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Renal Functions

Renal Functions
1: Regulation of Water and Electrolyte

Balance 2: Excretion of Metabolic Waste 3: Excretion of Bioactive Substances (Hormones and Many Foreign Substances, Specifically Drugs) That Affect Body Function 4: Regulation of Arterial Blood Pressure

5: Regulation of Red Blood Cell

Production Erythropoietin is secreted by the renal cells (particular group cells in the interstitium). 6: Regulation of Vitamin D Production The active form of vitamin D (1,25dihydroxyvitamin D3), is actually made in the kidneys, 7: Gluconeogenesis Most gluconeogenesis occurs in the liver, but a substantial fraction occurs in the kidneys, particularly during a prolonged

Anatomy of the Kidneys and Urinary System


Gambar

Between the tubules and blood vessels

lies an interstitium, which comprises less than 10% of the renal volume. The interstitium contains scattered interstitial cells (fibroblasts and others) that synthesize an extracellular matrix of collagen, proteoglycans, and glycoproteins.

The Nephron
Each kidney

contains approximately 1 million nephrons, Each nephron consists of a spherical filtering component, called the renal corpuscle, and a tubule extending from the

The Renal Corpuscle


consists of glomerulus (pl. glomeruli) or

glomerular capillaries, surrounded by a balloon-like hollow capsule: Bowman's capsule

Structure of the Bowmans (glomerular) capsule


Parietal layer of glomerular capsule Afferent arteriole

Juxtaglomerular cell
Capsule space

Efferent arteriole
Proximal convoluted tubule Endothelium of glomerulus Pedicel

Podocyte

Filtration barrier consists of 3 layers;


the capillary endothelium of the

glomerular capillaries, a rather thick basement membrane, and a singlecelled layer of epithelial cells the endothelial cells of the capillaries, is perforated by many large fenestrae ("windows"), like a slice of Swiss cheese, and is freely permeable to everything in the blood except red blood cells and platelets

The filtration barrier - podocytes


pedicel basal lamina

filtration slit

fenestrated endothelium

basal lamina podocyte

filtration slit
fenestrated endothelium podocyte primary cell body process

secondary process (pedicel)

The basement membrane in the middle is

a gel-like acellular meshwork of glycoproteins and proteoglycans, like a kitchen sponge. The epithelial cells that rest on the basement membrane and face Bowman's space are called podocytes. Small "fingers," called pedicels (or foot processes), extend from each arm of the podocyte and are embedded in the basement membrane. Pedicels interdigitate with the pedicels from

Spaces between adjacent pedicels

constitute the path through which the filtrate, once through the endothelial cells and basement membrane, travels to enter Bowman's space. The functional significance of this anatomic arrangement is that it permits the filtration of large volumes of fluid from the capillaries into Bowman's space but restricts filtration of large plasma proteins such as albumin.

mesangial cellsis found in the central

part of the glomerulus between and within capillary loops. act as phagocytes and remove trapped material from the basement membrane, also contain large numbers of myofilaments and can contract in response to a variety of stimuli in a manner similar to vascular smooth muscle cells

The Tubule

The cells in the thick ascending limb

closest to Bowman's capsule (between the afferent and efferent arterioles) are specialized cells known as the macula densa. the tubular epithelium has a one-cell thickness throughout, however, beginning in the second half of the distal convoluted tubule, 2 cell types are found in most of the remaining segments.

principal cells are the majority of cells

in the particular segment, is considered specific for that segment, intercalated cells are individual cells that Interspersed among the segmentspecific cells , type A and B

Blood Supply to the Nephrons


Normally only about 20% of the plasma

(and none of the erythrocytes) entering the glomerulus is filtered from the glomerulus into Bowman's capsule. Gambar

Vascular supply to the nephron


Proximal convoluted tubule Glomerulus Arcuate vein Arcuate artery Collecting duct Vasa recta Thick ascending limb of the loop of Henl Descending limb loop of Henl Thin ascending limb of the loop of Henl

Efferent arteriole Afferent arteriole Distal convoluted tubule

Categories of Nephrons
(1) In superficial cortical

nephrons, (2) in midcortical nephrons, (3) the juxtamedullary nephrons, All juxtamedullary nephrons have long loops, which extend into the inner medulla, often to the tip of a papilla.

The Juxtaglo merular Apparatu s


is made up of 3 cell types: (1) granular cells,

which are differentiated smooth muscle cells in the walls of the afferent arterioles; (2) extraglomerular mesangial cells; and (3) macula densa cells, specialized thick ascending limb epithelial cells.

The granular cells are the cells that secrete

the hormone renin, a crucial substance for control of renal function and blood pressure. The extraglomerular mesangial cells are morphologically similar to and continuous with the glomerular mesangial cells but lie outside Bowman's capsule. The macula densa cells are detectors of the luminal content of the nephron at the very end of the thick ascending limb and contribute to the control of glomerular

Basic Renal Processes

The volume of filtrate formed per unit

time is known as the glomerular filtration rate (GFR). In a normal young adult male, the GFR is an incredible 180 L/day (125 mL/min)!

Regulation of Renal Function


Neural signals originate in the

sympathetic celiac plexus. Sympathetic signals exert major control over renal blood flow, glomerular filtration, and release of vasoactive substances (the renin-angiotensin system). intrarenal chemical messengers Hormonal signals originate in the adrenal gland, pituitary gland, and heart.

The adrenal cortex secretes the steroid

hormones aldosterone and cortisol, and the adrenal medulla secretes the catecholamines epinephrine and norepinephrine. The pituitary gland secretes the hormone arginine vasopressin (also called ADH). The heart secretes hormones, natriuretic peptides, that contribute to signaling

Referensi

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