The urinary system

Dr Isabel Hwang

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LECTURE OUTLINE
• General functions of human urinary system
• Components of the urinary system
• Basic structure of the kidneys
• Nephron as the functional unit of kidneys
• Renal (nephron) processes:
• Glomerular filtration
• Renal reabsorption
• Renal secretion
• Physiological events at different sites of a nephron
• ADH action is facilitated by the high osmolarity in the
interstitial fluid
• Micturition is excretion of urine
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Structure and functions of the urinary system

• Kidneys: multiple physiological functions (next slide)

• Ureters: transport urine from kidneys to bladder
• Bladder: store urine until voided from body
• Urethra: carry urine from bladder to the outside of the body
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Some key kidney functions
1. Regulation of blood plasma volume
and thus blood pressure (MAP)
2. Regulation of plasma osmolarity

3. Regulation of pH
4. Production of hormone and enzymes
(erythropoietin and renin)
5. Excretion of wastes

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Relationship between volume and plasma
osmolarity

• Volume of water not only affects blood pressure but also value of
osmolarity.
• Osmolarity value, in return would initiate physiological response
that brings about homeostatic control of body fluid compartment
especially plasma volume.
• Therefore, volume and osmolarity are inter-related.
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Location of the kidneys
• Either side of vertebral
column
• Retroperitoneal (behind the
peritoneum) but supported
by connective tissue
• The peritoneum is a
continuous membrane which
lines the abdominal cavity
and covers the abdominal
organs
• Fibrous capsule covers each
kidney
• Capsule surrounded by
adipose tissue

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Blood supply to the kidney

• Kidneys receive 20 –25% of cardiac output (at rest)

• Blood flow starts

with renal artery

• Blood exits kidney

with renal vein

to urinary
bladder 7
Structure of the kidney
Two layers:
1. Renal cortex is
outer layer
2. Renal medulla is
inner layer
• Contains cone-
shaped renal
pyramids
• Tip is called renal
papilla and projects
into renal pelvis

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Nephron is the function unit of kidneys
One nephron consists of
1. Renal corpuscle
• Glomerulus and Bowman’s
capsule (glomerular capsule)
• Filtration occurs across
glomerulus

2. Renal tubules
• Proximal convoluted tubule,
Loop of Henle, distal
convoluted tubule and
collecting duct
• Different segments have
different transport
mechanisms

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Nephrons are well supplied by blood
capillaries called peritubular capillaries
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3
6
4

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 The nephron

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Three renal (nephron) processes
1 Glomerular filtration is a bulk-flow
passive process in which hydrostatic
pressure forces water and all low-
molecular-weight substances
(including smaller polypeptides)
through a filtration barrier.

2 Tubular secretion is the movement

of substances from the peritubular
capillaries into the tubular lumen.

3 Tubular reabsorption is the

movement of substances from the
fluid in the tubular lumen or material
produced within the epithelial cell
into the peritubular capillaries.

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Renal processes of the nephron

1 * 2 * 3
Excretion

*To be covered in this lecture

⚫ Blood filtrate (after glomerular filtration) is refined to urine
through reabsorption and secretion
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Glomerular filtration
• Afferent arterioles supply the glomerulus while the efferent
arteriole drains it
• Glomeruli are mass of capillaries inside Bowman’s (glomerular)
capsule that gives rise to filtrate that enters nephron tubule

Peritubular capillaries
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Glomerular filtration
• Occurs at the glomerulus
• Filters plasma (minus proteins and blood cells) into the
Bowman’s capsule
• Includes valuable nutrients (glucose, amino acids), ions (Na
and K), and water

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Three filtration barriers:
1. Capillary endothelium
2. Basement membrane (basal lamina)
3. Epithelium of the Bowman’s capsule (foot processes of
podocyte)

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Glomerular filtration
• Occurs at the
glomerulus
• Filters plasma (minus
proteins and blood
cells) into the
Bowman’s capsule
• Includes valuable
nutrients (glucose,
amino acids), ions (Na
and K), and water

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Glomerular filtration rate (GFR)
• Index of renal function
• Amount of filtrate produced by kidneys/minute
• Average is 125 mL/min or 180 L/day
• Depending on:
✓Blood flow to kidney (cardiac output = 20-25% at rest)
✓Net filtration pressures (NFP)

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Resistance changes in renal arterioles
• Affect renal blood flow and GFR

• Vasoconstriction of the afferent arteriole increases resistance

and decreases renal blood flow, PGC and GFR
• Vasoconstriction of efferent arteriole decreases renal blood flow
but increases PGC and GFR
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Excretion and filtered load of a substance

Amount Amount Amount Amount

= − reabsorbed + secreted
excreted filtered

Filtered
load = GFR (ml/min) x [ substance X ]plasma (mg/ml)
(mg/min)

• Filtered load is the amount of any substance filtered from renal

glomerular capillaries into the Bowman’s capsule

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Tubular reabsorption
• Begins from the proximal
tubule to the collecting
duct.
• This can occur through the
cell (transcellular
transport) or across tight
junctions (paracellular
transport).
• Transport can be active
(requiring ATP) or passive
(no ATP required).

