tubule, collecting tubule and
finally collecting duct.
*Result of tubular handling:
1- Volume is decreased .
2- Composition altered by the process of
reabsorption and secretion.
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U/P ratio Concentration in plasma
(P)
Concentration in Urine
(U)
Substance
0 100 0 1-Glucose
(mg/dl)
0.6 150 90 Na+
(mEq/L)
60 15 900 Urea
(mEq/L)
150 1 150 Creatinine
(mg/dl)
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Tubular reabsorption It involves:
1-Transport of substance across the tubular epithelium
into renal interstitial fluid.
2-Transport from the interstitial fluid into peritubular
capillaries.
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Tubular Secretion *Transport of substances from the blood in peritubular capillaries
into the renal tubule.
Urinary excretion rate=
Filtration rate –reabsorption rate
+Secretion rate
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Type of transport across the tubylar
epithelium
1-Transcellular
2-Paracellular
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Mechanism of tubular
transport
Active transport
Passive transport
Pinocytosis
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Active -1Transport
A-Primary active
Transport
B-Secondary active
transport
a- Co-transport
b- Counter transport
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1-Active transport
It’s against concentration or electrical gradient
A-Primary active transport:
-Energy derived from direct hydrolysis of ATP by membrane
bound ATPase.
e.g. Na+ reabasorption across proximal tubular epithelium.
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B-Secodary active transport:
-Energy NOT derived directly from ATP or from high energy
phosphate sources.
-Types:
a) Co-transport.
b) Countertransport.
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a)Co-transport:
2 substances bind to specific carrier molecule and are co
transported together across the membrane one down its
electrochemical gradient and the other substance against its
chemical gradient.
-e.g. Secondary active transport of glucose
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b) Countertransport:
The reabsorption of one substance is linked to secretion of
another.
e.g. Secondary active secretion of H+ into the tubule.
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2-Passive transport a-Passive reabsorption of chloride.
b-Osmosis of water.
c-Passive reabsorption of urea.
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a-Passive reabsorption of chloride:
-Through paracellular pathway
,following Na+ reabsorption.
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b-Osmosis of water:
-After solute reabsorption out of the
tubule →↓their concentration inside
the tubule and ↑in the interstitium→
concentration gradient→osmosis of
water
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c-Passive reabsorbtion of urea:
As water is reabsorbed from the tubule→ ↑urea concentration in
the tubular lumen→ concentration gradient favoring reabsorption
of urea.
*About 50% of the filtered urea is passively reabsorbed and the
remainder pass in urine.
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3-Pinocytosis -Active transport for
reabsorption of proteins and
peptides in the proximal
convoluted tubule.
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Tubular Transport maximum
*For many actively transported substances there is a
maximum rate at which each can be transported ,due to
saturation of the carrier system.
*The maximum rate that can be achieved is termed transport
maximum (Tm ) for the substance is expressed as mg/min.
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Solutes that exhibit Tm-limited reabsorption:
*Glucose ,amino acid ,phosphate, sulphate.
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Solutes with Tm-limited
secretion:
*Para-aminohippuric acid PAH
*Penicillin
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Gradient time transport *All substances that are reabsorbed by diffusion ,transport by
this type is termed gradient –time transport
*It is determined by:
1-The electrochemical gradient for the substance across the
membrane.
2-The time that the fluid containing the substance remains within
the tubule which depends on tubular flow rate.
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*Some actively transported substances
obeys the gradient-time transport
e.g. Na+ reabsorption by the proximal
tubule,as it is determined by:
1-Concentration of Na+ in the proximal
tubule.
2-The rate of flow (the slower the flow rate
of the tubular fluid, the greater the %of
Na+ that can be reabsorbed).
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Absorption by the peritubular capillaries *Fluids and electrolytes are reabsorbed from the renal
interstitium into the peritubular capillaries by bulk flow as
peritubular capillaries behave like venous end of the
capillary.
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Forces that act across peritubular
capillaries
2-Forces that oppose
reabsorption:
a) Hydrostatic
pressure inside the
peritubular capillaries
(13mmHg).
b) Colloid osmotic
pressure of proteins
in renal
interstitium(15mmHg).
1-Forces that favour
reabsorption:
a) Colloid osmotic
pressure of
peritubular
capillary(32mmHg).
b) Hydrostatic
pressure in renal
interstitium(6mmHg).
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