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URINARY SYSTEM

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FUNCTIONS OF THE SYSTEM URINARY

1. FILTERING OF BLOOD2. REGULATION OF BLOOD VOLUME3. REGULATION OF BLOOD SOLUTES4. RBC SYNTHESIS5. VITAMIN D SYNTHESIS6. GLUCONEOGENESIS

KIDNEY ANATOMY

ORGANS OF THEURINARY SYSTEM

1. KIDNEYS2. URETERS3. URINARY BLADDER4. URETHRA

ORGANS OF THEURINARY SYSTEM

5. INTERNAL URETHRAL SPHINCTER.

6. EXTERNAL URETHRAL SPHINCTER.

LOCATION AND EXTERNALANATOMYOF KIDNEYS

The kidneys liebehind peritoneumon the posteriorabdominal wall oneither side ofvertebral column. The right kidney isslightly lower thanthe left.

EXTERNAL ANATOMY OF THE KIDNEY

The covering of kidney consistsof three layers. The inner

layer, the renal capsule, themiddle layer, the adipose

capsule, and the outer, renalfascia.

INTERNAL ANATOMY OF THE KIDNEY

A FRONTAL SECTIONS OF A

KIDNEY REVEALS 3 REGIONS:

1. RENAL CORTEX2. RENAL MEDULLA3. RENAL PELVIS

RENAL CORTEX

• The outer layerof the kidneythat contain mostof the nephrons.

• It is the main sitefor filtration,reabsorption andsecretion.

RENAL MEDULLA

Within the renalmedulla arelocated the renalpyramids, renalpapilla, and renalcolumns.

RENAL MEDULLA

•The function of the renal columns is to provide the space to pass blood vessels to and from the nephrons.

RENAL MEDULLA

• Triangular shaped units in the medulla that house the Loops of Henle and collecting ducts of the nephron.

• Site for the counter-current system that concentrates salt and conserves water and urea

RENAL MEDULLA

• The tip of the renal pyramid.

• Releases urine into a calyx.


The nephrons of thekidneys produces urine. It flows from the renal papilla,to the minor calyce, to the major calyce, to the renal pelvis, and finally exits the

kidney within the ureter.

RENAL PELVIS

•The function of the renal pelvis collects urine from all of the calyces. •The urine then is conducted from the kidney to the urinary bladder using the ureter.


Two major blood vessels areassociated with the kidney. The renal artery, a branch of the abdominal aorta, and the renal vein, which empties into

the inferior vena cava.

THE NEPHRON

TYPES OF NEPHRONS

Cortical nephron: Originates in outer

2/3 of cortex. Involved in solute

reabsorption.

Juxtamedullary nephron: Originates in inner

1/3 cortex. Important in the

ability to produce a concentrated urine.

Has longer Loop of Henle.

Insert fig. 17.6

THE NEPHRON

THE NEPHRON

STRUCTURES OF THE NEPHRON

1. BOWMAN’S CAPSULE2. PROXIMAL CONVOLUTED TUBULE3. LOOP OF HENLE

A. DESCENDING LIMBB. ASCENDING LIMB

4. DISTAL CONVOLUTED TUBULETHESE EMPTY INTO THE COLLECTINGDUCT OR TUBULES.

PROXIMAL CONVOLUTED TUBULE

PROXIMAL CONVOLUTED TUBULES

Simple cuboidalepithelial cells

withprominent brushborders of microvilli.

DECENDING LIMB OF THE LOOP OF HENLE

DECENDING LIMB OF THE LOOP OF HENLE

Simple squamous epithelial cells

ASCENDING LIMB OF THE LOOP OF HENLE

ASCENDING LIMB OF THE LOOP OF HENLE

Simple cuboidalepthelial to lowcolumnar cells.

DISTAL CONVOLUTED TUBULE

DISTAL CONVOLUTED TUBULES

Simple cuboidal epthelial cells.

THE NEPHRON

1. Proximal convoluted tubule

2. Descending limb of Loop of Henle

3. Ascending Limb of Loop of Henle

4. Distal convoluted tubules

1. Simple cuboidal epithelial cells with prominent brush borders of microvilli.

2. Simple squamous epithelial cells

3. Simple cuboidal to low columnar epithelial cells.

4. Simple cuboidal epthelial cells.

THE NEPHRON

BLOOD VESSELS OF THE NEPHRON

1. AFFERENT ARTERIOLE2. GLOMERULUS3. EFFERENT ARTERIOLE4. PERITUBULAR CAPILLARIES5. VASA RECTA

JUXTAGLOMERULAR APPARATUS

THE JGA IS LOCATED WHERETHE INITIAL PORTION OF THE

DISTAL CONVOLUTED TUBULE LIES AGAINST THE AFFERENT,

AND SOMETIMES THE EFFERENT,ARTERIOLE.


