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GLOMERULAR
FILTRATION
By
Prof. Dr. Nusrat Tariq
4/17/2024 1
.
4/17/2024 2
LEARNING OBJECTIVES
By the end of this lecture you should be
able to:
• Define GFR
• Describe the determinants of GFR
• Explain the factors affecting GFR
• Discuss the hormones and autocoids
that affect GFR
4/17/2024 3
GLOMERULAR FILTRATION
RATE (GFR)
Glomerular Filtration Rate is defined
as volume of filtrate formed each
minute by both Kidneys.
Normal/ Average Adult GFR =
120 - 125 ml/ min or 180L/day
4/17/2024 4
GLOMERULAR FILTRATE
• The filtrate is devoid of proteins
and RBC
• The concentration of filtrate is
similar to ?????.
4/17/2024 5
GLOMERULAR FILTRATE
• The filtrate is devoid of proteins
and RBC
• The concentration of filtrate is
similar to plasma.
4/17/2024 6
RENAL BLOOD FLOW
• Renal blood Flow is 22% of the
cardiac output or 1100 ml/min
• Renal plasma flow is 55% of the
RBF approximately 600ml/min
• GFR is 20% of the renal plasma
flow
4/17/2024 7
FILTRATION FRACTION
• Filtration fraction is the fraction
of plasma which is filtered.
• Filtration fraction =GFR/RPF
=125/600
=0.2
4/17/2024 8
DETERMINANTS OF
THE GFR
GFR = Kf × Net filtration pressure
4/17/2024 9
FILTRATION COEFFICIENT
(KF)
Kf = the product of the hydraulic
conductivity and surface area of
the glomerular capillaries.
GFR = Kf × Net filtration pressure
Kf =????
4/17/2024 10
FILTRATION COEFFICIENT
(KF)
GFR = Kf × Net filtration pressure
Kf = GFR/Net filtration pressure
4/17/2024 11
NET FILTRATION
PRESSURE
forces causing filtration by the
glomerular capillaries
??????
4/17/2024 12
4/17/2024 13
NET FILTRATION PRESSURE
• sum of capillary hydrostatic pressure minus
the colloid osmotic pressure plus the
bowman's capsular pressure
• 60-(32+18)=10mmHg
• Capillary hydrostatic pressure is the outward
force (60 mmHg)
• Colloid osmotic and bowmans pressure are
inward forces (32mmHg+18mmHg)
4/17/2024 14
DETERMINANTS OF GFR
GFR=Kf x net filtration pressure
Net filtration pressure depends on three
forces
1. capillary hydrostatic pressure
2. capillary colloid osmotic pressure
3. bowman's capsular pressure
4/17/2024 15
1)Increased Glomerular Capillary Filtration
Coefficient (Kf) Increases GFR
2) Increased Bowman’s Capsule Hydrostatic
Pressure Decreases GFR
3) Increased Glomerular Capillary Colloid
Osmotic Pressure Decreases GFR
4) Increased Glomerular Capillary Hydrostatic
Pressure Increases GFR
4/17/2024 16
1)INCREASED GLOMERULAR
CAPILLARY FILTRATION
COEFFICIENT INCREASES GFR
Kf = GFR/Net filtration pressure
Total GFR = 125 ml/min
Net filtration pressure = 10 mm Hg
The normal Kf is = 12.5 ml/min /mmHg
of filtration pressure.
4/17/2024 17
1)INCREASED GLOMERULAR CAPILLARY
FILTRATION COEFFICIENT INCREASES
GFR
Some diseases lower Kf by
 Reducing the number of functional
glomerular capillaries(thereby reducing
the surface area for filtration)
 Increasing the thickness of the
glomerular capillary membrane and
(reducing its hydraulic conductivity).
4/17/2024 18
Example:
•chronic, uncontrolled
Hypertension
•diabetes mellitus
4/17/2024 19
2-INCREASED BOWMANS
HYDROSTATIC PRESSURE INCREASES
GFR
Stones that lodge in the urinary tract
obstruct outflow of the urinary tract
and raise the Bowman’s capsule
pressure causing reduction of GFR.
.
