 PAPER 2H – FUN REVISION 

4.5.3 Hormonal coordination in humans

(focus = kidney)

Q1. Water conservation is important to the human body.

(a) Which gland releases the hormone that controls water loss from the body? Tick (✓) one
box.

Adrenal

Pancreas

Pituitary

Thyroid

(1)

(b) Which hormone helps the kidneys to control water loss from the body? Tick (✓) one box.

ADH

Adrenaline

LH

Thyroxine

(1)

(c) A man is walking across a desert. The man has used up his supply of drinking water.

Explain how the gland you named in part (a) and the kidneys reduce water loss.

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(3)

(d) Some people have kidney failure. Doctors may treat patients with kidney failure by either:

• dialysis

• a kidney transplant.

Explain two biological reasons why most doctors think that a kidney transplant is a better
method of treatment than dialysis. Do not refer to cost or convenience.

Reason 1 __________________________________________________________

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Reason 2 __________________________________________________________

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(4)
(Total 9 marks)
Q2. The diagram shows the structure of a kidney tubule.

Cell in wall of Region X.

All of these cells have

large numbers of mitochondria.

(a) Give the full name of the process which takes place in the mitochondria.

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(2)

(b) The concentration of glucose in the blood at P, and in the fluid at Q, is 0.1 per cent. The
concentration of glucose in the fluid at R is 0.0 per cent.

Use information from the diagram, and your own biological knowledge, to explain the
change in glucose concentration from point P through to point R.

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(5)
(Total 7 marks)

Q3. It is important to remove waste products from our bodies. Healthy kidneys help to keep our internal
environment constant.

(a) Describe how a healthy kidney produces urine.

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(5)

(b) A child has kidney failure and is treated with dialysis.

Before the dialysis starts, the doctor measures the concentration of urea and glucose in
the child’s blood.

The table shows the results.

Concentration in the
blood before dialysis
starts in mmol per dm3

Urea 28

Glucose 6

The child has a normal blood glucose concentration.

 (i) Sketch a graph on Figure 1 to suggest what will happen to the concentration of urea
in the blood during dialysis.

(1)

(ii) Sketch a graph on Figure 2 to suggest what will happen to the concentration of
glucose in the blood during dialysis.

(1)

(c) (i) Another way of treating kidney failure is with a kidney transplant.

A transplanted kidney can be rejected.

Explain why the new kidney may be rejected.

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(3)

(ii) Describe one way in which doctors try to prevent kidney rejection.

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(1)
(Total 11 marks)

Q4.
Kidneys are important as they remove waste from blood and balance our water needs.

Kidney failure can be treated by transplant or dialysis using a kidney “machine”.

The money for expensive treatment for a few people could be used to provide
more patients with less expensive treatment for other complaints.

Dialysis – kidney “machines” Kidney transplant

Most expensive Very expensive but cheaper

than dialysis

Need own machine or share machine Need kidney from relative or

in hospital from “newly” dead person

Restricted life – special diet, must Independent

return to machine

Can be used while patient waits for Transplant may be rejected

transplant

Discuss the advantages and disadvantages of using dialysis or kidney transplants to keep
people alive.

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(Total 5 marks)
Q5. A person had diseased kidneys.
The table shows the concentrations of dissolved substances in this person’s urine.

Substance Concentration
in grams per dm3

Protein 6

Glucose 0

Amino acids 0

Urea 21

Mineral ions 19

(a) One of the substances found in this person’s urine would not be found in the urine of a
healthy person.

(i) Name this substance. _____________________________________________

(1)

(ii) Explain why this substance would not be found in the urine of a healthy person.

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(2)

(b) A person with diseased kidneys may be treated by dialysis.

Explain how dialysis trexatment restores the concentrations of dissolved substances in the
blood to normal levels.

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(4)
(Total 7 marks)
Q6. Taking the drug ecstasy affects the rate of urine flow from the kidneys.
Graph 1 shows the rate of filtration by the kidneys of a healthy person.
Graph 2 shows the rate of urine flow from the kidneys of the same person.

One hour after the first measurement, the person took ecstasy.

Graph 1

Graph 2

(a) Describe the effect of taking ecstasy on

(i) the rate of filtration

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(1)
 (ii) the rate of urine flow.

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(1)

(b) Use information from the graphs and your understanding of how the kidney works to
answer the following questions.

(i) Suggest an explanation for the change in the rate of urine flow after the person took
ecstasy.

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(2)

(ii) After a person has taken ecstasy, the concentration of ions in the blood changes.