SOME THE SMOOTH MUSCLE CELLS OF THE AFFERENT ARTERIOLES

ENLARGE AND HAVE PROMINENT SECRETORY GRANULES

CONTAINING RENIN. THESE CELLS ARE TERMED JG CELLS, ANDTHEY ACT AS BARORECEPTORS.


THE CELLS OF THE DISTAL CONVOLUTED TUBULE WHICH

CONTACT THE ARTERIOLES ARE TERMED THE MACULA DENSA.

THESE CELLS DETECT CHANGES IN THE RATE AT WHICH URINE FLOW

PAST THEM AND THE CONCENTRATION OF SOLUTES IN THE URINE.


THE MACULA DENSA CELLS TRIGGER THE RELEASE OF

LOCALLY ACTING CHEMICALS WHICH EITHER VASOCONSTRICT OR VASODILATE THE AFFERENTARTERIOLE. THIS RESULTS IN A

CHANGE THE GFR.

KIDNEY PHYSIOLOGY

KIDNEY PHYSIOLOGY

URINE FORMATION AND THE SIMULTANEOUS ADJUSTMENT OF BLOOD COMPOSITION INVOLVES

THREE MAJOR PROCESSES:

1. GLOMERULAR FILTRATION2. TUBULAR REABSORPTION3. SECRETION

KIDNEY PHYSIOLOGY

KIDNEY PHYSIOLOGY

FILTRATION is the movement of substances from the

glomerulus into the lumenof bowman’s capsule. This

forms filtrate.

KIDNEY PHYSIOLOGY

REABSORPTION is the movement of substances,

solutes and water, across the walls of

nephron into the capillariesassociated with the nephron.

KIDNEY PHYSIOLOGY

SECRETION is the movementof substances from the capillaries, associated

with the nephron, across the walls of nephron into the filtrate with

the nephron.

OSMOTIC EFFECTS

Water serves as the universal solvent in which

a variety of solutes aredissolved. Solutes can beclassified as electrolytes

and nonelectrolytes.

ELECTROLYTES

Electrolytes have ionic bonds which allow the compounds

to dissociate into ions in water. Because ions are

charged particles, they can conduct an electrical current.

ELECTROLYTES

Examples of electrolytesinclude inorganic salts,inorganic and organic

acids and bases, and some proteins.

NONELECTROLYTES

Nonelectrolytes have bonds,usually covalent bonds, that

prevent them from dissociating in solution.

Therefore, they have no electrical charge.

NONELECTROLYTES

Examples of nonelectrolytesinclude glucose, lipids,creatinine, and urea.

OSMOTIC EFFECTS

All dissolved solutescontribute to the osmotic

activity of a fluid. However,electrolytes have greater

power because each electrolyte molecule dissociates into at

least 2 ions.

OSMOTIC EFFECTS

Water moves according toosmotic gradients—from

areas of lesser osmolality to areas of greater osmolality.

OSMOLALITY

A solution’s osmolality is number of solute particles

dissolved in one liter of water. Osmotic activity is

determined only by the number of solute particles.

OSMOLALITY

Ten sodium ions have thesame osmotic activity as ten

glucose molecules or ten amino acids in the same

volume of solution.

OSMOLALITY

Water moves according to osmotic gradients—

from areas of lesser to higher osmolality.

GLOMERULAR FILTRATION

“Urine” formation begins withglomerular filtration. It is a passive process

in which fluids and solutes are forced through the glomerular membrane.


Substances which pass fromthe glomerulus into thenephron include: water,

electrolytes, glucose, aminoacids, vitamins, smallproteins, creatinine, urate ions, and urea.


The net filtration pressure(NFP) is responsible for

filtrate formation.

NFP=HPg- (OPg+ HPc)


Glomerular filtrationrate, GFR, is the total amount

of filtrate formed per minute by the kidneys. A normal GFR in both

kidneys is 120-125 ml/min orabout 180 l/day

GLOMERULAR FILTRATION RATE

FACTORS GOVERNINGFILTRATION RATE

Total surface area available for filtration.

