• Share
  • Email
  • Embed
  • Like
  • Save
  • Private Content


Flash Player 9 (or above) is needed to view presentations.
We have detected that you do not have it on your computer. To install it, go here.

Like this presentation? Why not share!

Cm5 renal function



by : Ms. Crizelda Liwanag

by : Ms. Crizelda Liwanag



Total Views
Views on SlideShare
Embed Views



0 Embeds 0

No embeds



Upload Details

Uploaded via as Adobe PDF

Usage Rights

© All Rights Reserved

Report content

Flagged as inappropriate Flag as inappropriate
Flag as inappropriate

Select your reason for flagging this presentation as inappropriate.

  • Full Name Full Name Comment goes here.
    Are you sure you want to
    Your message goes here
Post Comment
Edit your comment

    Cm5 renal function Cm5 renal function Presentation Transcript

    • • Renal Anatomy • Renal Blood Flow • Renal Physiology • Urine formation – Glomerular Filtration – Tubular Reabsorption – Tubular Secretion
    • Renal Anatomy
    • kidney What is the average weight of the kidney? 115-170 g What is its average size? 11 cm in length, 6 cm in width, 3 cm thick What is the rate of blood flow into the kidney via the renal artery? 600 mL/min
    • kidney
    • 2 regions of the kidney Cortex Medulla • Renal corpuscles • Loop of Henle • Proximal tubules • Vasa recta • Distal tubules • Collecting tubules
    • What is the functional unit of the kidney? of the kidney? NEPHRON
    • Renal Blood Flow 2 1 3a 3b
    • Renal Blood Flow
    • 1 2 6a 3b 3a 4a 7b 5a 8b 6b 4b 5b
    • Renal Physiology MAJOR FUNCTIONS The Body’s Filters: removing toxins & metabolic waste products • Ultrafiltration • Endocrine function • Osmolarity regulation • Volume regulation • Acid-base regulation
    • ultrafiltration
    • ultrafiltration Of the renal blood flow, how much is filtered by the glomerulus? 125 mL/min How many liters of blood is filtered by the kidney each day? 180 liters How much urine is produced per day? 1.5 liters
    • ultrafiltration The kidneys possess extraordinary mechanisms to reabsorb water while removing metabolic waste by-products and toxins. How is kidney function measured? GFR Glomerular Filtration Rate
    • Endocrine function 1. Erythropoietin 2. Active form of vitamin D (1,25- dihydroxy vitamin D3) 3. renin
    • Osmolarity regulation ADH – synthesized in the hypothalamus & released in the posterior pituitary in response to an increase in osmolarity as sensed by osmoreceptors in the anterior hypothalamus
    • ↓BP ↓PLASMA VOL ↑OSMOLARITY ↓venous pressure ↓venous return ↓ atrial pressure ↑ ADH secretion ↑ tubular permeability to water ↑ water reabsorption ↓ water excretion ↓ urine volume ↑ urine osmolarity
    • Volume Regulation Regulation of ECF volume thru the • Renin-Angiotensin-Aldosterone (RAA) pathway • Atrial Natriuretic Factor (ANF)
    • ↓BP ↓PLASMA VOL ↓Na ↑ Renal symp nerves ↓ arterial pressure ↓ renal arterial pressure ↑ renin secretion (into afferent arteriole) ↑ plasma angiotensin (from adrenal cortex) ANF ↑ aldosterone secretion ↑ tubular Na reabsorption ↓ Na excretion
    • Volume Regulation Atrial Natriuretic Factor (ANF) • Secreted by the cells in the atria of the heart to inhibit Na+ reabsorption in the kidneys • Inhibits secretion of aldosterone which stimulates Na+ reabsorption
    • Acid Base Regulation
    • Acid Base Regulation • To excrete X’s alkali: – Na2HPO4 – NaHCO3 • To excrete X’s acid: – NH4Cl – (NH4)2SO4 – NaH2PO4
    • What is the first step in urine formation? GLOMERULAR FILTRATION
    • Glomerular Filtration The filtration of a solute that is not reabsorbed or secreted Unit: mL/min Affected by: hydrostatic & oncotic pressure, Renin-angiotensin-aldosterone system, structure
    • Glomerular Filtration Substances retained: • Substances filtered: • Blood cells • Water • Serum proteins • Smaller molecules (MW: <70,000) – Ions – Amino acids – Glucose – Urea – Creatinine – Uric acid – ammonia
    • Glomerular Filtration • Approximately 20% of the volume of plasma that passes through the glomerular tuft is caught in Bowman’s space and is called the glomerular filtrate. • At this point, the filtrate is iso-osmotic with plasma and is called an ultrafiltrate. (sp. gr. 1.010 +/-0.002 ; pH 7.4)
    • What barriers are there to the passage of the filtrate? • Endothelium (glomerular capillary) • Basement membrane – Lamina rara interna – Lamina densa – Lamina rara externa • Podocytes (visceral layer)
    • Glomerular Filtration
    • Glomerular Filtration • To pass through the filtration barrier: – <4 nm in size – Threshold
    • Glomerular Filtration
    • Tubular Reabsorption • The movement of substances (by active or passive transport) – from the tubular ultrafiltrate into the peritubular blood or the interstitium by the renal tubular cells.
    • Tubular Reabsorption Substances reabsorbed by active transport: • Glucose, Amino acids, Salts (PCT) • Chloride (LOH) • Sodium (DCT)
    • Tubular Reabsorption Substances reabsorbed by passive transport: • Water (all nephron parts except ascending limb) • Urea (PCT, ascending limb) • Sodium (ascending limb)
    • Tubular Secretion • The movement of substances (by active or passive transport) – from the peritubular blood or the interstitium into the tubular ultrafiltrate by the renal tubular cells • To secrete substances the kidney is unable to eliminate via ultrafiltration
    • Tubular Secretion • Substances incompletely metabolized – E.g. thiamine • Substances not metabolized at all – E.g. radiopaque contrast media / mannitol • Substances not normally present – Certain drugs
    • SUMMARY • Close your notes...
    • •Glomerulus FILTRATION: water (ADH not required)., Na+, Glucose, K+, Cl-, Urea, Urate, Uric Acid, Proteins, Amino acids, Bicarbonates, Creatinine, Phosphate, Inulin, PAH REABSORPTION: -- SECRETION: -- •Proximal Tubule Isotonic filtrate FILTRATION: -- REABSORPTION: Water (ADH not required), Na+, Glucose, K+, Cl-, Urea, Urate, Uric Acid, Proteins, Amino acids, CO2
    • •Proximal Tubule SECRETION: Creatinine, Hydrogen, PAH •Loop of Henle Hypertonic filtrate REABSORPTION: Water, Na+, Cl-, Urate, Urea, CO2 SECRETION: -- •Distal Tubules Area of dehydration (where ADH acts) Iso or hypotonic filtrate; most common area of cast form’n REABSORPTION: Water (ADH required), Na+, Cl-, Urate, Urea, CO2 SECRETION: K+, Uric Acid, H+
    •  Collecting Duct Hypertonic or Hypotonic filtrate REABSORPTION: Water (ADH required), Na+, Cl-, Urate, Urea, CO2 SECRETION: K+, H+