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4-Urine concentration.ppt
- 1. 1 Dr. Mohand Hassan Moalla 2017
- 2. 2 Dr. Mohand Hassan Moalla 2017
- 3. 23.3 Liter/Day 0.5 Liter/Day 1400mOsm/L 30mOsm/L Maximal diluted urine Maximal concentrated urine 3 Dr. Mohand Hassan Moalla 2017
- 4. Urine concentration Kidney produce either a concentrated or diluted urine Concentration [mOsm/L] Volume [Liter/day] Maximal diluted urine 30 23.3 Maximal concentrated urine 1400 0.5 4 Dr. Mohand Hassan Moalla 2017
- 5. Urine concentration (water reabsorption ) ADH osmotic gradient Urine concentration 5 Dr. Mohand Hassan Moalla 2017
- 6. ADH osmotic gradient 6 Dr. Mohand Hassan Moalla 2017
- 7. Dr. Mohand Hassan Moalla 2017 7 300 mOsm/L 1200 mOsm/L cortex papilla countercurrent system urea recycling corticopapillary osmotic gradient
- 8. Urine concentration Urine concentration is operated by water reabsorption Water reabsorption requires ADH and osmotic gradient “corticopapillary osmotic gradient” The major factors that contribute to the buildup this osmotic gradient into the renal medulla are as follows:- 1. countercurrent system 2. urea recycling 8 Dr. Mohand Hassan Moalla 2017
- 9. it is a gradient of osmolarity in the interstitial fluid of the kidney from the cortex to the papilla The osmolarity of the cortex is approximately 300 mOsm/L The osmolarity of the papilla is approximately 1200 mOsm/L corticopapillary osmotic gradient 9 Dr. Mohand Hassan Moalla 2017
- 10. This occurs in:- loops of Henle vasa recta parallel counter [opposite direction] close proximity countercurrent system inflow outflow 10 Dr. Mohand Hassan Moalla 2017
- 11. The concentrating mechanism depends upon the maintenance of a gradient of increasing osmolality along the medullary pyramids countercurrent system concentrating mechanism countercurrent exchangers countercurrent multipliers 11 Dr. Mohand Hassan Moalla 2017
- 12. Loop of Henle countercurrent multipliers 12 Dr. Mohand Hassan Moalla 2017
- 13. 300 300 300 300 300 300 300 300 300 300 300 300 interstitial fluid Thick ascending loop of Henle 13 Dr. Mohand Hassan Moalla 2017
- 14. 300 300 300 300 200 200 200 200 400 400 400 400 interstitial fluid 14 Dr. Mohand Hassan Moalla 2017 H2O H2O H2O H2O
- 15. 400 400 400 400 200 200 200 200 400 400 400 400 300 interstitial fluid 15 Dr. Mohand Hassan Moalla 2017
- 16. 300 300 400 400 400 400 200 200 400 400 400 400 interstitial fluid 16 Dr. Mohand Hassan Moalla 2017
- 17. 300 300 400 400 300 300 150 150 350 350 500 500 interstitial fluid 17 Dr. Mohand Hassan Moalla 2017 H2O H2O H2O H2O
- 18. 350 350 500 500 300 300 150 150 350 350 500 500 300 interstitial fluid 18 Dr. Mohand Hassan Moalla 2017
- 19. 300 300 350 350 500 500 300 300 350 350 500 500 interstitial fluid 19 Dr. Mohand Hassan Moalla 2017
- 20. 300 300 350 350 400 400 225 225 425 425 600 600 interstitial fluid 20 Dr. Mohand Hassan Moalla 2017
- 21. interstitial fluid 425 425 600 600 400 400 225 225 425 425 600 600 300 21 Dr. Mohand Hassan Moalla 2017
- 22. countercurrent multipliers Single effect (First step) 1. NaCl is reabsorbed in the thick ascending limb 2. Water is reabsorbed in the descending limb flow of tubular fluid (second step) 1. inflow of tubular fluid from the proximal tubule 2. outflow of tubular fluid into the distal tubule. 22 Dr. Mohand Hassan Moalla 2017
- 23. 300 300 300 300 300 300 300 300 300 300 300 300 300 300 300 300 300 300 thick ascending limb NaCL NaCL NaCL 200 200 200 200 400 400 400 400 400 400 400 400 400 single effect 23 Dr. Mohand Hassan Moalla 2017
- 24. single effect NaCl is reabsorbed via the Na+-K+-2Cl- cotransporter out of the ascending limb NaCl is deposited in the surrounding interstitial fluid interstitial fluid osmolarity increases to 400 mOsm/L the fluid in the ascending limb is diluted to 200 mOsm/L. Fluid in the descending limb equilibrates with the interstitial fluid, and its osmolarity also becomes 400 mOsm/L. 24 Dr. Mohand Hassan Moalla 2017
- 25. 400 400 400 400 300 300 300 400 400 200 200 200 200 400 400 400 flow of fluid 300 isotonic fluid continues to flow into the thin descending limb hypotonic fluid out of the thick ascending limb. Hypertonicity accumulates at the apex of the loop. PCT DCT 25 Dr. Mohand Hassan Moalla 2017
- 26. New fluid with an osmolarity of 300 mOsm/L enters the descending limb from the proximal tubule Equal volume of fluid is displaced from the ascending limb High osmolarity fluid in the descending limb (400 mOsm/L) is "pushed down" toward the bend [apex] of the loop of Henle. flow of fluid 26 Dr. Mohand Hassan Moalla 2017
- 27. These two basic steps are repeated until the full corticopapillary gradient is established each repeat of the two steps increases, or multiplies, the gradient. The size of the corticopapillary osmotic gradient depends on the length of the loop of Henle. In humans, the osmolarity of interstitial fluid at the bend of the loop of Henle is 1200 mOsm/L countercurrent multipliers 27 Dr. Mohand Hassan Moalla 2017
- 28. vasa recta operate as countercurrent exchanger countercurrent exchange differs from countercurrent multiplication as follows:- countercurrent exchange countercurrent multiplication countercurrent exchange active process passive process establishes the osmotic gradient maintain the osmotic gradient 28 Dr. Mohand Hassan Moalla 2017
- 29. vasa recta are capillaries vasa recta consisted of:- 1. The descending limb (where Blood entering ) 2. The ascending limb (where Blood exit ) Purpose:- Maintaining of osmotic gradient by keeping solute (Na+, urea) in pyramid from losing by the circulation countercurrent exchange 29 Dr. Mohand Hassan Moalla 2017
- 30. 300 600 1200 Cortical Outer medulla inner medulla 300 NaCL & urea 600 NaCL & urea 1200 H2O H2O 600 NaCL & urea H2O 300 30 Dr. Mohand Hassan Moalla 2017
- 31. Urea Recycling Urea Cortical outer inner UT-A 50% ADH 10% 31 Dr. Mohand Hassan Moalla 2017
- 32. Urea contributes to the establishment of the osmotic gradient in the medullary pyramids ability to form a concentrated urine in the collecting ducts. Urea transport is mediated by urea transporters (UT-A) Urea is produced as result of protein catabolism high-protein diet increases the ability of the kidneys to concentrate the urine. Urea Recycling 32 Dr. Mohand Hassan Moalla 2017
- 33. 33 Dr. Mohand Hassan Moalla 2017