Diagrammatic representation of tubular epithelium

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Reabsorption at the proximal convoluted tubule
(PCT)
• Around 65% of glomerular filtrate
volume is reabsorbed at PCT
• All glucose, amino acids, and
other organic nutrients are
reabsorbed
• Ionic reabsorption of Na+, K+, Ca2+,
Mg2+, HCO3–
• Some are hormonally
regulated, like Ca2+ by
parathyroid hormone (PTH),
Na+ and K+ by aldosterone, etc.

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Mechanism of Na+ reabsorption in the
proximal tubule (X = glucose)

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Glucose reabsorption at the PCT
• Filtered glucose is normally 100% reabsorbed from
filtrate.
– Mediated by co-transporter (secondary active
transport) with Na+ ion.
• Transport maximum (Tm) of glucose (mg/min) is the
maximal amount of glucose that can be transported
by the carrier transporter
• Glucose transporters don't saturate under normal
conditions but do become saturated in diabetes

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Coupling of Na+ and water reabsorption

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The Loop of Henle
• Reabsorbs 25% of filtrate
• Fluid in descending limb flows
toward renal pelvis
• permeable to water, not
solutes
• Tubule makes 180-degree turn
• Fluid in ascending limb flows
toward renal cortex
• permeable to solutes, not
water
• Interstitial (tissue) fluid of
renal medulla has unusually
high solute (NaCl)
concentration
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Water is reabsorbed from the descending limb of
the Loop of Henle
• Is permeable to H2O only
• Is impermeable to salt (i.e.
NaCl)
• Because deep regions of
medulla are 1400mOsm,
H2O diffuses out of filtrate
until it equilibrates with
interstitial fluid
– This H2O is reabsorbed
by capillaries

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NaCl is actively pumped out of the ascending
limb of the Loop of Henle
• Has a thin segment in
depths of medulla and
thick part toward cortex
• Impermeable to H2O
(water-proof); permeable
to salt; thick part ATs salt
out of filtrate
– AT of salt causes
filtrate to become
dilute (100
mOsm) by end of LH

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The distal convoluted tubule (DCT)

• Is involved in
1. Active secretion of ions,
acids, drugs, and toxins
• E.g. hydrogen ions,
potassium ions
2. Selective reabsorption
of sodium under the
action of aldosterone

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The collecting duct (CD)

• Many distal convoluted tubules empty into one

collecting duct

• Functions
• Adjusts final filtrate
composition
• Determines final osmotic
concentration
• Determines final volume of
urine
• Acts as important sites of
aldosterone and ADH actions
urine
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Tubular events at the collecting duct under the
actions of hormones
• Water reabsorbed
under the action of
ADH
• Na ion reabsorbed
under the action of
aldosterone

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Anti-diuretic hormone (ADH)
• Also called vasopressin because
it is a potent vasoconstrictor at
higher concentrations
• Is secreted by posterior pituitary
in response to dehydration.
• Stimulates insertion of
aquaporins (water channels,
aquaporin-2) into apical side of
plasma membrane of distal
tubule and collecting duct.
• When ADH is high, H2O is drawn out
of collecting duct by high osmolality
of interstitial fluid.

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 • Aquaporins are virtually
absent in the collecting
Na+Cl−
ducts unless antidiuretic
H2O
hormone (ADH) is
Na+Cl− present.
H2O
• Water reabsorption
Na+Cl− under the effect of ADH
H2O
is facilitated by the high
osmotic gradient
Na+Cl− maintained in the
urea
medullary interstitium
H2O
• Achieved by the active
urea pumping of NaCl from the
ascending limb of the
Loop of Henle
Urine

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When ADH is absent When ADH is present

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Renal secretion

• Reabsorption in reverse;
occurs in different regions of
the nephron tubules
• Selected substances
• K+, H+, NH4+, creatinine,
organic acids and bases
move from peritubular
capillaries through tubule
cells into filtrate
• Substances synthesized in
tubule cells also secreted –
e.g., HCO3-

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Micturition
• Urination or voiding
• Three simultaneous events must occur

– Contraction of
detrusor muscle by
ANS
– Opening of internal
urethral sphincter
by ANS
– Opening of external
urethral sphincter
by somatic nervous
system

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Properties of normal urine

• Once filtrate leaves collecting duct:

• No other secretion or reabsorption can occur
• Fluid is now called urine
• Concentration and composition vary based on metabolic,
hormonal activities and hydration status
• Urine is temporarily stored in the urinary bladder
• When void volume is reached, micturition (urination)
reflex will be initiated

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Metabolic wastes in urine

• Must be excreted to maintain homeostasis

1. Urea
✓ From amino acid breakdown
2. Creatinine
✓ From breakdown of high-energy compound
called creatinine phosphate in skeletal muscles
3. Uric acid
✓ From breakdown of RNA

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Learning outcomes
• To define the followings:
• Osmolarity, osmolality, nephron, GFR, net filtration pressure,
renal processes, transport maximum.
• Define a nephron and describe its structure.
• Define glomerular filtration. Describe how the various favoring
and/or opposing pressures across the renal corpuscle affects
glomerular filtration.
• Describe how glucose is reabsorbed in the kidneys. Specify site
of nephron where glucose is reabsorbed.
• Summarize the events of countercurrent mechanism at the
nephron loop. Differentiate the structural and functional
characteristics between the descending and ascending limbs of
the Loop of Henle
• Write a flow diagram to summarise the physiological functions
of ADH.
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 The end.

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