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PROSES

PEMBENTUKAN
URIN
Rahmatina B. Herman
Bagian Fisiologi
Fakultas Kedokteran Universitas Andalas

Functions of Urinary System


The urinary system performs a variety of
functions aimed at maintaining homeostasis
In concert with hormonal and neural inputs, the
kidneys primarily responsible for maintaining the
stability of ECF volume, electrolyte composition,
and osmolarity (solute concentration)
Excreting (eliminating) the end products
(wastes) of bodily metabolism, such as urea, uric
acid, creatinine; since these wastes are toxic ,
especially to brain
Main route for eliminating potentially toxic
metabolic wastes and foreign compounds from
the body

Urinesystem
Formation
The urinary
forms the
urine and carries it to the outside
that consists of:
- The kidneys as the urine
forming organs
- The structures that carry urine
from kidneys to the outside for
eliminating from the body
Three basic processes in urine
formation:
1. Filtration by glomerolus

Filtration By Glomerolus
Glomerular capillaries:
impermiabel to protein

Glomerular filtrates:
- protein-free
- concentration of materials that do not bind with
protein as same as in plasma

Filtration rate
of glomerular capillary >> other capillaries, because
of greater in:
- hydrostatic pressure
- glomerular filtration coefficient (Kf)
product of permeability and effective filtration
surface area of glomerular capillary

Afferent arteriole

Efferent arteriole

Capillary
pore

Layers of glomerular membrane:


1 the pores between endothelium cells of glomerular capillary
2 an acellular basement membrane
3 filtration slits between foot processes of podocytes of inner

..Filtration By
Glomerolus
The factors governing filtration across
glomerular capillaries (GC) are the same
as all other capillaries
For each nephron:
- Glomerular filtration coefficient (Kf)
- Mean hydrostatic pressure in GC (PGC)
- Mean hydrostatic pressure in Bowmans
capsule (PT)
- Colloid osmotic pressure of plasma in GC ( GC)
- Colloid osmotic pressure of filtrate (T)
protein free

Net Filtration Pressure


PG

GC

Glomerular capillary

PT

Bowmans capsule

PGC : Mean hydrostatic pressure in GC


: 60
mmHg
GC
: Colloid
osmotic pressure of plasma in GC
: 32
mmHg
P : Mean hydrostatic pressure in Bowmans

Glomerular Filtration Rate (GFR)


Is actual rate of filtration by
glomerular capillaries
Depends on:
- Net filtration pressure
- Filtration coefficient (Kf)
GFR = (Kf) x Net filtration
pressure

In males: 125 mL/min (7.5 L/h or 180


L/d)
in females: 115 mL/min (6.9 L/h or
160 L/d)

Factors Affecting GFR


Changes in renal blood flow
Changes in glomerular capillary hydrostatic
pressure
- Changes in systemic blood pressure
- Afferent or efferent arteriolar constriction

Changes in hydrostatic pressure in Bowmans


capsule
- Ureteral obstruction
- Edema of kidney inside tight renal capsule

Changes in concentration of plasma proteins


- Dehydration , hypoproteinemia, etc (minor
factors)

Changes in Kf

- Changes in glomerular capillary permeability


- Changes in effective filtration surface area

..Filtration
Filtration fraction:
- Fraction of plasma flowing through
glomeruli that is filtered into tubules
GFR
- Ratio of GFR to renal plasma flow (RPF)
RPF
- Normal: 0,20
it means: 20 % of plasma that enters glomeruli
is filtered by glomerular capillaries

- GFR varies less than RPF


when there is fall in systemic blood pressure,
GFR falls less than RPF, because of efferent
arteriole constriction filtration fraction rises

Filterability
Filterability of solutes is
determined by:
- Size/ molecular weight (MW)
- Electrical charge:
Negative charge is more difficult
than positive charge, because
basement membran of
glomerular capillary consists
proteoglican with negative charge

..
Filterability
Filterability of substances by GC decreases
with increases MW

Substance

MW

Filterability

Water
Sodium
Glucose
Inulin
Myoglobin
Albumin

18
23
180
5.500
17.000
69.000

1,0
1,0
1,0
1,0
0,75
0,005

Secretion and Reabsorption


Once the glomerular filtrate is
formed, then the tubular cells will:
Increase the concentration of
certain substances in the filtrate
by secretion
Reduce the concentration of
certain substances in the filtrate
by reabsorption
Secretion or reabsorption rate
depending on the needs of the

Basic Mechanism of Secretion and


Reabsorption
Active transport:
- primary active transport
- secondary active transport
- active transport mechanism for
protein
reabsorption:
pinocytosis (endocytosis)

Passive transport:
- through intercellular space
- using carrier

Osmosis: water

Transport Maximum (Tm)


Limit of the rate at which the solute can be
transported through active transport mechanism
Due to transport carrier system becomes
saturated as tubular load increases
Passive transport does not demonstrate Tm,
because the rate is determined by other factors:
-

Electrochemical gradient for diffusion


Permeability of the membrane for the substance
The time that the fluid containing the substance
remains within the tubule

