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The removal of toxins and the waste from metabolism from the body.

Excretion vs. egestion

Egestion: removal of undigested material from alimentary canal. Not formed from
substances within cells, never been absorbed into cells. Not a product of metabolic

• The function of the kidney is to remove urea (excretion), and excess water
(osmo-regulation of water AND pH).
• Enters from renal artery, leaves through renal vein. Capillaries branch
throughout kidney in a complex fashions.
• Urine, formed in the kidneys, drains via the ureters into the bladder, for
storage, until appropriate time for release through the urethra.
• Made of cortex and medulla.
• Cortex: Outer dark red region, protected by fibrous capsule on the outside.
• Medulla: Inner thicker region, which is pale red.
o Consists of 12 to 16 conical structures called pyramids.
o The radial stripes on these pyramids indicate numerous uriniferous tubules, or
o The pyramids project into a funnel-like space called the renal pelvis.

How blood travels:

• Blood enters the kidney by the renal artery, which gives off numerous
branches or arterioles.
• Each branch breaks up into a mass of blood capillaries in the Bowman’s
capsule (glomerulus).
• Blood leaving the glomerulus enters the blood capillaries surrounding the
• These blood capillaries then unite to form venules, which in turn join to form a
branch of the renal vein.

Production of urine
Blood leaving kidney has lower concentration of mineral salts and nitrogenous waste
products than blood entering kidneys. It also has less oxygen and more carbon

(STEP ONE) Malpighian corpuscle: Ultrafiltration of very small molecules

from blood
• The passage of solutes and water out of the glomerulus, into the Bowman’s
• Blood passes from branches of renal artery into glomeuli in renal capsules.
• Mechanical filtration occurs in each glomerulus

1. Hydrostatic blood pressure in glomerulus

- Afferent arteriole bringing blood to glomerulus wider (larger lumen) than
efferent arteriole carrying blood away
- Creates hydrostatic blood pressure, providing main force for ultra-filtration
- Forces fluid through walls of glomerular capillaries into Bowman’s capsule,
forming filtrate

2. Partially permeable membrane

- Filter in glomerulus is partially permeable membrane wrapping around
glomerular blood capillaries
- Called the basement membrane
- Has very small pores allowing only water and very small molecules (glucose,
amino acids, mineral salts, nitrogenous waste products) to pass through
- Cells and large blood proteins remain in glomerular capillaries (blood cells,
platelets and large molecules such as proteins and fats)
- Filtrate in Bowman’s capsule has same composition as blood plasma, without
large proteins and red blood cells.
• If RBC or large proteins are found in urine; indicates the filtration mechanism
of the Malpighian corpuscle has broken down, and that blood is leaking from
the glomerulus into the Bowman’s capsule. A result of damaged glomerular
blood vessels, or very high blood pressure.

(STEP TWO) Proximal convoluted tubule: Selective reabsorption of filtrate

• Selective uptake of solutes and water through processes such as osmosis
(most water), active transport (all glucose, all amino acids and some sodium
chloride) and diffusion (half of urea)
• Takes place at proximal convoluted tubule
• As filtrate passes through tubule, useful materials taken back into
bloodstream by selective reabsorption
• As a lot of filtrate formed, most of filtrate has to be reabsorbed along length of
nephron to prevent dehydration (body losing too much water)

1. Osmosis
- Water
- Possible due to blood capillary networks surrounding PCT
- More negative water potential of blood in capillaries (due to RBC and proteins
present) allow for osmosis
- Most reabsorption of water occurs at PCT; Water also reabsorbed at loop of
Henle and DCT and collecting duct into surrounding blood capillaries

2. Active transport
- All glucose and amino acids and some sodium chloride (NaCl also reabsorbed
at DCT)
- Against concentration gradient
- Needs energy

3. Diffusion
- Urea
• Excess water, excess salts and metabolic waste products such as urea, uric
acid and creatinine pass out of collecting duct into renal pelvis as mixture
called urine
Loop of Henle – water conservation
- Large amount of sodium chloride pumped out of loop of Henle via active
- Retained in medullary region of kidney, providing high salt concentration
- Water potential of medulla decreases
- Water in loop of Henle travel from less negative water potential (LOH) to more
negative water potential (medulla) via osmosis down concentration gradient
- Osmotic concentration within kidney increases from outer cortex to medulla
Loop of Henle is long to increase surface area for osmosis to take place.