4/17/2024 20
3) INCREASED GLOMERULAR CAPILLARY
COLLOID OSMOTIC PRESSURE DECREASES
GFR
Filtration fraction = GFR/Renal plasma flow
= (125ml/m)/(650ml/m)
= 0.2
Increases in the filtration fraction
increases the plasma colloid osmotic
pressure as the proteins are
concentrated in the glomerular capillary
4/17/2024 21
4) INCREASED GLOMERULAR
CAPILLARY HYDROSTATIC PRESSURE
INCREASES GFR
Glomerular hydrostatic pressure is determined
by three variables:
(1) arterial pressure,
(2) afferent arteriolar resistance, and
(3) efferent arteriolar resistance.
• Constriction of afferent arterioles reduces GFR.
• Modest efferent constriction raises GFR, but
• Severe efferent constriction tends to reduce
GFR.
4/17/2024 22
4/17/2024 23
OTHERS FACTORS AFFECTING THE GFR
• Changes in renal blood flow
• Changes in systemic blood pressure
• Afferent or efferent arteriolar constriction
• Edema of kidney inside tight renal capsule
• Changes in concentration of plasma proteins:
dehydration, hypoproteinemia, etc (minor factors)
• Changes in glomerular capillary permeability
• Changes in effective filtration surface area.
• Contraction of mesangial cells: Decreases GFR by
reducing the Kf due to reduction in surface area for
filtration
4/17/2024 24
AGENTS CAUSING CONTRACTION OR
RELAXATION OF MESANGIAL CELLS.
• Contraction Relaxation
• Endothelins ANP
• Angiotensin II Dopamine
• Vasopressin PGE2
• Norepinephrine cAMP
• Thromboxane A2
• Histamine
4/17/2024 25
FACTORS WHICH CAN DECREASE GFR
• Kf in DM, HTN, renal diseases
• PB in urinary tract obstruction
• Glomerular Capillary oncotic
pressure due to RBF or in
plasma proteins
4/17/2024 26
FACTORS WHICH CAN DECREASE GFR
•  Glomerular hydrostatic pressure
1. Arteial Blood Pressure
2. angiotensin II
3. sympathetic stimulation leading
to vasoconstiction  RBF in
afferent arteriole
4/17/2024 27
4/17/2024 28
4/17/2024 29

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Glomerular Filtration rate and its determinants.pptx

  • 3. LEARNING OBJECTIVES By the end of this lecture you should be able to: • Define GFR • Describe the determinants of GFR • Explain the factors affecting GFR • Discuss the hormones and autocoids that affect GFR 4/17/2024 3
  • 4. GLOMERULAR FILTRATION RATE (GFR) Glomerular Filtration Rate is defined as volume of filtrate formed each minute by both Kidneys. Normal/ Average Adult GFR = 120 - 125 ml/ min or 180L/day 4/17/2024 4
  • 5. GLOMERULAR FILTRATE • The filtrate is devoid of proteins and RBC • The concentration of filtrate is similar to ?????. 4/17/2024 5
  • 6. GLOMERULAR FILTRATE • The filtrate is devoid of proteins and RBC • The concentration of filtrate is similar to plasma. 4/17/2024 6
  • 7. RENAL BLOOD FLOW • Renal blood Flow is 22% of the cardiac output or 1100 ml/min • Renal plasma flow is 55% of the RBF approximately 600ml/min • GFR is 20% of the renal plasma flow 4/17/2024 7
  • 8. FILTRATION FRACTION • Filtration fraction is the fraction of plasma which is filtered. • Filtration fraction =GFR/RPF =125/600 =0.2 4/17/2024 8
  • 9. DETERMINANTS OF THE GFR GFR = Kf × Net filtration pressure 4/17/2024 9
  • 10. FILTRATION COEFFICIENT (KF) Kf = the product of the hydraulic conductivity and surface area of the glomerular capillaries. GFR = Kf × Net filtration pressure Kf =???? 4/17/2024 10
  • 11. FILTRATION COEFFICIENT (KF) GFR = Kf × Net filtration pressure Kf = GFR/Net filtration pressure 4/17/2024 11
  • 12. NET FILTRATION PRESSURE forces causing filtration by the glomerular capillaries ?????? 4/17/2024 12
