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Renal Physiology
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Macroscopic Anatomy
• Kidneys:– Cortex– Medulla– Pelvis
• Ureter• Urinary bladder• Renal arteries and veins
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Microscopic Anatomy
• Nephrons– Vascular components: Afferent arteriole,
Glomerular capillary, Efferent arteriole, Peritubilar capillaries, venules
– Tubular component: Bowman’s capsule, proximal tubule, Loop of Henle (descending and acsending), distal tubule, collecting duct
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Urine formation
• Glomerular filtration• Tubular reabsorption• Tubular secretion• Excretion
– Excretion rate = filtration rate - reabsorption rate + secretion rate
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Glomerular Filtration
• GFR = filtration coefficient * net filtration pressure– Kf = permeability * surface area
• The glomerular membrane– Capillary wall: fenestrated and very permeable– Basement membrane restricts plasma proteins– Podocytes: create filtration slits
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GFR and tubule pressures
• Glomerular hydrostatic pressure: favors filtration• Glomerular osmotic pressure: opposes filtration• Bowman’s capsule pressure: opposes filtration• Net filtration pressure = 10 mm Hg
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Regulation of GFR• Factors:
– blood pressure in the capillaries
– Capillary surface area
– Membrane permeablility
• Purpose :– Keep GFR
constant
• Increase Kf; increases GFR
• Increase capsule hydrostatic pressure: decrease GFR
• Increase glomerular colloid osmotic pressure; decrease GFR
• Increase glomerularcapillary hydrostatic pressure, increases GFR
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Regulation of GFR
• Autoregulation of GFR– Keeps GFR constant in spite of arterial BP– Allows precise control over renal excretion (salt
and water)– Vasoconstriction/vasodilation adjust capillary
pressure back to 60 mmHg• Extrinsic control: Sympathetic inputs• Hormonal /Chemical control
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Reabsorption and SecretionReabsorption - movement of solutes from the tubule lumen back toThe capillary
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Reabsorption and Secretion
Active transport:Na,glucose, amino acids, Phosphate and calcium
Passive transport:Chloride and water, urea
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Secondary active transport
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Reabsorption of substancesIs linked to Na by passive transport
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Proximal tubule:65% NA H20 and Cl Reabsorbed hereExtensive brush boarderLots of mitochondria
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Loop of Henle:Descending thin, ascending thin,no brush boarderDescending thin is site of water reabsorption
Loop of Henleascending thickHi metabolic activityImpermeable to water
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Distal tubule
Early:Juxtaglomerular apparatus:Feedback control over GFR and blood flow, ion reabsorptionDiluting segment!
Late and Cortical:Principal and cortical cellsUrea not reabsorbed hereNa reabsorbed under control of aldosteroneH secreted for acid -base balanceWater permeability controlled by ADH
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Medullary Collecting Duct
• Reabsorbs < 10% water• Determines final output of water and solutes
in urine• ADH has large control over urine volume
here• Tubular urea absorbed here - helps form a
concentrated urine• H secreted for acid base balance
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Regulation of reabsorption• Glomerulotubular balance- rate of reabsorption
matches tubular inflow
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Regulation of reabsorption• Hormonal control
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Regulation of reabsorption• Sympathetic control• Decreases sodium and water excretion by
by vasoconstriction which reduces GFR
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Chapter 22
• Excreting a dilute urine– Counter current exchange
• Excreting a concentrated urine– Counter current exchange and the vasa recta
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•Excreting a dilute urine
• Start with 300• Dilute filtrate• PT- solutes and water• Dloh- osmosis• Aloh-reabsorbtion solutes• DT-dilute• CD- no ADH!-> dilute urine!
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Renal medulla becomes Salty!
• Na, K, Cl pumped out of Aloh• Active transport of ions from CD to medulla• Passive diffusion of urea to medulla• Little diffusion of water to medulla from
CD
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Renal medulla becomes Salty!
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Excreting a concentrated urine
• Start with 300• Dilute filtrate• PT- solutes and water• Dloh- osmosis• Aloh-reabsorbtion solutes• DT-dilute• CD- High ADH!-> concentrated urine!
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Tloh pumps solutes to medulla
Dloh loses waterpassively
Hyper osmotic fluidMoves to Tloh,
Tloh pumps solutes to medulla, again
Cycle again
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Countercurrent multiplier
• Repetitive reabsorption of NaCl from Tloh• Continued inflow of new NaCl from PT
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Urea
• Urea builds up in the DT then diffuses to the medulla when it reaches the CT
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High permeabilityprevents dissipationof the salty medulla!
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• Design a system to monitor and keep blood osmolaratity at 300 mosm
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Sketch an osmoreceptor
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