Filtration membrane permeability

Net Filtration Pressure


GFR IS HELD RELATIVELY CONSTANT BY TWO IMPORTANT

MECHANISMS THAT REGULATE RENAL BLOOD FLOW:

1. INSTRINICALLY BY RENALAUTOREGULATION

2. EXTRINICALLY BY NEURAL AND HORMONAL CONTROLS

RENAL AUTOREGULATION OF GFR

To maintain a stable GFR, the kidney regulates the diameter

of the afferent arteriole.therefore, when B.P. decreases

the vessel dilates, and whenB.P. increases the vessel

constricts. This results in a stable G.F.R.

RENAL AUTOREGULATION OF GFR

THE KIDNEY USES TWO MECHANISMS TO PREFORM

AUTOREGULATION:

1. MYOGENIC MECHANISM2. TUBULOGLOMERULAR FEEDBACK

MYOGENIC MECHANISM

The myogenic mechanism is based onthe tendency of vascular

smooth muscle to contract when stretched. If B.P. is elevated, the

smooth muscle in the afferent arterioles are stretched. In response, the smooth

muscle contracts, which narrows the arteriole’s lumen, and renal blood flow

decreases, which reduces GFR to is previous level. This mechanism normalizes renal blood flow

and GFR within seconds after blood pressure changes.

TUBULOGLOMERULAR FEEDBACK

The macula densa cells of the juxtaglomerular apparatusrespond to changes in theosmolarity and changes in flow rate of the filtrate at

the junction of the D.C.T. and the ascending limb of the loop of

Henle.

TUBULOGLOMERULAR FEEDBACK

This results in the secretion of chemicals which produce

local vasoconstriction of the afferent and efferent

arterioles. Examples include nitric oxide, adenosine, endothelin, and prostaglandins.This mechanism operates more slowly than

the myogenic mechanism.

EXTRINIC CONTROL OF GFR

THE GFR CAN ALSO BE CONTROLLED EXTRINICALLY

BY:

1. SYMPATHETIC NERVOUS SYSTEM2. RENIN, ANGIOTENSION,

ALDOSTERONE MECHANISM

TUBULAR REABSORPTION

The proximal convolutedtubules are the most active

in tubular reabsorption.All glucose, lactate, and

amino acids are reabsorbed in this area.


About 65% of sodium, 70% ofwater, are also reabsorbed

90% of bicarbonate ions, 50% of chloride ions, and 55% of

potassium are reabsorbed in the proximal convoluted

tubules.


This large amount oftubular reabsorption

associated with the pct, results in the GFR

being reduced from 120 ml/minto about 40 ml/min.

REABSORPTION IN PROXIMAL NEPHRON


Tubular reabsorption from the loop of Henleresults in 10% of water

being reabsorbed from thedescending limb, 30% of

potassium ions, 20% of sodium,and 35% of chloride from the

ascending limb.

REABSORPTION IN LOOP OF HENLE


Fluids enters the distalconvoluted tubules at a rate of about 25 ml/min.

because about 80% of the water in the filtrate has been

reabsorbed.


As fluid flows throughthe DCT, sodium and chlorideare reabsorbed. By the time fluids reaches the end of the DCT, about 90% of the filtered solutes and water has been

returned to the blood.

THE COUNTER CURRENTMECHANISM

One of the functions of thekidneys is to regulate urineconcentration and volume.

The kidneys accomplish this bythe countercurrent

mechanism.


In the kidneys the countercurrent mechanism

involves the interaction between the flow of filtratethrough the loops of Henle,

and the flow of blood through the adjacent vasa recta

blood vessels.


The flow in these two structures is opposite in

direction.


The NaCl concentrationof the medulla acts as an

osmotic force which “draws”water from the descendinglimb of the loop of Henle.


This is possible because the descending limb is lined with simple squamous epithelial cells,

that are permeableto water, but, impermeableto NaCl and other solutes.


The movement of water causesthe osmolarity of the filtrate

to increase from 300 to 1,200

mOSM/L.


The ascending limb of the loop of Henle reabsorbs

chloride by active transport.In addition, as chloride moves

from the filtrate it “pulls”sodium along into the

medulla.


This is possible because the ascending limb is

impermeable to water.


The movement of NaCl into the medulla decreases

the osmolarity of the filtrate from 1,200 to 100

mOsm/L.


The hyperosmotic medulla also “pulls” water from the collecting ducts. This variesdepending on the amount ofADH. As water moves from

the collecting duct, urea follows.