Suggest an explanation for this.

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(2)
(Total 6 marks)

Q7.
In this question you will be assessed on using good English, organising information clearly and
using specialist terms where appropriate.

Homeostasis keeps conditions in the body relatively constant. The amount of water in the body
is controlled by homeostasis. Kidney function is controlled by a gland in the brain.

Describe how the water content of the blood is controlled.

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(Total 6 marks)

Q8.
Urine consists of water, ions and other substances such as urea.
Urine is formed in the kidney by filtering the blood.
The diameter of the pores in the filter is about 6 nanometres.

The table shows the diameters of the molecules of some of the substances in the
blood.

Diameter of
Substance molecule in
nanometres

A 10 to 20

B 1

C 0.6

D 0.5

E 0.2

Use information from the table and your own knowledge to answer the questions.

(a) (i) Which substance, A, B, C, D or E, is protein?

(1)
 (ii) Protein is not found in the urine of a healthy person.

Explain why.

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(2)

(b) Substance B is not found in the urine of a healthy person.

Suggest an explanation for this.

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(2)

(c) Haemolytic anaemia is a disease in which some of the red blood cells burst open.

Small amounts of haemoglobin may be found in the urine of a person suffering from
haemolytic anaemia.
The diameter of a haemoglobin molecule is 5.5 nanometres.

Haemoglobin is not found in the urine of a healthy person, but haemoglobin can be
found in the urine of a person with haemolytic anaemia.

Explain why.

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(3)
 (Total 8 marks)

Q9.
Use your knowledge of how the kidney works to answer the following questions.

(a) Blood plasma contains mineral ions, glucose, urea and proteins.

Explain why urine contains mineral ions and urea, but no glucose or protein.

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(4)

(b) A man ate and drank the same amounts of the same substances and he did the same
amount of exercise on two different days. On one of the two days the weather was hot
and on the other day the weather was cold.

The man’s urine contained a higher concentration of mineral ions and urea on the hot day
than on the cold day.

Explain why.

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(4)
(Total 8 marks)
Mark schemes

Q1.
(a) pituitary
1

(b) ADH
1

(c)
allow ecf for name of hormone from part (b)
ignore name of gland

high(er) concentration of blood causes (more) ADH / hormone release

allow low(er) water potential of blood causes
(more) ADH / hormone release
allow alternative descriptions in terms of – eg
low(er) water concentration / level or high(er)
osmotic pressure or high(er) solute concentration
/ level
1

(and hormone / ADH causes) increased permeability of kidney tubules (to

water)
allow increased permeability of collecting duct /
distal convoluted tubule
1

(so) increased water reabsorption

allow more water taken back into blood
ignore reference to urine
1

(d)
allow converse if clearly describing dialysis
explanation must match reason

changes in concentrations / levels of substances / urea are minimised

allow no change in concentration / level of
substances / urea
allow correctly named substances
1

(so) less / no chance of causing damage to body cells / tissues

allow eg less / no osmotic stress or not poisoned
by urea
1

not repeatedly puncturing skin or blood not in contact with machine

allow blood does not leave the body
1

(so) less / no chance of infection or less / no chance of blood

clots or no need to take anti-clotting drugs
allow less / no chance of microorganisms
entering body
allow only one operation so less chance of
 infection for 2 marks
allow dialysis requires anti-clotting drugs and so
may lose more blood if cut for 2 marks
1
[9]

Q2.
(a) aerobic
1

respiration
‘anaerobic respiration’ = 1 mark
1

(b) any five from:

• glucose is a small molecule

• glucose passes through filter or glucose is filtered out of blood or

glucose enters the capsule / kidney tubule / Q

• glucose reabsorption or glucose taken (back) into blood

do not accept ‘filtered’ into blood / out of tubule

• cells lining tubule have microvilli / shape described or

cells lining tubule have large surface area

• active transport

• up concentration gradient

• use of energy / ATP

• long tubule for more reabsorption

5
[7]

Q3.
(a) (the kidney) filters the blood
ignore refs to hormones and drugs
1

(and then) reabsorbs all of the glucose

1

reabsorbs some of the ions

allow salts
ignore minerals
1

reabsorbs some of the water

1

releases urea (in urine)

1
 (b) (i) should fall from 28 (to the end of dialysis)
ignore any line drawn after end of dialysis
allow + / - 0.5 square
graph line must fall to / below
below 15
1

(ii) should stay level at about 6 throughout

ignore slight variations
allow + / - 1 square
ignore any line drawn after end of dialysis
1

