Renal Structure and

Function
Dr. Catherine McDermott

Learning Objectives
This lecture aims to introduce
and discuss the following:
Renal

Physiology

Glomerular filtration
Tubular reabsorption and
secretion
Urine formation

Regulation

of urine
concentration
Control

of micturition

Lecture learning outcomes

After actively participating in this weeks lecture and
completing additional tasks as indicated, you will be able
to:
Describe

the functions of the urinary system

Describe the structure of kidneys
Explain the process of glomerular filtration
Describe glomerular filtration rate (GFR) and its regulation
Explain the process of tubular reabsorption and tubular
secretion
Explain the role of sympathetic, parasympathetic and
somatic nerves in control of micturition

Urinary System Functions

Excretion

Removal of waste products from the body

Regulator

Volume and chemical composition of blood

Water, salts, acids and bases

Blood pressure

Production of hormones

Renin

Erythropoietin

Metabolizing vitamin D to active form

Gluconeogenesis

Kidney Gross Anatomy

Bean shaped, located in superior part of lumbar region,

receiving some protection from rib cage

Renal cortex

Cone shaped medullary pyramids

Renal pelvis

Most superficial region

Renal medulla

150g each

Funnel shaped tube continuous with ureter

Renal hilum

Ureter, renal blood vessels, lymphatics and nerves

The Nephron

Structural and functional units of the kidney

Over 1 million per kidney

Glomerulus
Glomerular/Bowmans capsule

Renal
Corpuscle

Renal tubule

Proximal convoluted tubule (PCT)

Loop of Henle (descending and ascending limb)
Distal convoluted tubule (DCT)
Collecting duct

The Nephron

The Nephron
Cortical nephron

85% of nephrons
Small portion of Loop of Henle projects into outer
medulla

Juxtamedullary nephron

15% located in cortex-medullary junction

Important in producing concentrated urine
Loops of Henle deeply invade medulla

Nephron Capillary Beds

Every nephron has two capillary beds:
Glomerulus

High pressure capillaries

Site of filtration

Fluids and solutes forced into glomerular capsule

Fed and drained by arterioles

Afferent and efferent arterioles

Peritubular

capillaries

Arise from efferent arteriole

Low pressure porous capillaries

Readily reabsorb water and solutes from filtrate back into blood
Vasa recta long straight vessels serving juxtamedullary nephrons

The Nephron

Juxtaglomerular Apparatus

Region where distal portion of ascending limb lies

against afferent arteriole

Juxtaglomerular / granular cells

Enlarged smooth muscle cells

Secretory granules containing renin
Mechanoreceptor that sense BP in afferent arteriole

Macula densa

Closely packed cells of ascending limb

Chemoreceptors
Changes in NaCl of filtrate
Vasoconstriction

Juxtaglomerular Apparatus

Kidney Physiology: Urine

Formation

Urine formation and adjustment of blood volume and composition

1200ml blood pass through the glomeruli each minute

Concentrates filtrate formed by glomerular filtration

120 -125 ml forced into renal tubules

Prevent excess fluid loss

Valuable materials reabsorbed and retained

Filtrate
Cell and protein free blood
Loses most ions, nutrients and water in the collecting ducts
What remains is called urine

Mostly metabolic wastes and unneeded substances

Urine Formation 3
Processes
Glomerular Filtration

1.

BP forces fluids and solutes

across glomerular capillaries in
glomerular capsule

Tubular Reabsorption

2.

Removal of water and solutes

from filtrate into peritubular
capillary

Tubular Secretion

3.

Movement of solutes from

peritubular capillaries into
tubular fluid

1. Glomerular Filtration

Passive filtration process

Small molecules move down pressure gradient across

filtration membrane

Water, ions (e.g. Na+, Cl-, K+), small organic molecules (e.g. glucose,
amino acids, nitrogenous waste)
Many of these reabsorbed

Proteins and blood cells remain in the blood

More efficient filter than other capillary beds

Large surface area

High pressure

Glomerular Filtration

Driven by blood pressure

Net Filtration Pressure
(NFP)

Glomerular hydrostatic
pressure (BP)
Blood colloidal osmotic
pressure
Capsular hydrostatic pressure

Net filtration pressure

10 mmHg

Glomerular Blood Pressure

Afferent and efferent arterioles offer high resistance to

blood flow
BP in glomerulus ~ 60 mmHg

Afferent arterioles

Short, large diameter

Blood at high pressure

Efferent arterioles

Smaller diameter
Maintain blood pressure in glomerulus by restricting outflow

Glomerular Filtration Rate

(GFR)

The volume of filtrate formed each minute

Directly proportional to NFP
Adults 120-125 ml/min

Regulation of Glomerular Filtration

Renal autoregulation

Neural control

Sympathetic activity GFR by constricting renal arterioles

Stress / emergency

Hormonal control

Renin-angiotensin mechanism
pressure leads to production of angiotensin II
Constrict arterioles