Thus, water is conserved, as well as,

a certain amountof urea. The urea contributes to the high osmolarity of the

medulla.


The vasta recta is composedof capillaries which

surround the loop of henle.The vessels flow

counter (opposite) to theloop of Henle and act as a counter current exchanger.


As blood flows through thevasa recta it picks up waterand leaves behind NaCl.


Therefore, the vasa recta returns water back to the

body and the NaClmaintains the hyperosmotic

medulla.

TUBULAR SECRETION

Tubular secretion is themovement of chemicals from the blood into the

nephron. This process can occur in the proximal or distal convoluted tubules.

TUBULAR SECRETION

THIS PROCESS IS IMPORTANT FOR:

1. Disposing of substances which were not filtered.

2. Removal of excess K+ .3. Controlling blood ph.4. Eliminating substances which have

been reabsorbed.

TUBULAR SECRETION

Most secretion occurs withinthe PCT. Substances such as

neurotransmitters, bile pigment, uric acid, penicillin,

atropine, morphine, H+ ,and ammonia are secreted.

TUBULAR SECRETION

The DCT receives mainlyK+ and H+ ions from

the blood.

SECRETION OF HYDROGEN AND POTASSIUM

KIDNEY PHYSIOLOGY

AMOUNT AMOUNT AMOUNT

FILTERED = REABSORBED + EXCRETED

KIDNEY PHYSIOLOGY

If the kidneys filters 16 grams of NaCl per day, and

reabsorb 14 grams of NaCl per day, then 2 grams of NaCl

would be excreted by the kidneys per day.

KIDNEY PHYSIOLOGY

Renal clearance refersto the volume of plasma

that is cleared of a particular substance in a

given time, usually 1 minute.

KIDNEY PHYSIOLOGY

RENAL CLEARANCE CAN BE CALCULATED USING:

RC = UV/P

U=CONCENTRATION OF SUBSTANCE IN URINE (mg/ml)

V= FLOW RATE OF URINE FORMATION (ml/min)

P=CONCENTRATION OF SUBSTANCE IN PLASMA (mg/ml)

RENAL CLEARANCE

QUESTIONS:1. If the renal clearance rate is = to

GFR?

2. If the renal clearance rate is greater than GFR?

3. If the renal clearance rate is less than GFR?

RENAL CLEARANCE

1. All of the substance is filtered—inulin.

2. All of the substance is filtered and addition is secreted—PAH.

3. Some of the substance is reabsorbed—urea.

RENAL CLEARANCE

HORMONAL CONTROL OF THE KIDNEYS

ANTIDIURETIC HORMONE

HORMONAL CONTROL OF URINE CONCENTRATION

One of the most important hormones in

the control of urine concentration and

volume is antidiuretic hormone, ADH.

ANTIDURETIC HORMONE

Antiduretic hormone prevents wide variation in water balance, helping to

avoid dehydration or edema.

ADH is synthesized by neurosecretory cells whose cells bodies are located in the supraoptic nuclei of the hypothalamus.

The ADH is “packaged” within vacuoles. The vacuoles move by axonal transport to the axonal terminals of the neurosecretory cells which make up the hypothalamic hypophyseal tract. The vacuoles are stored in the posterior lobe of the pituitary.

ANTIDURETIC HORMONE

The chemical class of ADHis a protein

ANTIDURETIC HORMONE

Solute concentrations in the blood are monitored by osmoreceptorsin the hypothalamus.

This is an example of humerol control.

ANTIDURETIC HORMONE

When solute concentrationsincrease, thereby, increasing

osmotic pressure, the receptors are stimulated.

ANTIDURETIC HORMONE

The osmoreceptors,in turn, stimulate

hypothalamic neurons in the supraoptic nucleus, which

synthesize ADH.

ENDOCRINE SYSTEMENDOCRINE SYSTEM

ANTIDURETIC HORMONE

Nerve action potentials trigger the release of ADHfrom the axonal terminalsin the posterior lobe of the

pituitary.

ENDOCRINE SYSTEMENDOCRINE SYSTEM

ANTIDURETIC HORMONE

ADH travels through the systemic circulation to the distal convolutedtubules of the nephronand the collecting ducts.

ANTIDURETIC HORMONE

ADH causes water to bereabsorbed from the

D.C.T. and the collecting ducts into the capillaries

which surround the nephron.

