Denielle

Genesis B. Camato

II. RENAL FUNCTION

ANALYSIS O F URINALYSIS AND BODY FLUIDS | REVIEWER

Renal physiology
Nephron

TUBULAR REABSORPTION & TUBULAR SECRETION

1 to 1.5 million functional units of the kidney

REABSORPTION- is the movement of substances out of the tubules

across the surrounding interstitial fluid into the blood of the
capillaries.

Two types of Nephrons:

1)
Cortical nephrons
r 85% of nephrons;
r Situated at the cortex of the kidney
2)

SECRETION- occurs in small amounts in the nephron; process

whereby substances moved form the blood through the interstitial
fluid into the tubule.
ACTIVE TRANSPORT- responsible for the reabsorption of GLUCOSE,
AMINO ACIDS and SALTS in the PROXIMAL CONVOULTED TUBULES
and the reabsorption of CHLORIDE in the ascending loop of henle and
SODIUM in the distal convoluted tubule.

Juxtamedullary nephrons
r longer Henles loops and extends deep into
the medulla of the kidney

PASSIVE TRANSPORT- movement of molecules across a membrane

as a result of differences in their concentration or electrical
potential on opposite sides of the membrane. UREA and SODIUM;
Proximal convoluted tubules and ascending loop of henle, ascending
loop of henle.

4 Essential Renal Functions:

r Renal blood flow
r Glomerular filtration
r Tubular reabsorption
r Tubular secretion

Most!component!of!the!blood!except!
blood!cells!&!proteins!are!ltered!into!
the!pores!of!the!glomerulus!before!
reaching!the!Bowmans!capsule.!
Glomerular!ltrates!contents.!

RENAL BLOOD FLOW

1!

Waste!products.!Small!amounts!are!ok!
but!harmful!in!large!doses.!

2!
Next!desDnaDon!of!
the!ltrate;!Twisted!
or!coiled!

!RENAL!ARTERY!

Each kidney is supplied with blood by a single renal artery that

arises on its respective side of the aorta before dividing into fine
segmented arteries that enters the HILUS within the kidney.

RENAL&VEIN&

!
!

3!

Each segmented artery branches into several lobular arteries. The

lobular arteries further subdivides into interlobular arteries which
branched off into AFFERENT ARTERIOLE (blood enters); blood
flows INTO the GLOMERULI (filter) through the afferent arteriole.
Blood flows OUT of the GLOMERULUS through the EFFERENT
ARTERIOLE (blood exits).

4!

Lines!the!proximal!
convoluted!tubules!

URETHER&

URINE&FORMATION&

NEPHRON'

1.FILTRATION- of the blood by the glomerulus to form the

ultra filtrate of the urine
2.TUBULAR REABSORPTION- of electrolytes and nutrients
needed to make the consistency of the internal
environments
3.EXCRETION of waste materials
---------------------------------------------------------------------------FILTRATION
-occurs as blood flows into the glomerulus from its afferent
arteriole & plasma moves to the glomerular capillaries into
the BOWMANS CAPSULE. From the glomerulus, the filtrate
moves into the tubular segments of the nephron; here
through TUBULAR REABSORPTION electrolytes and
nutrients move from the filtrate back into the blood
stream. Tubular secretion substances move from the
peritubular capillaries into the urine filtrate. The filtrate
concentrate passes into the collecting tubules then find its
way to the renal pelvis where it is directed to the ureter, to
the bladder, then to the urethra for elimination
(EXCRETION).! URINE.

Ac1ve'
transport'

5"

Ac1ve'
transport'
&'
Passive'
transport'

7"

65%"of"SODIUM"are"reabsorbed;"NaCl"or"
table"salt;"salty"outside"the"tubule.."

65%"water"leaves"by"OSMOSIS;"65%"potassium"
is"reabsorbed"as"well"as"90%"bicarbonate"ions"
which"are"impt"in"maintaining"the"pH"of"the"
blood"(7.35M7.45)"

6"
Glucose"&"Amino"acids"100&"reabsorbed"to"be"used"in"
respiraTon"&"making"proteins;"not"all"UREA"(Passive'
Transport)'"leaves"as"about"50%"is"reabsorbed."
SECRETION?"Ammonia"&"drugs"are"secreted"into"the"
tubules""

LOOP'OF'HENLE;'
"
DescendingM"ltrates"travels"down"
AscendingM"ltrate"travels"up"

8"

Denielle Genesis B. Camato

II. RENAL FUNCTION

ANALYSIS O F URINALYSIS AND BODY FLUIDS | REVIEWER

&essen*al"for"the"ltra*on"of"blood"in"the"nephrons"within"
the"kidney"

&thin"line"of"the"loop"is"lined"
with"squamous"epithelial"
cells"

..and"H20"cannot"follow"
because"ascending"loop"
is"(impermeable(to"
water;"hence"the"
intersAAal"uid"
becomes"salty"

10"

9"
..by"the"Ame"ltrate"reaches"the"end"of"
loop"its"highly"concentrated"because"of"
signicant"amount"of"water"that"has"
leL."
&however"in"the"ascending"loop"water"
that"leaves"cannot"escape"the"
"ltrate."

