THREE BASIC RENAL PROCESSES <ul><li>Glomerular Filtration: Filtering of blood into tubule forming the primitive urine </li...
BASIC RENAL PROCESSES 03/29/10 GF TR TA Urine Excreted Efferent Arteriole Afferent Arteriole Glomerulus Kidney Tubule Peri...
Glomerular Filtration <ul><li>First step in urine formation </li></ul><ul><li>180 liters/day filtered </li></ul><ul><li>En...
Forces Involved in Glomerular Filtration 03/29/10 Glomerular Capillary Blood Pressure + 55 Plasma Colloid  Osmotic Pressur...
Tubular Reabsorption <ul><li>Water: 99% reabsorbed </li></ul><ul><li>Sodium: 99.5% reabsorbed </li></ul><ul><li>Urea: 50% ...
Tubular Reabsorption <ul><li>By passive diffusion </li></ul><ul><li>By primary active transport: Sodium </li></ul><ul><li>...
Tubular Reabsorption is a Function of the Epithelial Cells Making up the Tubule 03/29/10 Lumen Plasma Cells www.freelivedo...
Sodium Reabsorption 03/29/10 Lumen Plasma Cells PUMP: Na/K ATPase Sodium Potassium Chloride Water www.freelivedoctor.com
Rennin-Angiotensin-Aldosterone System <ul><li>Stimulates Sodium Reabsorption in distal and collecting tubules </li></ul><u...
Rennin-Angiotensin-Aldosterone System 03/29/10 Fall in NaCl, extracellular fluid volume, arterial blood pressure Juxtaglom...
DIURETICS <ul><li>ACE Inhibitors (Angiotensin Converting Enzyme): Cause loss of salt---> water follows </li></ul><ul><li>A...
Glucose and Amino Acids are reabsorbed by secondary active transport <ul><li>They are actively transported across the apic...
GLUCOSE REABSORPTION HAS A TUBULAR MAXIMUM 03/29/10 Renal threshold (300mg/100 ml) Plasma Concentration of Glucose Glucose...
Tubular Secretion <ul><li>Protons (acid/base balance) </li></ul><ul><li>Potassium </li></ul><ul><li>Organic ions </li></ul...
Potassium Secretion 03/29/10 Lumen Plasma Cells PUMP: Na/K ATPase Sodium Potassium Chloride Water www.freelivedoctor.com
DUAL CONTROL OF ALDOSTERONE SECRETION 03/29/10 Fall in sodium ECF Volume Blood Pressure Increased  Plasma Potassium Increa...
Reabsorption in Proximal Tubule (Summary)  <ul><li>Glucose and Amino Acids </li></ul><ul><li>67% of Filtered Sodium </li><...
Secretion in Proximal Tubule (Summary) <ul><li>Variable Proton secretion for acid/base regulation </li></ul><ul><li>Organi...
Reabsorption in Distal Tubule (Summary) <ul><li>Variable Sodium controlled by Aldosterone </li></ul><ul><li>Chloride follo...
Secretion in Distal Tubule (Summary) <ul><li>Variable Proton for acid/base regulation </li></ul><ul><li>Variable Potassium...
Collecting Duct (Summary) <ul><li>Variable water reabsorption controlled by vasopressin </li></ul><ul><li>Variable Proton ...
REGULATION OF URINE CONCENTRATION <ul><li>Medullary countercurrent system </li></ul><ul><li>Vasopressin </li></ul>03/29/10...
Medullary countercurrent system <ul><li>Osmotic gradient established by long loops of Henle </li></ul><ul><li>Descending l...
Descending limb <ul><li>Highly permeable to water </li></ul><ul><li>No active sodium transport </li></ul>03/29/10 www.free...
Ascending limb <ul><li>Actively pumps sodium out of tubule to surrounding interstitial fluid </li></ul><ul><li>Impermeable...
COUNTERCURRENT MAKES THE OSMOTIC GRADIENT 03/29/10 300 450 600 750 900 1050 1200 1200 From  Proximal Tubule To Distal Tubu...
THE OSMOTIC GRADIENT CONCENTRATES THE URINE WHEN VASOPRESSIN (ANTI DIURETIC HORMONE [ADH]) IS PRESENT 03/29/10 From  Dista...
WHEN VASOPRESSIN (ANTI DIURETIC HORMONE [ADH]) IS ABSENT A DILUTE URINE IS PRODUCE 03/29/10 From  Distal Tubule Cortex Med...
Renal Failure <ul><li>Acute:  Sudden onset, rapid reduction in urine output - usually reversible </li></ul><ul><li>Chronic...
THE URINARY BLADDER STORES THE URINE <ul><li>Gravity and peristaltic contractions propel the urine along the ureter </li><...
Reflex and Voluntary Control of Micturition <ul><li>Bladder filling reflexively contracts the bladder </li></ul><ul><li>In...
Upcoming SlideShare
Loading in...5
×