ANTIDURETIC HORMONE

THE RESULTS OF ADH:

1. A decrease in osmolality2. An increase in blood volume3. A decrease in urine output4. An increase in the

concentration of the urine.

ANTIDURETIC HORMONE

This chart is a good summary of the events of ADH.

ANTIDURETIC HORMONE

ADH is regulated by negative feedback; when solute concentrations are

reduced to normal levels the amount of ADH is reduced.

ANTIDURETIC HORMONE

PATHOLOGY

1. Hypersecretion can produce SIADH.

2. Hyposecretion can produce diabetes insipidus.

ALDOSTERONE

ALDOSTERONE

Aldosterone’s function is tohelp maintain Na+ ion

balance, and indirectly water balance and K+,

within the fluid compartments of the body.

ALDOSTERONE

The chemical class of aldosterone is steroid

ALDOSTERONE

A decrease in blood pressure

ALDOSTERONE

Aldosterone is synthesized by the cells of the zonaglomerulosa in theadrenal cortex.

ALDOSTERONE

Aldosternone targets the D.C.T.

of the nephron.

ALDOSTERONE

EFFECTS OF ALDOSTERONE:

1. REABSORPTION OF Na+ IONS.

2. WATER IS REABSORB USING THESAME TRANSPORT MECHANISM.

3. K+ IONS ARE SECRETION INTO THE DCT FROM THE CAPILLARIES.

ALDOSTERONE

Aldosterone secretion is controlled by negative

Feedback.

ALDOSTERONE

PATHOLOGY:

1. Hypersecretion can producealdosteronism.

2. Hyposecretion can produce addison disease.

ESTROGEN

ESTROGEN

Estrogen is a female sexhormone produced by

the ovaries.

ESTROGEN

EFFECTS OF ESTROGEN:

1. Reabsorption of Na+ ions.

2. Water is reabsorb using the same transport mechanism.

3. Ca2+ deposition into bone.

CORTISOL

CORTISOL

Cortisol is a hormone produced by the cortex ofthe adrenal gland. It helps in the conversion of lipids and proteins to form glucose (gluconeogensis).

CORTISOL

EFFECTS OF CORTISOL:

1. Reabsorption of Na+ ions.

2. Water is reabsorb using the same transport mechanism.

3. Can cause edema.

BONE CALCIUM REGULATION

CALCITONIN

Calcitonin is a hormoneproduced by the thyroid gland in response to highlevels of Ca2+ ions in the

blood.

CALCITONIN

EFFECTS OF CALCITONIN:

1. Ca2+ ion deposition into bone.

2. Inhibit osteoclasts.

CALCITONIN

Calcium

PARATHYROID HORMONE

Parathyroid hormoneis produced by the

parathyroid gland in responseto low levels of Ca2+ ions

in the blood.

PARATHYROID HORMONE

EFFECTS OF PTH:

1. Causes the break down of the inorganic matrix of bone, releasing Ca2+ ions.

2. Increase absorption of Ca2+ ions.

3. Reabsorption of Ca2+ ions from the DCT.

PARATHYROID HORMONE

Calcium

ACID BASE BALANCE

BLOOD pH REGULATED BY:1. KIDNEYS2. LUNGS3. BUFFERS IN BLOOD

KIDNEY REGULATION

The kidney can regulatepH by retaining or excreting

hydrogen or bicarbonateions.

ACID-BASE BALANCE

Blood

Kidney NephronHCO3

-

H+

Urine

RESPIRATORY REGULATION

The respiratory systemregulates pH by

regulating the amountof carbon dioxide in

the blood.

CARBON DIOXIDE and pH

CO2 + H2O H2CO3 H+ + HCO3-

Carbonic Acid

RESPIRATORY REGULATION

If the pH is low, therespiratory rate will

be decreased, and if thepH is high, the respiratory

rate will be increased.

DISEASES and ABNORMALITIES ASSOCIATED WITH THE URINARY SYSTEM

ACIDOSIS

1. pH below 7.35

2. Depresses the nervous system.

ALKALOSIS

1. pH above 7.45.

2. Overexcites the nervous system.

RESPIRATORY ACIDOSIS

Any condition that impairs breathing can

cause respiratory acidosis.This can result in an increase

in the amount of carbondioxide in the blood and a

reduction in the pH.

RESPIRATORY ALKALOSIS

Any condition that leadsto hyperventilation can

cause respiratory alkalosis.This can result in an decrease

in the amount of carbondioxide in the blood and a

increase in the pH.