(c) (i) immune system

allow white blood cells / lymphocytes
1

(produces) antibodies
1

(which) attack the antigens (on the transplanted kidney)

non-matching antigens insufficient
1

(ii) any one from:

• tissue typing (to find match)
• treating with drugs that suppress the immune system
accept treat with immunosuppressants.
1
[11]

Q4.
• cost of dialysis and transplant compared

• idea that both expensive and may need to balance cost against other medical
priorities
• restricted diet/movement with dialysis
and
• no restriction/independence for transplant
each for 1 mark
• idea that donated kidney may not be available
• transplant may be rejected/dialysis consistently reliable

[Credit problem of finding body access points for repeated dialysis over the long term]
[5]

Q5.
(a) (i) protein
1

(ii) (protein molecules too) large

1

cannot pass through filter or can’t leave blood or can’it pass into kidney tubule
 / named part
NB holes in the filter are too small = 2 marks
1

(b) any four from:

• use of partially permeable membrane or only small molecules can pass

through membrane

• dialysis fluid has ‘ideal’ concentrations of solutes

allow correct named example

• diffusion of waste substances out of blood

accept named example – eg urea

or
waste passes from high to low concentration

• reference to equilibrium (between plasma & dialysis fluid)

accept reference to counterflow to maintain concentration
gradient
4
[7]

Q6. (a) (i) no effect / little effect

1

(ii) reduced
ignore reference to later increase
1

(b) (i) more (re)absorption

do not allow if extra incorrect reference to filtration made
1

or more (material) taken into blood

of water
allow only if linked to reabsorption
do not accept water if in a list of substances
1

(ii) ions in blood diluted

1

or concentration of ions decreases

increased water reabsorption

do not allow if extra incorrect reference to filtration made

or more water present in blood

accept sensible alternative suggestion
eg reabsorption of ions disrupted
1
[6]
Q7.
Marks awarded for this answer will be determined by the Quality of Communication (QC)
as well as the standard of the scientific response. Examiners should also refer to the
information on page 5, and apply a ‘best-fit’ approach to the marking.

0 marks
No relevant content.

Level 1 (1 – 2 marks)
There is a brief description of kidney function including a mention of pituitary gland
or hormones but roles may be confused.

Level 2 (3 – 4 marks)
There is a clear description of kidney function in relation to fluctuations in blood
water levels and the roles of the pituitary gland or hormone is mentioned with
correct role.

Level 3 (5 – 6 marks)
There is a clear and detailed scientific description of kidney function in relation to
fluctuations in blood water levels and of the roles of the pituitary gland and ADH.

examples of biology points made in the response:

• if water content too low, ADH released

• from pituitary gland
• into the blood
• (causing) kidney reabsorbs more water
• more concentrated / small volume urine produced
• if water content too high, ADH lowered / not produced
• less water reabsorbed by kidney
• more dilute / larger volume urine produced
full marks may be awarded for detailed description of either
water loss or gain
[6]

Q8.
(a) (i) A
1

(ii) (protein) molecule is large

ignore letters
1

cannot pass through filter

(protein is) too big to get through the filter = 2 marks
1

(b) B is taken back into the blood or

B is reabsorbed
1

reabsorbed completely

or reabsorbed after filtration

1
 (c) RBC is too big to pass through filter
1

Haemoglobin is inside red blood cells

or haemoglobin released when RBC bursts
1

Haemoglobin is small enough to pass through filter

or haemoglobin diameter
1
[8]

Q9.
(a) proteins are not filtered
1

glucose is filtered and (re)absorbed

allow glucose (completely) reabsorbed
1

ions are filtered and some (re)absorbed

allow some ions are reabsorbed
1

urea is filtered [and some / none (re)absorbed]

allow some / no urea is reabsorbed
1

(b) more / a lot of sweating occurred

accept converse arguments for cold day
1

more / a lot of water loss (by sweating)

1

more / a lot of water reabsorption / more water absorption by the kidney

1

lower volume of urine

allow less urine / less water in urine
1
[8]
Examiner reports

Q1.
(a) About 71% of students correctly selected the pituitary gland as the hormone-
producing gland for the control of water loss from the body.

(b) Around 85% of students knew that the hormone that helps the kidneys control water
loss was called ADH.