This type of transport is referred to as gradienttime transport

Transport in Proximal
Tubules
Proximal tubule epithelial cells are highly
metabolic and have large numbers of mitochondria
to support potent active transport processes
Proximal tubule epithelial cells have extensive
brush border on the luminal side and also
extensive labyrinth of intercellular and basal
channels extensive surface area for rapid
transport
Epithelial brush border is loaded with protein
carrier molecules and a large number of sodium
ions secondary active transport (co-/ counter
transport)
So, it is the most active reabsorption process
Water moves across membrane by osmosis

Reabsorption in Proximal
Tubule
In the first half
of proximal tubule:
- sodium is reabsorbed by co-transport
along with glucose, amino acids, and
other solutes
- leaving behind solution that has
higher chloride concentration flow to
the second half of proximal tubule

In the second half of proximal


tubule:
- sodium is reabsorbed mainly with
chloride ions
- little glucose and amino acids remain

Secretion in Proximal
Tubule
Proximal tubule is important site for
secretion of many substances that must
be rapidly removed from body, such as:
- organic acids and bases
- end product of metabolism
- many potentially harmful drugs or toxin
- para-aminohippuric acid (PAH)
Normal person can clear 90 % of PAH from
plasma flowing through kidneys and
excrete it into urine
So, PAH clearance can be used as index of
renal plasma flow (RPF)

Transport in Loop of Henle


Loop of Henle consists of 3 functionally
distinct segments:
- the descending thin segment
- the ascending thin segment
- the thick ascending segment
The thin segments have thin epithelial
membranes with no brush borders, few
mitochondria, and minimal levels of
metabolic activity
The thick segment has thick epithelial cells
that have high metabolic activity and are
capable of active reabsorption of sodium,
chloride, and potassium

..Transport in Loop of
Henle
The descending thin segment:
- Highly permeable to water
- Moderately permeable to most solutes,
including urea
and sodium

The ascending thin segment:

- impermeable to water
- reabsorption capacity is very low

The thick ascending segment

- impermeable to water
- highly metabolic active reabsorption of
Na, Cl, K (25%)
- has Na-H counter transport mechanism

tubular fluid becomes very dilute

Transport
in
Distal
Tubules
The very first portion of distal tubule
forms part of juxtaglomerular complex
that provides feedback control of GFR
and blood flow in the same nephron
The next early part of distal tubule is
highly convoluted and has many of the
same reabsorptive characteristics of
the thick segment of ascending limb of
loop of Henle:
- avidly reabsorbs most of ions
including Na, Cl, K
- virtually impermeable to water and
urea

The secondin
half
of distal
tubule
and the
Transport
Late
Distal
Tubules
subsequent
cortical
collecting
tubule have
and
Cortical
Collecting
Tubule

similar functional characteristics


Anatomically, composed of 2 distinct cell
types:
> principal cells: reabsorb Na+ & water,
and secrete K +
> intercalated cells: reabsorb K + &
HCO3-, and actively
secrete H + play a
key role in acid-base regulation
Almost completely impermeable to urea
Rate of Na+ reabsorption and K + secretion is
controlled by aldosterone and their
concentration in body fluids
Permeability to water is controlled by ADH

Transport in Medullary Collecting


Play an extremely
important role in
Duct
determining the final urine output of
water and solutes

Epithelial cells are nearly cuboidal with


smooth surfaces and relatively few
mitochondria
Permeability to water is controlled by
ADH
Permeable to urea reabsorbed into
medullary interstitium raise
osmolality concentrated urine
Capable of secreting H + also play key

Countercurrent Mechanism
Countercurrent mechanism produces
hyperosmotic renal medullary interstitium
concentrated urine
Countercurrent mechanism depends on special
anatomical arrangement of the loops of Henle and
vasa recta (specialized peritubular capillaries of
renal medulla)
Basic requirements for forming a concentrated
urine:
- High level of ADH increases permeability of distal
tubules and collecting ducts to water avidly reabsorb
water
- High osmolarity of renal medullary interstitial fluid
osmotic gradient necessary for water reabsorption to
occur in the
presence of high levels of ADH

..Countercurrent
Mechanism
Major factors that contribute to build up of solute
concentration into renal medulla:
1.
Active transport of Na+ and co-transport of K +,
Cl - and other ions out of thick limb into medullary
interstitium
2.
Active transport of ions from collecting ducts
into medullary interstitium
3. Passive diffusion of large amounts of urea from
inner medullary collecting ducts into medullary
interstitium
4. Diffusion of only small amounts of water from
medullary tubules into medullary interstitium, far
less then reabsorption of solutes into medullary
interstitium

Tubule Characteristics Urine


Concentration
Segment of Tubules

Active
NaCl
Transpo
rt

Thin descending limb

Thin ascending limb


Thick ascending limb

0
+++++

Distal tubule
Cortical collecting
tubule
Inner medullary

+
+

Permeability
H2O NaCl
+++
++
0
0
+
ADH
+
ADH
+

Ure
a

+
0

+
0

0
++

Thank You