Distal convoluted tubule – pH adjustment, ion reabsorption (to fine-tune

- Ions useful in metabolism selectively reabsorbed from filtrate
- Under control of hormone aldosterone formed in cortex of adrenal glands
- If blood pH falls below pH 7.35, H+ ions withdrawn from blood to filtrate and
HCO- ions transported from filtrate to blood.
- If blood pH rise above 7.45, OH- ions removed from blood to filtrate along with
HCO- ions.
- Blood pH does not vary wider than limits 7.35-7.45 but pH of urine varies
much more from 4.5 to 8.2

Collecting duct – water reabsorption

- Passes through this region of high salt concentration
- Collecting tubule is permeable to water but not to salt
- Water passes from collecting tubule back into kidney and into blood vessels.
- ADH increases permeability of cell membranes of collecting ducts.

Maintaining water potential of blood

• If blood plasma too dilute, water enter blood cells by osmosis and blood cells
swell and burst. Tissue cells also swell because of water moving into cells
• If blood plasma too concentrated, water move out of cells by osmosis. Blood
cells and tissue cells become dehydrated and shrink, unable to carry out
metabolic functions.
- Water potential dependent on amount of water and salts in plasma.
- Amt of water in blood controlled by vasopressin or antidiuretic hormone (ADH)
- ADH produced by region of brain called hypothalamus, released by pituitary
gland and increases water reabsorption by kidney tubules
- Kidneys = osmoregulators and regulates water or salt concentration in blood

1. Loss of water through sweating

• Water potential in plasma decreases

• Stimulates hypothalamus in brain
• Pituitary gland releases more ADH into bloodstream
• Kidney tubules reabsorb more water (less urine produced, urine more conc.)
• Water potential in blood returns to normal
2. Large intake of water e.g. drinking

• Water potential in plasma increases

• Stimulates hypothalamus in brain
• Pituitary gland releases less ADH into bloodstream
• Kidney tubules reabsorbs less water. More urine, urine more diluted
• Water potential in blood returns to normal

(STEP THREE) Collecting tubule: Active secretion

• Secretion is the active excretion of particular substances by cells of tubule
• Ammonium, potassium and hydrogen ions are actively secreted into the
• Various dyes and drugs (e.g. penicillin, antibiotics and aspirin) are also
eliminated by tubular secretion.

The composition of urine varies considerably due to several factors

• A protein rich diet: more urea present in the urine. This is because urea is
formed when proteins are delaminated in the liver
• Taking in more liquids: increases the water potential of the blood. Therefore
more urine is excreted. This happens too in cold places, where sweating is
• Taking in lots of salt: excess salt being excreted in the urine
• Sugar rich food will result in traces of sugar being found in the urine after the

Kidney failure:
• Retention of waste in the blood and imbalance of salts in the internal
environment, which prevents proper cell function.
• Kidney failure may develop suddenly, leading to death within a few days
(acute kidney failure), or there may be a slower progressive loss of kidney
function until a stage is reached when the remaining kidney tissue is unable
to carry out the normal function of the kidney (chronic kidney failure).
• Can be treated by: kidney transplant or dialysis.

Kidney transplant:
• Permanent and successful
• Patient does not require to go for daily dialysis treatments if receptive
• The patient’s health status would also be unaffected by mechanical errors.
• The patient would not be susceptible to infection. This is unlike peritoneal
dialysis, where the patient is required to have a catheter coming out from
within his body.
• Body might still reject the kidney.
• Immunosuppressant drugs cause immune system to weaken, to prevent the
body’s immune system from attacking the foreign kidney. Patient more
susceptible to bacterial or viral attack. Diminished immunity can increase the
risk of contracting cancer. Can cause cataracts, diabetes, extra stomach acid,
high blood pressure, and bone disease.
• Suggested diet after a kidney transplant/ kidney disease:
o No/ low (10g) protein as urea cannot be excreted.
o No salt, since salt cannot be excreted.
o Low water intake (500ml) as water cannot be expelled as urine.
o Restricted fruit (no banana/ papaya), to control potassium which
cannot be excreted.

Method of removing toxic substances from blood when kidneys are unable to do so.