Basic Processes Of Kidney

8,098

Published on

0 Comments
1 Like
Statistics
Notes
  • Be the first to comment

No Downloads
Views
Total Views
8,098
On Slideshare
0
From Embeds
0
Number of Embeds
1
Actions
Shares
0
Downloads
155
Comments
0
Likes
1
Embeds 0
No embeds

No notes for slide

Basic Processes Of Kidney

  1. 1. THREE BASIC RENAL PROCESSES <ul><li>Glomerular Filtration: Filtering of blood into tubule forming the primitive urine </li></ul><ul><li>Tubular Reabsorption: Absorption of substances needed by body from tubule to blood </li></ul><ul><li>Tubular Secretion: Secretion of substances to be eliminated from the body into the tubule from the blood </li></ul>03/29/10 www.freelivedoctor.com
  2. 2. BASIC RENAL PROCESSES 03/29/10 GF TR TA Urine Excreted Efferent Arteriole Afferent Arteriole Glomerulus Kidney Tubule Peritubular Capillary www.freelivedoctor.com
  3. 3. Glomerular Filtration <ul><li>First step in urine formation </li></ul><ul><li>180 liters/day filtered </li></ul><ul><li>Entire plasma volume filtered 65 times/day </li></ul><ul><li>Proteins not filtered </li></ul>03/29/10 www.freelivedoctor.com
  4. 4. Forces Involved in Glomerular Filtration 03/29/10 Glomerular Capillary Blood Pressure + 55 Plasma Colloid Osmotic Pressure - 30 15 10 Bowman’s Capsule Hydrostatic Pressure - Net Filtration Pressure + www.freelivedoctor.com
  5. 5. Tubular Reabsorption <ul><li>Water: 99% reabsorbed </li></ul><ul><li>Sodium: 99.5% reabsorbed </li></ul><ul><li>Urea: 50% reabsobed </li></ul><ul><li>Phenol: 0% reabsorbed </li></ul>03/29/10 www.freelivedoctor.com
  6. 6. Tubular Reabsorption <ul><li>By passive diffusion </li></ul><ul><li>By primary active transport: Sodium </li></ul><ul><li>By secondary active transport: Sugars and Amino Acids </li></ul>03/29/10 www.freelivedoctor.com
  7. 7. Tubular Reabsorption is a Function of the Epithelial Cells Making up the Tubule 03/29/10 Lumen Plasma Cells www.freelivedoctor.com
  8. 8. Sodium Reabsorption 03/29/10 Lumen Plasma Cells PUMP: Na/K ATPase Sodium Potassium Chloride Water www.freelivedoctor.com
  9. 9. Rennin-Angiotensin-Aldosterone System <ul><li>Stimulates Sodium Reabsorption in distal and collecting tubules </li></ul><ul><li>Naturetic peptide inhibits </li></ul><ul><li>In absence of Aldosterone, 20mg of sodium/day may be excreted </li></ul><ul><li>Aldosterone can cause 99.5% retention </li></ul>03/29/10 www.freelivedoctor.com
  10. 10. Rennin-Angiotensin-Aldosterone System 03/29/10 Fall in NaCl, extracellular fluid volume, arterial blood pressure Juxtaglomerular Apparatus Renin Liver Angiotensin + Angiotensin Angiotensin Aldosterone Lungs Converting Enzyme Adrenal Cortex Increased Sodium Reabsorption Helps Correct www.freelivedoctor.com
  11. 11. DIURETICS <ul><li>ACE Inhibitors (Angiotensin Converting Enzyme): Cause loss of salt---> water follows </li></ul><ul><li>Atrial Naturetic Peptide (ANP) also inhibits sodium reabsorption </li></ul><ul><li>Osmotic diuretics: Are not reabsorbed </li></ul>03/29/10 www.freelivedoctor.com
  12. 12. Glucose and Amino Acids are reabsorbed by secondary active transport <ul><li>They are actively transported across the apical cell membranes of the epithelial cells </li></ul><ul><li>Their active transport depends on the sodium gradient across this membrane </li></ul><ul><li>All other steps are passive </li></ul>03/29/10 www.freelivedoctor.com
  13. 13. GLUCOSE REABSORPTION HAS A TUBULAR MAXIMUM 03/29/10 Renal threshold (300mg/100 ml) Plasma Concentration of Glucose Glucose Reabsorbed mg/min Filtered Excreted Reabsorbed www.freelivedoctor.com
  14. 14. Tubular Secretion <ul><li>Protons (acid/base balance) </li></ul><ul><li>Potassium </li></ul><ul><li>Organic ions </li></ul>03/29/10 www.freelivedoctor.com
  15. 15. Potassium Secretion 03/29/10 Lumen Plasma Cells PUMP: Na/K ATPase Sodium Potassium Chloride Water www.freelivedoctor.com
  16. 16. DUAL CONTROL OF ALDOSTERONE SECRETION 03/29/10 Fall in sodium ECF Volume Blood Pressure Increased Plasma Potassium Increased Aldosterone secretion Increased Tubular Potassium Secretion Increased Urinary Potassium Secretion Increased Tubular Sodium Reabsorption Fall in Urinary Sodium Excretion www.freelivedoctor.com