(c) How the hormone stimulated the kidneys to reduce water loss was fully understood
by about 3% of students and less than a half gained any credit in this question.
 The scenario was a man walking in a desert without any drinking water, hence he
would need to conserve water. Thus, his blood would have become more
concentrated which would have stimulated ADH release by the pituitary to increase
the permeability of the walls of the kidney tubules so that more water would have
been reabsorbed. Some students referred to ‘how much’ water was in the blood
rather than mentioning concentration (or water potential) or wrote about the ‘body’
having a reduced water content, rather than the blood.

Some students thought that the rate of ‘filtration’ of the blood would have been
reduced while others thought that less water would be ‘absorbed’ from the blood into
the kidney tubules. It was evident that many students had limited knowledge of how
the kidneys work in this challenging question.

(d) Explanations of two reasons why a kidney transplant was preferable to treatment by
dialysis were required by this question, with the proviso that cost and convenience
should not be included. This meant that biological explanations had to be given.
Many students still answered just in terms of cost and convenience.

Higher-attaining students understood that concentrations of urea and salts, and the
volume of water, would increase between dialysis sessions and hence had the
potential for causing damage to body cells. A second reason was that the skin would
be repeatedly punctured with needles with dialysis treatment, thus increasing the
chance of infection or blood clots. A very small minority of students scored three or
four marks in this question.

Q2.
This question proved to be difficult for large numbers of candidates. However, had they
used their knowledge of filtration and reabsorption and linked this to the structure of the
cell shown, they should have been able to achieve good marks. Few candidates referred
to filtration between P and Q (although diffusion was more common, though incorrect) and
even less to reabsorption between Q and R. Despite the cue about respiration in part (a),
very few candidates linked this to their answer in part (b). Many candidates believed that
glucose was reabsorbed simply to drive the process of respiration in the cells of the
nephron, with apparently no purpose for the energy produced. Very few candidates
referred to the microvilli. Despite these difficulties, many examiners identified that the
question discriminated well at its intended level of A/A* and there was a number of
excellent, well-argued answers that linked various components of the specification well.

Q3.
(a) This question was a good discriminator and approximately a third of all students
gained three or more marks, so the role of the kidney seemed to be well understood
by many.
There were some excellent descriptions of the Bowman’s capsule, nephrons and
collecting ducts that are not needed for this specification, but did provide further
indications of good understanding. Many students also described the origin of the
urea and although there was no credit for this here, it bodes well for future biologists
that they are being taught a good level of detail. Where marks were lost it was often
for not making it clear that it is the blood that is filtered or not, making it clear that all
of the glucose is reabsorbed.

(b) (i) The vast majority of students gained credit for showing the concentration of
urea falling during dialysis.

Some common errors seen were:

 • Concentration rising after the beginning
• Starting one square in
• Starting in bottom left corner
• Normal distribution curve drawn.

(ii) In contrast to part (b)(i), only just over half of all students showed the
concentration of glucose remaining constant throughout dialysis.
In both parts (b)(i) and (b)(ii), students would have benefitted from having
sharp pencils and rulers with which to sketch their graphs.

(c) (i) Students struggled to answer this question and almost a third did not gain
credit. Many of the answers given were very general, with statements such as
‘the kidney was rejected because it was seen as foreign’ or ‘it was not
recognised by the body’ or ‘the body treated it as a pathogen / disease and
attacked / killed it’ were common.
Blood types being different or non-matching DNA were also mentioned
frequently, and some students even wrote about the kidney being the wrong
size, shape or age. Quite often antigens and antibodies were mixed up and so
no marks could be given.
Students who did achieve marks usually gained one mark for mentioning the
immune system or white blood cells. When antigens were correctly described
students often failed to mention that they were attacked and so again could
not gain the mark.

(ii) Most students knew about immunosuppressants and so gained the mark. A
few students gained the mark by saying tissue typing / matching.

Q4.
Most candidates were able to gain most of the marks for this question. Relatively few
candidates pointed out that both forms of treatment are expensive and so may also need
to be weighed against the advantages of, possibly less expensive, treatments for other
diseases.

Q5.
(a) Most candidates recognised that protein was the substance present in the urine of
the person with diseased kidneys which would not have been present in the urine of
a healthy person. Although many understood that protein molecules are too large to
befiltered out of the blood by a normal, healthy kidney, many candidates
concentrated on a supposed purpose for this rather than the cause, eg stating that
proteins are needed by the body. Others thought that protein did pass through the
filter but was later reabsorbed.

(b) A very large number of candidates have a poor understanding of how dialysis
treatment actually works, with over half scoring no marks in this section. The most
common correct point was the use of a partially permeable membrane. Very few
mentioned concentration gradients and diffusion or the idea that the blood plasma
would come into equilibrium with the ideal concentrations of solutes in the dialysis
fluid.

