Your SlideShare is downloading. ×
  • Like
Basic Processes Of Kidney
Upcoming SlideShare
Loading in...5
×

Thanks for flagging this SlideShare!

Oops! An error has occurred.

×

Now you can save presentations on your phone or tablet

Available for both IPhone and Android

Text the download link to your phone

Standard text messaging rates apply

Basic Processes Of Kidney

  • 7,051 views
Published

 

  • Full Name Full Name Comment goes here.
    Are you sure you want to
    Your message goes here
    Be the first to comment
    Be the first to like this
No Downloads

Views

Total Views
7,051
On SlideShare
0
From Embeds
0
Number of Embeds
1

Actions

Shares
Downloads
148
Comments
0
Likes
0

Embeds 0

No embeds

Report content

Flagged as inappropriate Flag as inappropriate
Flag as inappropriate

Select your reason for flagging this presentation as inappropriate.

Cancel
    No notes for slide

Transcript

  • 1. THREE BASIC RENAL PROCESSES
    • Glomerular Filtration: Filtering of blood into tubule forming the primitive urine
    • Tubular Reabsorption: Absorption of substances needed by body from tubule to blood
    • Tubular Secretion: Secretion of substances to be eliminated from the body into the tubule from the blood
    03/29/10 www.freelivedoctor.com
  • 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. Glomerular Filtration
    • First step in urine formation
    • 180 liters/day filtered
    • Entire plasma volume filtered 65 times/day
    • Proteins not filtered
    03/29/10 www.freelivedoctor.com
  • 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. Tubular Reabsorption
    • Water: 99% reabsorbed
    • Sodium: 99.5% reabsorbed
    • Urea: 50% reabsobed
    • Phenol: 0% reabsorbed
    03/29/10 www.freelivedoctor.com
  • 6. Tubular Reabsorption
    • By passive diffusion
    • By primary active transport: Sodium
    • By secondary active transport: Sugars and Amino Acids
    03/29/10 www.freelivedoctor.com
  • 7. Tubular Reabsorption is a Function of the Epithelial Cells Making up the Tubule 03/29/10 Lumen Plasma Cells www.freelivedoctor.com
  • 8. Sodium Reabsorption 03/29/10 Lumen Plasma Cells PUMP: Na/K ATPase Sodium Potassium Chloride Water www.freelivedoctor.com
  • 9. Rennin-Angiotensin-Aldosterone System
    • Stimulates Sodium Reabsorption in distal and collecting tubules
    • Naturetic peptide inhibits
    • In absence of Aldosterone, 20mg of sodium/day may be excreted
    • Aldosterone can cause 99.5% retention
    03/29/10 www.freelivedoctor.com
  • 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. DIURETICS
    • ACE Inhibitors (Angiotensin Converting Enzyme): Cause loss of salt---> water follows
    • Atrial Naturetic Peptide (ANP) also inhibits sodium reabsorption
    • Osmotic diuretics: Are not reabsorbed
    03/29/10 www.freelivedoctor.com
  • 12. Glucose and Amino Acids are reabsorbed by secondary active transport
    • They are actively transported across the apical cell membranes of the epithelial cells
    • Their active transport depends on the sodium gradient across this membrane
    • All other steps are passive
    03/29/10 www.freelivedoctor.com
  • 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. Tubular Secretion
    • Protons (acid/base balance)
    • Potassium
    • Organic ions
    03/29/10 www.freelivedoctor.com
  • 15. Potassium Secretion 03/29/10 Lumen Plasma Cells PUMP: Na/K ATPase Sodium Potassium Chloride Water www.freelivedoctor.com
  • 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. Reabsorption in Proximal Tubule (Summary)
    • Glucose and Amino Acids
    • 67% of Filtered Sodium
    • Other Electrolytes
    • 65% of Filtered Water
    • 50% of Filtered Urea
    • All Filtered Potassium
    03/29/10 www.freelivedoctor.com
  • 18. Secretion in Proximal Tubule (Summary)
    • Variable Proton secretion for acid/base regulation
    • Organic Ion secretion
    03/29/10 www.freelivedoctor.com
  • 19. Reabsorption in Distal Tubule (Summary)
    • Variable Sodium controlled by Aldosterone
    • Chloride follows passively
    • Variable water controlled by vasopressin
    03/29/10 www.freelivedoctor.com
  • 20. Secretion in Distal Tubule (Summary)
    • Variable Proton for acid/base regulation
    • Variable Potassium controlled by aldosterone
    03/29/10 www.freelivedoctor.com
  • 21. Collecting Duct (Summary)
    • Variable water reabsorption controlled by vasopressin
    • Variable Proton secretion for acid/base balance
    03/29/10 www.freelivedoctor.com
  • 22. REGULATION OF URINE CONCENTRATION
    • Medullary countercurrent system
    • Vasopressin
    03/29/10 www.freelivedoctor.com
  • 23. Medullary countercurrent system
    • Osmotic gradient established by long loops of Henle
    • Descending limb
    • Ascending limb
    03/29/10 www.freelivedoctor.com
  • 24. Descending limb
    • Highly permeable to water
    • No active sodium transport
    03/29/10 www.freelivedoctor.com
  • 25. Ascending limb
    • Actively pumps sodium out of tubule to surrounding interstitial fluid
    • Impermeable to water
    03/29/10 www.freelivedoctor.com
  • 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. 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. 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. Renal Failure
    • Acute: Sudden onset, rapid reduction in urine output - usually reversible
    • Chronic: Progressive, not reversible
    • Up to 75% function can be lost before it is noticeable
    03/29/10 www.freelivedoctor.com
  • 30. THE URINARY BLADDER STORES THE URINE
    • Gravity and peristaltic contractions propel the urine along the ureter
    • Parasympathetic stimulation contracts the bladder and micturition results if the sphincters (internal and external urethral sphincters) relax
    • The external sphincter is under voluntary control
    03/29/10 www.freelivedoctor.com
  • 31. Reflex and Voluntary Control of Micturition
    • Bladder filling reflexively contracts the bladder
    • Internal Sphincter mechanically opens
    • Stretch receptors in bladder send inhibitory impulses to external sphincter
    • Voluntary signals from cortex can override the reflex or allow it to take place
    03/29/10 www.freelivedoctor.com