  • 14. NET FILTRATION PRESSURE • sum of capillary hydrostatic pressure minus the colloid osmotic pressure plus the bowman's capsular pressure • 60-(32+18)=10mmHg • Capillary hydrostatic pressure is the outward force (60 mmHg) • Colloid osmotic and bowmans pressure are inward forces (32mmHg+18mmHg) 4/17/2024 14
  • 15. DETERMINANTS OF GFR GFR=Kf x net filtration pressure Net filtration pressure depends on three forces 1. capillary hydrostatic pressure 2. capillary colloid osmotic pressure 3. bowman's capsular pressure 4/17/2024 15
  • 16. 1)Increased Glomerular Capillary Filtration Coefficient (Kf) Increases GFR 2) Increased Bowman’s Capsule Hydrostatic Pressure Decreases GFR 3) Increased Glomerular Capillary Colloid Osmotic Pressure Decreases GFR 4) Increased Glomerular Capillary Hydrostatic Pressure Increases GFR 4/17/2024 16
  • 17. 1)INCREASED GLOMERULAR CAPILLARY FILTRATION COEFFICIENT INCREASES GFR Kf = GFR/Net filtration pressure Total GFR = 125 ml/min Net filtration pressure = 10 mm Hg The normal Kf is = 12.5 ml/min /mmHg of filtration pressure. 4/17/2024 17
  • 18. 1)INCREASED GLOMERULAR CAPILLARY FILTRATION COEFFICIENT INCREASES GFR Some diseases lower Kf by  Reducing the number of functional glomerular capillaries(thereby reducing the surface area for filtration)  Increasing the thickness of the glomerular capillary membrane and (reducing its hydraulic conductivity). 4/17/2024 18
  • 20. 2-INCREASED BOWMANS HYDROSTATIC PRESSURE INCREASES GFR Stones that lodge in the urinary tract obstruct outflow of the urinary tract and raise the Bowman’s capsule pressure causing reduction of GFR. . 4/17/2024 20
  • 21. 3) INCREASED GLOMERULAR CAPILLARY COLLOID OSMOTIC PRESSURE DECREASES GFR Filtration fraction = GFR/Renal plasma flow = (125ml/m)/(650ml/m) = 0.2 Increases in the filtration fraction increases the plasma colloid osmotic pressure as the proteins are concentrated in the glomerular capillary 4/17/2024 21
  • 22. 4) INCREASED GLOMERULAR CAPILLARY HYDROSTATIC PRESSURE INCREASES GFR Glomerular hydrostatic pressure is determined by three variables: (1) arterial pressure, (2) afferent arteriolar resistance, and (3) efferent arteriolar resistance. • Constriction of afferent arterioles reduces GFR. • Modest efferent constriction raises GFR, but • Severe efferent constriction tends to reduce GFR. 4/17/2024 22
  • 24. OTHERS FACTORS AFFECTING THE GFR • Changes in renal blood flow • Changes in systemic blood pressure • Afferent or efferent arteriolar constriction • Edema of kidney inside tight renal capsule • Changes in concentration of plasma proteins: dehydration, hypoproteinemia, etc (minor factors) • Changes in glomerular capillary permeability • Changes in effective filtration surface area. • Contraction of mesangial cells: Decreases GFR by reducing the Kf due to reduction in surface area for filtration 4/17/2024 24
  • 25. AGENTS CAUSING CONTRACTION OR RELAXATION OF MESANGIAL CELLS. • Contraction Relaxation • Endothelins ANP • Angiotensin II Dopamine • Vasopressin PGE2 • Norepinephrine cAMP • Thromboxane A2 • Histamine 4/17/2024 25
  • 26. FACTORS WHICH CAN DECREASE GFR • Kf in DM, HTN, renal diseases • PB in urinary tract obstruction • Glomerular Capillary oncotic pressure due to RBF or in plasma proteins 4/17/2024 26
  • 27. FACTORS WHICH CAN DECREASE GFR •  Glomerular hydrostatic pressure 1. Arteial Blood Pressure 2. angiotensin II 3. sympathetic stimulation leading to vasoconstiction  RBF in afferent arteriole 4/17/2024 27