11"

&leaves"passively"
the"ascending"
loop"&"is"
pumped"out"
acAvely"of"the"
ascending"loop;"

&network"of"capillaries"
capillary"tu="

Pumped"
out!"

&region"wherein"it"is"highly"salty;"
WHY?"Because"sodium"is"acAvely"
pumped"out"
&descending"loop"is"permeable"to"
h20;"but"has"very"low"permeability"to"
Na"&"urea;"so"as"ltrate"travels"down"
water"leaves"b/c"of"salty"
environment.."

1"
&most"capillaries"
have"an"arterial"end"
and"a"venous"end"
"
Aerent1"where"
blood"ows"
FROM;"enters"

&in"total"25%"of"NaCl"is"
reabsorbed"in"the"LOOP"
of"HENLE"

&lter"
then"is"
diluted"

2"

&components"of"the"
blood"are"ltered"out;"
glomerular*ltrate*

Eerent1"blood"
ows"THROUGH;"
exits"

12"

&uid"that"enters"
the"capsule"

4"

3"

&kitchen"strainer;"water"and"other"small"par/cles"are"able"
to"passed"through."In"glomerulus"molecules"<1.8"nm"
(water,"sodium,"inulin,"glucose)"are"freely"ltered"out"
while"those"that"are">3.6"are"not"ltered"(red"blood"cells,"
haemoglobin..)"

!place$wherein$ini6al$adjustments$are$
made$in$the$ltrate.$Under$the$
inuence$of$hormone$
ALDOSTERONE$

&where"ltra/on"
occurs"

!in$order$to$prevent$cells$from$being$
damaged$

Collec<ng#
ducts;#where$
nal$
adjustments$
takes$place#

!NaCl$is$reabsorbed$in$addi6on$to$Urea;$
although$some6mes$Urea$can$RE!enter$the$
tubules$at$the$loop$of$henle$(urea$recycling)$

6"

3)LAYERS)
Capillary)wall)membrane)
!Fenestra(ons&"pores;"lets"
everything"through"except"for"
blood"cells"
Basement)Membrane&"
prevents"ltra/on"of"large"
proteins"
Visceral)Epithelium)of))
Bowmans)Capsule&"has"podocytes.
"
Pedicels&"nger&like"projec/ons;"
so"
close"to"each"other"has"narrow""
Slits"between"them;"allows"small"
molecules"to"pass"through"

$$$$$$UREA$

NaCl$

16#

15#

5"

Distal#convoluted#
tubules#

14#

13#
!Na$is$reabsorbed$followed$closely$by$Cl;$while$POTASSIUM,$all$hydrogen$ions$are$
secreted$in$the$tubules.$Almost$all$remaining$bicarbonate$is$reabsorbed;$although$
DCT$is$normally#impermeable#to#water:#small$amounts$maybe$reabsorbed$too..$

Zoomed&in)sec,on)of)barrier)

&barrier"is"charge&selec/ve;"dicult"for"nega/ve"molecules"to"pass"through"hence"albumin"is"not"
ltered"despite"being"in"the"size"range.""""

8"

7"

water*channels*
in*the*epithelium*
allowing*H20*to*
be*reabsorbed*

!regulates*water*
in*the*body.*Acts*
to*retain*levels*of*
water*in*the*body*
by*reabsorp9on*

17#

18#

&pressure"exerted"by"plasma"
protein"on"walls"in"which"
they"are"contained;"sponge&
like"eect"encouraging"uid"
to"be"drawn&in"hence"""""
pulling"

&refers"to"the"force"a"uid"
exerts"on"the"walls"of"its"
compartments;"eg:"water"
pushing"inside"the"water"
balloon"but"uid"can"be"
pushed"out."

***Medulla*is*SALTY*so*if*
the*water*is*given*
permission*to*leave..*It*
WILL!*!*

9"

###DEHYDRATED#

&depends"on"a"balance"
that"favours"the"ltra8on"
and"those"that"opposed"
it"

10"

&major&driving&force&for&
ltra2on;&forces&uid&out&of&
capillary&

!lack*of*ADH*means*collec9ng*duct*
is*less*impermeable*to*H20*so*
excess*water*can*passed*out*into*
the*URINE!**

19#

&opposes"the"hydrosta8c"force"
of"the"capillary""

!in*general*URINE*contains*
H20,*urea,*NaCl,*potassium*
and*crea9nine..*

20#
#####OVERHYDRATED##

12"

11"

GLOMERULAR)FILTRATION)