  17. 17. Reabsorption in Proximal Tubule (Summary) <ul><li>Glucose and Amino Acids </li></ul><ul><li>67% of Filtered Sodium </li></ul><ul><li>Other Electrolytes </li></ul><ul><li>65% of Filtered Water </li></ul><ul><li>50% of Filtered Urea </li></ul><ul><li>All Filtered Potassium </li></ul>03/29/10 www.freelivedoctor.com
  18. 18. Secretion in Proximal Tubule (Summary) <ul><li>Variable Proton secretion for acid/base regulation </li></ul><ul><li>Organic Ion secretion </li></ul>03/29/10 www.freelivedoctor.com
  19. 19. Reabsorption in Distal Tubule (Summary) <ul><li>Variable Sodium controlled by Aldosterone </li></ul><ul><li>Chloride follows passively </li></ul><ul><li>Variable water controlled by vasopressin </li></ul>03/29/10 www.freelivedoctor.com
  20. 20. Secretion in Distal Tubule (Summary) <ul><li>Variable Proton for acid/base regulation </li></ul><ul><li>Variable Potassium controlled by aldosterone </li></ul>03/29/10 www.freelivedoctor.com
  21. 21. Collecting Duct (Summary) <ul><li>Variable water reabsorption controlled by vasopressin </li></ul><ul><li>Variable Proton secretion for acid/base balance </li></ul>03/29/10 www.freelivedoctor.com
  22. 22. REGULATION OF URINE CONCENTRATION <ul><li>Medullary countercurrent system </li></ul><ul><li>Vasopressin </li></ul>03/29/10 www.freelivedoctor.com
  23. 23. Medullary countercurrent system <ul><li>Osmotic gradient established by long loops of Henle </li></ul><ul><li>Descending limb </li></ul><ul><li>Ascending limb </li></ul>03/29/10 www.freelivedoctor.com
  24. 24. Descending limb <ul><li>Highly permeable to water </li></ul><ul><li>No active sodium transport </li></ul>03/29/10 www.freelivedoctor.com
  25. 25. Ascending limb <ul><li>Actively pumps sodium out of tubule to surrounding interstitial fluid </li></ul><ul><li>Impermeable to water </li></ul>03/29/10 www.freelivedoctor.com
  26. 26. COUNTERCURRENT MAKES THE OSMOTIC GRADIENT 03/29/10 300 450 600 750 900 1050 1200 1200 From Proximal Tubule To Distal Tubule Cortex Medulla 300 450 600 750 900 1050 1200 1200 100 250 400 550 700 850 1000 1000 Active Sodium Transport Passive Water Transport Long Loop of Henle www.freelivedoctor.com
  27. 27. THE OSMOTIC GRADIENT CONCENTRATES THE URINE WHEN VASOPRESSIN (ANTI DIURETIC HORMONE [ADH]) IS PRESENT 03/29/10 From Distal Tubule Cortex Medulla 300 450 600 750 900 1050 1200 1200 300 400 550 700 850 1000 1100 1200 Interstitial Fluid Collecting Duct Pores Open Passive Water Flow www.freelivedoctor.com
  28. 28. WHEN VASOPRESSIN (ANTI DIURETIC HORMONE [ADH]) IS ABSENT A DILUTE URINE IS PRODUCE 03/29/10 From Distal Tubule Cortex Medulla 300 450 600 750 900 1050 1200 1200 100 100 100 100 100 100 100 100 Interstitial Fluid Collecting Duct Pores Closed No Water Flow Out of Duct www.freelivedoctor.com
  29. 29. Renal Failure <ul><li>Acute: Sudden onset, rapid reduction in urine output - usually reversible </li></ul><ul><li>Chronic: Progressive, not reversible </li></ul><ul><li>Up to 75% function can be lost before it is noticeable </li></ul>03/29/10 www.freelivedoctor.com
  30. 30. THE URINARY BLADDER STORES THE URINE <ul><li>Gravity and peristaltic contractions propel the urine along the ureter </li></ul><ul><li>Parasympathetic stimulation contracts the bladder and micturition results if the sphincters (internal and external urethral sphincters) relax </li></ul><ul><li>The external sphincter is under voluntary control </li></ul>03/29/10 www.freelivedoctor.com
  31. 31. Reflex and Voluntary Control of Micturition <ul><li>Bladder filling reflexively contracts the bladder </li></ul><ul><li>Internal Sphincter mechanically opens </li></ul><ul><li>Stretch receptors in bladder send inhibitory impulses to external sphincter </li></ul><ul><li>Voluntary signals from cortex can override the reflex or allow it to take place </li></ul>03/29/10 www.freelivedoctor.com
  1. A particular slide catching your eye?

    Clipping is a handy way to collect important slides you want to go back to later.

×