• The diffusion of small molecules through a partially permeable membrane into
dialysate in a dialyser.
• The patient’s arterial blood is taken from the arm, and passed through a
dialysing unit where it exchanges urea and other salts by diffusion with
warmed dialysing fluid (dialysiate: containing ions, glucose and amino acid).
• The blood is then passed through a bubble trap (which removes air bubbles in
the blood), before the blood is returned to a vein.
• Blood travels in a counter-current opposite to the flow of dialysis liquid, to
maintain a concentration gradient.
• If blood travels in the same direction as the dialysate, the waste products are
not able to diffuse outward, because with the dialysate travelling with the
blood at the same rate, the concentration gradient will be reduced and
maintained at zero.

Peritoneal dialysis:
• The diffusion of small molecules through the partially permeable peritoneal
membrane into the dialysate in the abdominal cavity.
• Instead of blood being purified outside body like haemodialysis; purified inside
body using peritoneum as natural filter
• Abdomen is filled with dialysis fluid via a catheter. Fluid then removes toxins
and water from blood via peritoneum by absorbing it.
• “Dirty fluid” drained out and replaced with further new, clean fluid for further
• Toxins absorbed via diffusion
• Water passes through to the fluid known as ultrafiltration. The lower water
potential in the fluid causes water to pass over.

Exchange of substances between blood and dialysis fluid

• Dialysis fluid contains same concentration of essential substances (such as

mineral salts) as the blood. Ensures that such substances don’t diffuse out of
blood into dialysis fluid. If patient’s blood lacks essential salts, salts will diffuse
from dialysis fluid into blood in the tubing.
• Dialysis fluid does not contain metabolic waste products. Concentration
gradient exist which allows waste products such as urea, uric acid and
creatinine and excess water and mineral salts to diffuse out of tubing into
dialysis fluid. Waste products removed from blood. Maintains water potential
of blood.
• Tubing is narrow, long and coiled to increase surface area to volume ratio.
Speed up rate of exchange of substance between blood and dialysis fluid
• Direction of blood flow opposite to flow of dialysis fluid. Maintains
concentration gradient for removal of waste products.

Similarities of dialysis machine and kidney:

• Function of the artificial kidney is based on dialysis, which is the diffusion
(process) of small solute molecules through a partially permeable membrane
• Small molecules are free to diffuse through the dialyzing membrane, but
larger proteins and cells do not. This is similar to the filtration stage of normal
kidney function.

Differences between dialysis machine and kidney:

• Dialysis: Blood is led from an artery in the arm through a series of very thin
channels bounded by partially permeable membranes and back to a vein. On
the other sides of the membranes is dialysing fluid. Dialysing fluid contains
normal blood levels of various ions, but not urea or other waste substances.
This means that urea diffuses from blood into the dialysing fluid along its
concentration gradient. Other ions diffuse across the membrane, reaching
normal plasma levels. Blood leaving the artificial kidney and re-entering the
body has had much of its urea removed and has had its ion concentrations
• A chemical (heparin) is added to the blood to prevent it from clotting as it
travels through the machine.
• Most artificial kidneys can cleanse urea from 100 – 200mL of blood plasma
per minute. This is twice as fast as two normal kidneys can achieve.
• However, the artificial kidney can only be used for limited periods, perhaps 6 –
12 hours at a time, two or three times a week. This is because of the dangers
of using too much heparin (the anti-clotting agent), physical damage to blood
cells as they pass through the artificial channels, and increased chances of

Importance of kidneys
• Excretory organ – remove mainly nitrogenous waste products like urea,
excess water and mineral salts in form of urine
• Osmoregulators: regulate salt and water balance of body fluid.
• Increased intake of liquid food, tissue respiration or reduction of sweat
secretion will increase water amt in blood. Kidneys reabsorb less water.
Remove more water from urine. Vice versa

Kidneys help control blood pressure

• Remove metabolic waste and control water and solute levels in blood
• Vital role in blood volume control and blood pressure
• IF blood volume increases, blood pressure rise
• Blood volume same but diameter of blood vessels decreases, blood pressure
rise too.
• Large increase in blood pressure ◊ blood vessels in brains burst, stroke.
• Drugs called antidiuretics which reduce production of ADH.
• Large amt of dilute urine produced and volume of water in blood decreased,
lowering blood pressure