'#We#tend#to#ignore#onco2c#
pressure#of#the#bowmans#capsule#
as#only#2ny#amounts#of#protein#
are#usually#present#in#the#
glomerular#ltrate#

RENAL&CORPUSCLE.))essen2al)for)the)ltra2on)of)blood)in)
the)nephrons)of)the)kidney)
)
GLOMERULUS.)basically)a)network)of)the)capillaries;)
capillary)tuF.)Located)within)the)BOWMANS)CAPSULE.)
Although)the))glomerulus)serves)as)a)nonselec2ve)lter)of)
plasma)substances)with)molecular)weights)of)less)than)
70,000,)several)factors)inuence)the)actual)ltra2on)process.)
)
FACTORS:)
Structure)of)the)capillary)walls)&)Bowmans)capsule)
Hydrosta2c)and)Onco2c)pressures)
Renin.Angiostenin.Aldosterone)system)

14#

610%mmHg%of%mercury..%

GFR#accounts#for..#
'there#are#many#nephrons#
hence#there#are#many#renal#
corpuscles#in#the#kidney.##
#
GFR'#refers#to#the#total#amount#
of#the#ltrate#all#formed#by#the#
renal#corpuscle#in#both#kidneys#
per#minute#

)
)
)

NFP$#equals#the#pressure#
favouring#ltra2on:##
#
minus&the#pressures#
opposing#ltra2on#(eg:%
hydrosta.c%pressure%of%
the%glomerulus)%%
minus#hydrosta2c#
pressure#of#the#bowmans#
capsule##
minus&the#pressure#of#the#
glomerular#onco2c#
protein#which#is#equals#
to#

13#

15#

&of"BOWMANS"
Capsule"

#
#And&permeability&of&&

The#standard#test#used#to#
measure#the#ltering#capacity#of#
the#glomeruli#is#the#clearance+
test.+As#its#name#implies,#a#
clearance#test#measures#the#rate#
at#which#the#kidneys#are#able#to#
remove#(to#clear)#a#lterable#
substance#from#the#blood.##

glomeruli!&
#

'can#be#used#to#assessed#as#a#clue#
whether#an#individual#has#renal#
impairment.#

16#

Denielle Genesis B. Camato

II. RENAL FUNCTION

ANALYSIS O F URINALYSIS AND BODY FLUIDS | REVIEWER

##

GFR=#product#of#surface#
area#and#permeability#
mul*plied-by#NFP.##

17#

The#GFR#is#reported#in#mL/min;#
therefore,#determining#the#number#of#
milliliters#of#plasma#from#which#the#
clearance#substance#(crea=nine)#is#
completely#removed#during#1#min#is#
necessary#

.ltra*on-coecient-mul=plied#by#
NFP-

18#

Kpermeability#of#surface#area#of#
glomeruli#tends#to#be#greater#b/c#
of#fenestra=ons#and..#

19#

20#

Example:#if#we#constrict#the#aerent#arteriole;##
the#hydrosta;c#pressure#of#the#blood#will#
decrease#due#to#the#reduc;on#of#blood;#as#this#
pressure#is#associated#with#NFP,#this#will#also#
decrease#so#as#GFR..#

Glomerulus#&#bowmans#
capsule#is#highly#specialized#in#
ltra;on#of#blood#and..#

21#

22#

GFR#is#a#good#indicator#as#to#how#well#the#
kidneys#are#working..#

KEY$NOTES:$
When# interpre;ng# the# results# of# a# crea;nine# clearance# test,# the# GFR# is#
determined# not# only# by# the# number# of# func;oning# nephrons# but# also# by# the#
func;onal#capacity#of#these#nephrons.#
Currently,# rou;ne# laboratory# measurements# of# GFR# employ# crea;nine# as# the#
test# substance.# Crea;nine,# a# waste# product# of# muscle# metabolism# that# is#
normally# found# at# a# rela;vely# constant# level# in# the# blood,# provides# the#
laboratory#with#an#endogenous#procedure#for#evalua;ng#glomerular#func;on.#
Therefore,# although# the# crea;nine# clearance# is# a# frequently# requested#
laboratory# procedure,# its# value# does# not# lie# in# the# detec;on# of# early# renal#
disease.# Instead,# it# is# used# to# determine# the# extent# of# nephron# damage# in#
known# cases# of# renal# disease,# to# monitor# the# eec;veness# of# treatment#
designed#to#prevent#further#nephron#damage,#and#to#determine#the#feasibility#
of#administering#medica;ons,#which#can#build#up#to#dangerous#blood#levels#if#
the#GFR#is#markedly#reduced.#

LOOP OF HENLE.MP4

23#

Source:
https://www.youtube.com/watch?v=8UVlXX-9x7Q
https://www.youtube.com/watch?v=9A2dAyWyK6o
https://www.youtube.com/watch?v=cYyJF_aSC6o