Last edited: 11/21/2021

1. GLOMERULAR FILTRATION
Glomerular Filtration Medical Editor: Mariel Antoinette L. Perez

OUTLINE

I) RENAL CORPUSCLE
II) GLOMERULAR MESANGIAL CELLS
III) GLOMERULAR FILTRATION RATE (GFR)
IV) APPENDIX (i) Lamina Rara Interna
V) REVIEW QUESTIONS
VI) REFRENCES  Fenestrated ~10% surface area (50-100nm pores
in capillaries)
 Freely permeable to everything
I) RENAL CORPUSCLE • except cells and platelets
 “Endothelial layer”
• Spherical filtering component distributed throughout the
• Part of membrane closest to endothelial cells
cortex
 Made up of specific types of molecules
• Responsible for 1st step of urine formation
• E.g., proteoglycans
− Separation of a protein-free filtrate from plasma  Has heparin sulfate
• Made of glomerulus and Bowman’s capsule
(ii) Lamina Densa
 made of Type IV collagen and laminins

(iii) Lamina Rara Externa

 Also has heparin sulfate
 Surround or cling to glomerular capillaries
 Rest on basement membrane and face Bowman’s
space
 have an unusual octopus-like structure

(B) BOWMAN’S CAPSULE

“Glomerular Capsule”
Hollow sphere composed of epithelial cells
Figure 1. Renal Corpuscle (1) Visceral Layer
(A) GLOMERULUS Surround or cling to glomerular capillaries
Filtration site where most excreted substances enter the rest on the basement membrane and face Bowman’s
nephron space
compact tuft of interconnected, fenestrated capillary Podocytes
loops of blood vessels o have an unusual octopus-like structure
o 50-100 nm in diameter o foot processes / “small fingers”
o Have medium intracellular clefts o Filtration slit
o Have fenestration pores running through endothelial  extremely thin processes (25-30nm)
cells  spaces in between podocytes
o Moderate permeability o Slit diaphragms
 bridge slits between podocytes
 E.g., RBCs, WBCs, platelets  crucial for filtration barrier selectivity
• prevent excess leak of plasma protein
(albumin)
 Water, electrolytes, nutrients, waste products  made of Nephrin

(1) Arterioles
(2) Parietal Layer
The glomerulus is one of the only examples in the
body wherein the capillary bed is both being fed and
drained by an arteriole
(i) Afferent Arterioles
(ii) Efferent Arterioles
(2) Glomerular Basement Membrane
Extremely negatively-charged due to heparin sulfate on
lamina rara interna and lamina rara externa
o Importance: acts as a barrier of filtration
 proteins are negatively charged
(C) FILTRATION
Substances that can pass through
o Electrolytes
 E.g., HCO3–, Na+, K+, Cl–, Ca2+, Mg2+, H2O
 Despite the negative charge on some of these
electrolytes, they’re very small; Hence, they will
get freely filtered
o Non-negatively charged low-Molecular weight
molecules
 E.g., glucose, amino acids, lipids, urea, creatinine,
vitamins)
These substances will move through the fenestration
pores  glomerular basement membrane  filtration slit
 nephrin  Proximal Convoluted Tubule

GLOMERULAR FILTRATION RENAL PHYSIOLOGY: Note #1. 1 of 3

 II) GLOMERULAR MESANGIAL CELLS (iii) Capsular Hydrostatic Pressure
center of glomerulus between and within capillary loops  As fluid is being filtered out, the pressure will push
Phagocytose and remove trapped macromolecules from things back into the capillary bed
basement membrane of capillaries (such as in slit  By the pressure build-up in the Bowman’s capsule
diaphragms)  Average value: 15 mmHg
Contain many myofilaments  Clinical Correlate:
o contracts in response to a variety of stimuli (like • Renal calculi
vascular smooth muscle cells) o Kidney stone stuck in nephron
o contracts and controls o > 5mm in diameter
o Pressure backs up and starts increasing 
Has gap junctions that connect it with Juxtaglomerular CHP
cells • Hydronephrosis
o Produce renin o Due to renal ptosis
o Baroreceptors o Rapid weight loss
o Important in maintenance of blood pressure o CHP  more fluid being pushed back
into the glomeruli and not much
III) GLOMERULAR FILTRATION RATE (GFR)
glomerular filtration
Plasma volume being filtered out of the glomerulus into
the bowman’s capsule every minute (iv) Capsular Osmotic Pressure
On average, 125 mL/min  As long as the filtration membrane is intact, there
o Per min., 1.2L goes to AA  625mL used in filtration should be no proteins in the Bowman’s capsule
process  only 20% (125mL) is filtered  Average value: 0 mmHg
(A) GFR = NFP X KF (2) Filtration Coefficient
Any fluctuations in either the Net Filtration Pressure (i) Surface Area (SA)
(NFP) or Filtration Coefficient (KF) directly affects GFR
 Lower surface area  lower GFR
(1) Net Filtration Pressure (NFP)  Larger SA  greater GFR
 Clinical Correlate
(i) Glomerular Hydrostatic Pressure (GHP)
• Certain conditions can change or affect the SA
 Force that pushes plasma out of the glomerular • Diabetic Nephropathy
capsule into the bowman’s space o Proteins and deposits that make the
 Directly dependent on systolic blood pressure glomeruli thicker, lessening the SA, and
• BP = GHP lowering the GFR
• BP = GHP
 Average value: 55 mmHg (ii) Permeability of Glomerulus
 Lesser channels, lower GFR
(ii) Colloid Osmotic Pressure (COP)  More channels, higher GFR
 Exerted by plasma proteins like albumin  Clinical Correlate: Glomerulonephritis
 Keeps water in the blood • Makes basement membrane very porous 
 Average value: 30 mmHg higher GFR  lose more proteins
 Clinical Correlates:
• Multiple myeloma
o Amount of proteins in blood  holds on
to more water in the blood  COP
• Hypoproteinemia
o Loses substances/proteins  can’t hold on
to water as much  COP

IV) APPENDIX

Figure 2. Summary of Glomerular Filtration

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 VI) REFRENCES
V) REVIEW QUESTIONS
● Sabatine MS. Pocket Medicine: the Massachusetts General
1) Which of the following is the least important Hospital Handbook of Internal Medicine. Philadelphia: Wolters
Kluwer; 2020.
pressure in Glomerular Filtration? ● Le T. First Aid for the USMLE Step 1 2020. 30th anniversary
a) Capsular Hydrostatic Pressure edition: McGraw Hill; 2020.
b) Glomerular Hydrostatic Pressure (GHP) ● Jameson JL, Fauci AS, Kasper DL, Hauser SL, Longo DL,
c) Capsular Osmotic Pressure Loscalzo J. Harrison's Principles of Internal Medicine, Twentieth
Edition (Vol.1 & Vol.2). McGraw-Hill Education / Medical; 2018
d) Colloid Osmotic Pressure (COP) ● Marieb EN, Hoehn K. Anatomy & Physiology. Hoboken, NJ:
Pearson; 2020.
2) Which of the following directly affects the ● Boron WF, Boulpaep EL. Medical Physiology.; 2017.
Glomerular Filtration Rate? Guyton and Hall Textbook of Medical Physiology. Philadelphia, PA:
a) Surface Area Elsevier; 2021.
b) Glomeruli Permeability
c) Net Filtration Pressure
d) All of the Above
3) Which is a not a component of Filtration Coefficient?
a) Surface Area
b) Glomeruli Permeability
c) All of the Above
d) None of the Above

CHECK YOUR ANSWERS

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