DEAA

E ..

CF




(, , ,
Hb, ,
).

/-

D3

1. Bowman
2.
3. enle
4.
-

5.

~ .~ ~

~
~
~ - ~
.~ .~ .

(vasa recta)
Henle.

 RBF- 2

1200 ml/min .
20%
.

2 6 ml/100g/min.
H Da-v 1.5 ml/dl
.

2

+ +.

:
1.
2. (
4 nm)
3. T ()

FP = (Pcap - PBow) - COPcap

(12.5 ml/min/mm Hg)

GFR=Kf NFP
GFR 125 ml/min 180 lt/day.


:
1.

,
( f)
2.

3.
NFP
FF=GFR/RPF
FF 20 %
.

GFR RBF
H
90190 mm Hg
MAP
70 mm Hg.
H

,

.


GFR

RBF GFR
. FF .

RBF GFR
. FF .



(
- ,
GFR).

, ,

- ).
PGE2 , PGI2


RBF GFR.

 -
o Tubuloglomerular feedback

Cl

.
1.

2.
/

3.


-Glomerotubular
balance

ECF GFR,
+ 2
.
ECF.

()

()

.

,
f.

:


1
:




GFR.


.

GFR.

+
.
.
,
, g2+,
Ca2+.

.

= (+)

 (Clearance)


.

C x= U x V
Px
H
GFR :

, ,

Clearance ratio
Cx/Cin = 1 (,
, 12)
Cx/Cin < 1 +
(, )
Cx/Cin > 1 +
( PAH,
, )
Tubular fluid-to-plasma TF/P osmolality ratio
TFosm/Posm = 1

TFosm/Posm < 1

TFosm/Posm > 1

 PAH
.

.

RPF. mPAH ,

S.
RPF = UPAH V
ERPF = UPAH V
APAH VPAH
APAH
ERPF = UPAH V = CPAH
PPAH



GFR. 80-110
ml/min, .


GFR.


Filtered load

.
Filtered load = GFR Px = Cin
Px
Excretion rate

.
xcretion rate = Ux V

Tm Tr
(, ,
HPO42-)
Tr = Cin Px - Ux V

m s
(, ,
).
Ts = Ux V - Cin Px
E : +
+
m.

,
(2), .

m

(.. ).

 -
(symport) . + ,
,
(antiport) + +
.

3+-2+ -Pase
3H+-ATPase

+
+

+ -+
+ 4+

H+-K+-ATPase

+ 3CO3

+ -Ca2+

Ca2+-ATPase

Na + -2Cl K+

Cl HCO3

K+ -Cl

:
Gate function:
.
Fence function:
.. ++

++ATPase
.

E + ( 70%-85%
+ )

+
+ ( + ).

,
Cl-
HCO-3 ( CO2

H2O
).

E +

(67%)

+

+ -+ -P.

 Na+ enle (22%)

+
2 Cl +.

enle,
a+K+ATPase

 +
(4-5%)

Na+ - +
Na+ - +
+ +
+.

+ +
,

+
.
:

 +
+



Henle.
+

.
+


+
. .

+

,

.

 + (4300 mEq/d)

85% +
15%
. :
+- +
+ , +
CO3
.
+- Pase (5%
+)

 +
( +)

O . +
( CO3 )
.
(20 mmol/d )
( ).

 +
( +)

40
mmol/d
+

4Cl.
NH3 /

1/2.5.


500 mmol/d 4Cl .

-
300-500
mmol/d 4Cl 75-250
mmol/d

PCO2 ( PCO2,
+ )
H + (
)
()
()

 HCO3
HCO3
+

+.

HCO3 .
+
HCO3 .
.

 HCO3
HCO3

HCO3 (
).
T :
1.

2.
, +
, HCO3 .

 Cl
Cl

+.

Henle +-2Cl-K+.


NH4Cl.


75-80%
. 5%
Henle.

(facultative
reabsoption) ADH (88-99%).

 Ca++ -PTH

PTH

Ca++

.
PTH
HPO4-
Ca++

.
PTH
a+, K+
CO3-
4+
+.

..

Countercurrent multipliers

900 mOsm/kg.


enle
.
Henle ,
, .

Countercurrent multipliers- enle

enle

NaCl
(concentrating segment).

NaCl.

(diluting segment).

Countercurrent multipliers-

aCl .
,
H2O
Henle, .


(- )

,

.


enle.

Countercurrent multipliers-
aCl

.
.

DH.

Countercurrent exchangers-

Henle
.

.
NaCl
enle
.
a+
.

Countercurrent exchangers-
a+, Cl


enle,

.


enle

.


.

1.

()
3.
,

4.
5.
A

()
5. ,