METABOLIC ACIDOSIS

Metabolic acidosis iscaused by excess acids in the blood. This can be the

result of renal disease, diabetes mellitus, or a

decrease in the number of bicarbonate ions in the blood.

METABOLIC ALKALOSIS

Metabolic alkalosis is caused by a reduction in the amount of acid in the blood.

This can be the result of vomiting, diuretics, or

excessive bicarbonate ionsin the blood.

SODIUM

FUNCTIONS:

1. Attracts water into the ECF.

2. Nerve impulses.

3. Muscle contraction.

HYPERNATREMIA

EXCESS SODIUM:

1. Hypertension2. Muscle twitching3. Mental confusion4. Coma

HYPONATREMIA

DEFICIENCY OF SODIUM:

1. Hypotension2. Tachycardia3. Muscle weakness

POTASSIUM

FUNCTIONS:

1. Attracts water into the ICF.

2. Nerve impulse

3. Muscle contractions

HYPERKALEMIA

EXCESS POTASSIUM:

1. Can lead to a cardiac arrhythmia

2. Elevated t waves

3. Muscle weakness

HYPOKALEMIA

DEFICIENCY OF POTASSIUM:

1. Can lead to cardiac arrhythmia.

2. Depressed (flatened) t waves

3. Muscle weakness

CALCIUM

FUNCTIONS:

1. Matrix of bones and teeth

2. Nerve impulse

3. Muscle contraction

HYPERCALCEMIA

EXCESS CALCIUM:

1. Excess in calcium in blood

2. Kidney stones

3. Cardiac arrhythmia

HYPOCALCEMIA

DEFICIENCY OF CALCIUM:

1. Tetany

2. Weak heart muscle contractions.

3. Increased clotting time.

URINARY DISEASES

RENAL CALCULI (KIDNEY STONES)

1. Caused by the crystallization of Ca2+ and Mg2+ salts in the renal pelvis.

2. If the stone travel down the ureter, the patient will be in pain.

URINARY DISEASES

CYSTITIS

1. Caused by bacteria, usually E. coli, Klebsiella, or Proteus.

2. Leads to inflammation, fever, increased urgency and frequency of urination and pain.

URINARY DISEASES

GLOMERULONEPHRITIS:1. Caused by inflammation of theglomerulus due to streptococcalantibody complexes.

2. Inflammation of the glomerulusleads to faulty filtration.

URINARY DISEASES

INCONTINENCE:

1. Caused by loss of the ability to control voluntary micturition due to age, emotional disorders, pregnancy, or damage to the nervous system.

2. Leads to wet clothing.

URINARY DISEASES

GOUT:1. Caused by a increased blood level of uric acid. This leads toinflammation of the soft tissue associated with joints.

2. Decreased and painful movement.

ALDOSTERONISM

EXCESS ALDOSTERONE:

1. Elevated sodium levels

2. Depressed potassium levels

3. Hypertension

ADDISON’S DISEASE

DEFICIENCY OF ALDOSTERONE:

1. Hypotension

2. Low blood glucose levels.

3. Color of skin.

CUSHING’S SYNDROME

EXCESSIVE GLUCOCORTICOIDS:

1. Hyperglycemia

2. Fat accumulation

DIABETES MELLITUS

HYPOSECRETION OR ACTIVITY OFINSULIN:

1. Hyperglycemia2. Polyurea3. Thirst4. Body burns fat-ketones5. Vascular problems

INSULIN

Glucose

Cell

Blood

DIABETES INSIPIDUS

HYPOSECRETION OF ADH:

1. Increased urine volume.

2. Polyurea

ADH

ADH

Hypertonic Interstitial Fluid

Collecting Duct

H2O

Urine

DIALYSIS THERAPY

Dialysis is a process that artificiallyremoves metabolic wastes from the blood in order to compensate for kidney (renal)failure. Kidney failure results in the rapidaccumulation of nitrogen waste

(urea,etc.). Uremia and ion disturbances can also occur. This condition can cause acidosis,labored breathing, convulsions, coma and death.

DIALYSIS THERAPY

The most common form of dialysisishemodialysis which uses a machine to transfer patient’s blood through a semipermeable tube that is permeable only to selected substances. The

dialysismachine contains an appropriate

dialysis fluid that produces a diffusion gradient.

DIALYSIS THERAPY

This gradient allows abnormal substances

to diffuse from the patient’s blood and produce a “cleaning” effect.

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