AJAO F.

O
Physiology Department
LAUTECH
 Most of the functions of the kidney are carried out
in the process of urine formation.

 Three processes are involved in urine formation

namely:

(i) glomerular filtration

(ii) tubular reabsorption and
(iii) tubular secretion or excretion
➢ This is the filtration of plasma into the bowman’s
capsule as blood passes through the glomerular
capillaries.

➢ The filtered fluid is called glomerular filtrate.

➢ Glomerular filtrate is the plasma without plasma

proteins

➢ Glomerular filtration is also called ultra filtration

because even the minute particles are filtered from
glomerular capillary into Bowman’s capsule.

➢ This Glomerular filtration rate (GFR) is the total

amount of filtrate formed in all the nephrons of
both kidneys per unit time.
GFR is 125mL/min or 180L/day.
➢ The pressures which determine the GFR are

• glomerular capillary pressure (60mmHg),

• colloidal osmotic pressures exerted by plasma proteins

in the glomerulus (25mmHg)

• hydrostatic pressure in Bowman’s capsule (10mmHg).

➢The glomerular pressure favors filtration.

Colloidal osmotic pressure and hydrostatic
pressure oppose or prevent filtration.

➢ The effective filtration pressure therefore =

60 – (25 +10) = 25 mmHg.
➢Tubuloglomerular
feedback mechanism
This is the process
in which, the GFR is
constantly regulated
by means of feedback
from the renal tubule.
Macula densa of JGA is
responsible for this
➢ Glomerular capillary pressure
GFR is directly proportional to glomerular capillary
pressure

➢ Collodal osmotic pressure

GFR is inversely proportional to osmotic pressure exerted
by proteins.

➢ Hydrostatic pressure in Bowman’s capsule

GFR is inversely proportional to hydrostatic pressure.

➢ Renal blood flow

GFR is directly proportional to renal blood flow.
➢ Constriction of afferent arterioles
This reduces the blood flow to glomerular capillaries and
thus reducing GFR.

➢ Surface area of capillary membrane

GFR is directly proportional to this. In renal diseases,
surface area for filtration is reduced, so there is
reduction in GFR.

➢ Permeability of capillary membrane

GFR is directly proportional to this

➢ Contraction of Glomerular Mesangial Cells

Glomerular mesangial cells are situated in between the
glomerular capillaries. Contraction of these cells
decreases surface area of capillaries resulting in
reduction in GFR.
➢ Hormonal and Other Factors
Many hormones and other secretory factors alter GFR by
affecting the blood flow through glomerulus.

◦ Factors increasing GFR by vasodilatation

i. Atrial natriuretic peptide
ii. Brain natriuretic peptide
iii. cAMP
iv. Dopamine
v. Endothelia-lderived nitric oxide
vi. Prostaglandin (PGE2).
◦ Factors decreasing GFR by vasoconstriction
i. Angiotensin II
ii. Endothelins
iii. Noradrenaline
iv. Platelet activating factor
v. Platelet derived growth factor
vi. Prostaglandin (PGF2).
➢ This is the fraction (portion) of the renal plasma,
which becomes the filtrate.

➢ It is the ratio between renal plasma flow and

glomerular filtration rate. It is expressed in
percentage.

➢ Filtration fraction = GFR × 100

Renal plasma flow

=125 mL/min × 100

650 mL/min

= 19.2%.

➢ Normal filtration fraction varies from 15% to 20%.

In the proximal convoluted tubule (PCT)

➢ Tubular reabsorption is the process by which water

and other substances are transported from renal
tubules back to the blood.

➢ Tubular reabsorption is also called selective

reabsorption,

➢ In the PCT, 7/8th of the sodium load is actively

reabsorbed.

➢ This is followed by passive reabsorption of chloride

along the electro-chemical gradient set up by
sodium reabsorption.
➢ 7/8th of the water load in the PCT is passively
reabsorbed. This is 2o to the osmotic gradient
created by active sodium reabsorption.

➢ Potassium is almost 100% actively reabsorbed in

the PCT

➢ Glucose is also 100% actively reabsorbed provided

its renal threshold of about 180mg/dl or 10 – 12
micromole/L is not exceeded.

 Glucose and Na+ bind to the common carrier SGLT2 (sodium

dependent glucose transporter) in the luminal membrane
and glucose is carried into the cell as Na+ moves down its
chemical and electrical gradient.
➢ Bicarbonate is totally reabsorbed from the proximal
tubule provided the body pH is normal.

➢ Large amount of urea is passively reabsorbed in

the PCT

➢ Phosphate is actively reabsorbed in the PCT and its

reabsorption is restricted to the PCT.

➢ Sulphate, ammonia acids and traces of protein are

actively reabsorbed in the PCT.

In the loop of Henle,

➢ Sodium and chloride are reabsorbed in the
ascending limb. Water is only reabsorbed in the
descending limb
In the distal tubule,
➢ Sodium is active reabsorbed chloride follows
passively.

➢ Potassium and Hydrogen ion is secreted in

exchange for Na+ reabsorption.

➢ Water is also reabsorbed depending on the level of

ADH. (facultative water reabsorption).

In the collecting duct,

➢ Sodium chloride is actively reabsorbed. Collecting
Duct is impermeable to water.

➢ Ph of urine is 4.5 – 6.0

➢ Tubular reabsorption is regulated by three factors

❖ Glomerulotubular balance
 is the balance between the filtration and reabsorption of
solutes and water in kidney.

 When GFR increases, the tubular load of solutes and water

in the proximal convoluted tubule is increased.

 It is followed by increase in the reabsorption of solutes

and water.

❖ Nervous factors
 Activation of sympathetic nervous system increases the
tubular reabsorption (particularly of sodium) from renal
tubules.
❖ Hormonal factors

Table 1: Hormones regulating tubular reabsorption

Hormones Actions
Aldosterone Increases sodium reabsorption in ascending limb, distal convoluted
tubule and collecting duct
Angiotensin II Increases sodium reabsorption in proximal tubule, thick ascending limb,
distal tubule and collecting duct (mainly in proximal convoluted tubule)

Antidiuretic Increases water reabsorption in distal convoluted tubule and collecting

hormone duct
Atrial natriuretic Decreases sodium reabsorption
factor

Brain natriuretic Decreases sodium reabsorption

factor

Parathormone Increases reabsorption of calcium, magnesium and hydrogen

Decreases phosphate reabsorption

Calcitonin Decreases calcium reabsorption

➢ Tubular secretion is the process by which the
substances are transported from blood into renal
tubules. It is also called tubular excretion.

➢ In addition to reabsorption from renal tubules,

some substances are also secreted into the lumen
from the peritubular capillaries through the tubular
epithelial cells.

➢ Dye phenol red was the first substance found to be

secreted in renal tubules in experimental
conditions.
➢ Later many other substances were found to be
secreted

◦ Such substances are:

1. Paraaminohippuric acid (PAH)
2. Diodrast
3. 5hydroxyindoleacetic acid (5HIAA)
4. Amino derivatives
5. Penicillin.
„
➢ Potassium is secreted actively by sodium
potassium pump in proximal and distal
convoluted tubules and collecting ducts

➢ Ammonia is secreted in the proximal

convoluted tubule.

➢ Hydrogen ions are secreted in the proximal and

distal convoluted tubules. Maximum hydrogen
ion secretion occurs in proximal tubule.

➢ Urea is secreted in loop of Henle.

Figure 1: Events of Urine formation