Extrinsic Controls

Renal Autoregulation
Myogenic mechanism

Smooth muscle contracts when stretched

Increased BP causes afferent arterioles to constrict
Restricting blood flow to glomerulus
Maintaining GFR

Tubuloglomerular feedback mechanism

Macula densa of juxtaglomerular apparatus

Responds to filtrate NaCl
If GFR , insufficient time for tubular reabsorption and NaCl remains high
Cells release vasoconstrictor
Decreases NFP and GFR

Intrinsic

mechanisms cannot handle extremely low systemic BP

Autoregulation ceases when MAP drops below 80 mmHg

Sympathetic Control
Volume of ECF normal

SNS at rest
Blood vessels dilated
Renal autoregulation prevails

Stress/Emergency

Shunt blood to vital organs

Noradrenaline acts on -adrenoceptors
Constricting afferent arterioles
Inhibition of filtrate formation
Also stimulates granular cells to release renin

Glomerular Filtration Rate

2. Tubular Reabsorption

Useful tubule contents returned to the blood

Begins in proximal convoluted tubule
Selective transepithelial process

Healthy human kidney

Reabsorption of water and ions regulated and adjusted

All glucose and amino acids are completely reabsorbed

Hormonal control

Transport by passive diffusion, facilitated diffusion, active

transport

Tubular Reabsorption

Sodium Reabsorption

Na+ ions most abundant in the filtrate

Na+ reabsorption is almost always by active transport

Na+ enters tubule cells

Na+ is actively transported across the basolateral membrane by Na+ /
K+-ATPase pump
Na+ and water rapidly taken up by adjacent peritubular capillaries

Active pumping of Na+ drives reabsorption of:

Water by osmosis
Cations and fat-soluble substances
Organic nutrients and selected cations by secondary active transport
(symport or antiport)

Influence of Na+
Reabsorption

Transport Maximum (TM)

Almost every substance that is reabsorbed using a

transport protein has a TM

Reflects number of transport proteins in renal tubule

High TM value

Plenty of carriers
Glucose, amino acids

Transporters saturated

Excess is excreted in urine

Hyperglycemia in uncontrolled diabetes mellitus

Reabsorption in PCT

Reabsorption in Loop of
Henle

Permeability of tubule epithelium changes

Water reabsorption not coupled to solute reabsorption

Can leave descending but not ascending limb as aquaporins are scarce
or absent
Opposite true for solutes

Reabsorption in DCT and

Collecting Duct

Reabsorption from this point dependent on bodys specific

needs

Regulated by hormones

Aldosterone
ADH
ANP

Reabsorption: Hormonal
Regulators
Anti-diuretic hormone (ADH)

Hypothalmic neurons called

osmoreceptors monitor solute
concentrations in the blood
Becomes too concentrated

ADH released by posterior pituitary

Targets collecting ducts via cAMP
system
Water reabsorbed from filtrate

Other stimuli include pain, low

BP and drugs such as nicotine,
barbiturates and morphine

Alcohol inhibits ADH release

Reabsorption: Hormonal
Regulators
Aldosterone

Fine tunes reabsorption of

remaining Na+

Adrenal cortex releases

aldosterone

Decreased blood volume or BP

Low extracellular Na+
High extracellular K+

DCT and collecting duct

Synthesize and retain more luminal

Na+ and K+ channels
Basolateral Na+ / K+-ATPase pumps
Na+ retained in body
Increase blood volume

Reabsorption: Hormonal
Regulators
Atrial natriuretic peptide

Hormone secreted by
specialized cardiac muscle
cells in the atria

Increased BP

Inhibits the renin-angiotensin

system and release of
aldosterone

Inhibits Na+ and water

reabsorption

blood volume and BP

3. Tubular Secretion

Substances move from capillaries into renal tubule

Essential for:

Removing substances not already filtered

Eliminating waste products reabsorbed by passive processes

E.g. drugs and metabolites bound to plasma proteins

Urea and uric acid

Removing excess K+
Controlling blood pH by secretion of H+ or HCO3-

PCT is the main site of secretion

Except for K+
Secretion in DCT and collecting duct

Urinary Bladder

Brain

Sympathetic
(hypogastric
nerve)
Intramural
ganglia

T10L2

Bladder detrusor
smooth muscle

Parasympathetic
(pelvic nerve)
S2S4

Somatic
(pudendal nerve)

Adapted from Abrams P and Wein A. 1998.

Internal sphincter
(smooth muscle)

External sphincter
(skeletal muscle)
Urethral smooth muscle

Micturition / Urination
The act of emptying the bladder (voiding)
Detrusor muscle must contract
Internal urethral sphincter must open
External urethral sphincter must open

1.
2.
3.

Afferent stretch receptors in bladder relay awareness of

bladder fullness to the pons

Pontine storage centre

parasympathetic and sympathetic activity to bladder

Pontine micturition

References

Human Anatomy and Physiology, 9th Edition by Marieb

and Hoehen, Chapter 25, p. 955-977