Q6.
In this question, candidates had to interpret data on the effects of the drug ecstasy on
kidney function. This required knowledge and understanding of kidney functioning. It did
not require anecdotal knowledge of the effects of ecstasy on the body. Those attempting
to apply the latter, without a thorough grasp of the former, frequently came unstuck.
 (a) This part of the question simply required translation of the data displayed in the two
graphs.

(i) Many candidates spoiled their answers by inclusion of the change in the
pattern before the ecstasy was taken, the actual rate of filtration did, in fact,
not drop after ecstasy was taken. Only two thirds gave an adequate
description, ie no effect or very little effect or a slight rise after a half-hour
delay. Some misinterpreted the initial horizontal part of the line, on 123 cm 3
per minute, as filtration having stopped.

(ii) This turned out to be more straightforward and the vast majority of candidates
were impressed by the massive drop in urine flow which followed the taking of
ecstasy.

(b) (i) Only a sixth of candidates made any headway with this part. Far too few were
able to associate a decrease in urine flow with an increase in the reabsorption
of water by the kidney. Most candidates clearly do not appreciate that urine is
mainly water. Many candidates invoked a supposed reduction in filtration rate,
despite evidence to the contrary in Graph 1. Anecdotal answers relating to an
increased rate of sweating, leaving less water to be filtered by the kidney
simply conflicted with the data.

(ii) This part required understanding of the principles tested in part (b)(i), thus if
more water were reabsorbed by the kidney, the concentration of ions in the
blood would be expected to fall. Only a small number of candidates fully
appreciated this. Many ingenious, but incorrect, suggestions were put forward,
ranging from the supposed ion content of ecstasy to an imagined temporary
suspension of kidney functioning due to the drug.

Q8.
This question was about kidney functioning, focusing in particular on the process of
filtration in relation to the size of the pores in the filter and the sizes of molecules of
different substances which may or may not therefore be able to pass through the filter.

(a) The vast majority of students were able to identify that the substance with the
largest molecular size (substance A) was the protein. Almost two thirds also
understood that protein was not normally found in the urine due to its inability to
pass through the filter in the kidney. Despite data to the contrary, many persisted in
their erroneous belief that protein would pass through the filter and subsequently be
reabsorbed back into the blood.

(b) Almost one third of students scored both marks in this section for demonstrating that
they understood from the data that substance B was not present in urine because,
although it was small enough to pass through the kidney’s filter, it would then be
reabsorbed back into the blood. Very few stressed that it would all be reabsorbed.

(c) From the stated size of the haemoglobin molecule, many students were able to work
out that it was capable of passing through the pores in the kidney’s filter. Many
correctly pointed out that the haemoglobin did not normally appear in the urine
because it was contained within the red blood cells. Surprisingly few students made
the observation that the red blood cells were too large to pass through the filter, but
a good number were able to deduce that, if some of the red cells were to burst in a
person with haemolytic anaemia, then the haemoglobin would be released and
could therefore enter the urine. This question differentiated very well across the
ability range.
Q9.
(a) This question differentiated very well across the ability range. Many students are
very confused about the working of the kidney. It was quite common to read that
both glucose and protein were too large to pass through the kidney’s filter and that
this might then be followed by both of these substances being reabsorbed back into
the blood: clearly, such students could not have understood what they were writing
about. Other students omitted essential details – often it was not clear whether the
named substances had passed through the filter or not. Just over a quarter of the
students clearly did understand the working of the kidney but the point most often
missed was the partial / selective reabsorption of some of the mineral ions: many
just indicated that ‘excess’ mineral ions were excreted without stating how this was
achieved. Many students simply forgot about the urea or confused ‘urea’ and ‘urine’.
Those that had little idea of how the kidney functioned merely stated that
substances were (somehow) retained if they were ‘needed’ by the body while the
remainder were eliminated.

(b) This question also differentiated well but with only a tiny minority attaining full marks.
Since the question was comparative, between a man on a hot and on a cold day, it
required a comparative answer. The man did not sweat only on the hot day, he
sweated more on that day and thus needed his kidneys to reabsorb more water.
Many students imagined all manner of strange properties of urea and mineral ions
but missed the point that it was the availability of water that determined whether the
urine would be concentrated or dilute and that this in turn related to the degree of
sweating. Others tried to answer the question in terms of the amount of urea and
ions lost in sweat.