RENAL (URINARY) SYSTEM:

the Biochemical aspect (PART 2)

Abdul Salam M. Sofro

YARSI University

http://www.indiana.edu/~nimsmsf/P215/p215notes/PPlectures/Printables/Kidney.pdf
http://www.rosalindfranklin.edu/cms/anatomy/histohome/lectures/renal/01/index.html
URINE FORMATION
 Process of Urine formation
Urine water and waste solutes
Nephron conduct 3 processes to convert
blood plasma into urine
Filtration

Filter blood plasma to retain

cells/proteins
Reabsorption

Remove valuable materials from

filtrate
Secretion

Transfer additional wastes to filtrate

& also water
conservation
 Only about 1% of the glomerular fitrate
actually leaves the body because the
rest (the other 99%) is reabsorbed into
the blood while it passes through the
renal tubules and ducts.
This is called tubular reabsorption and
occurs via three mechanisms. They are:
Osmosis

Diffusion, and

Active Transport.
Filtration, reabsoption, and excretion rates of substances
by the kidneys

Filtered Reabsorbed Excreted Reabsorbed

(meq/24h) (meq/24h) (meq/24h) (%)

Glucose (g/day) 180 180 0 100

Bicarbonate (meq/day) 4,320 4,318 2 >
99.9
Sodium (meq/day) 25,560 25,410 150
99.4
Chloride (meq/day) 19,440 19,260 180
99.1
Water (l/day) 169 167.5 1.5
99.1
Urea (g/day) 48 24 24
 Filtration

Occurs in the glomerulus

Fenestrated capillaries
3 layers of podocytes
form capillary walls
Small pores (fenestrae)
Filters plasma
Proteins + cells stay in
blood
Forms ultrafiltrate
 Filtration driven by blood
pressure
Glomerular filtration is non
selective
Small particles pass

(glucose, Na+, urea,

H2O)
Large ones do not

20% of plasma enters

tubule
Plasma filtered 65x/day

Glomerulus is red;
Bowman's capsule is white.
Reabsorption
Occurs in remainder of nephron
tubule
Selective movement of substances
from tubule into plasma
Return of valuable substances to

peritubular caps
Active or passive
Passive (no energy)

Active transport (requires energy)

Tubular reabsorption in PCT
What gets reabsorbed?
Sodium, chloride, & other

electrolytes
Glucose

Amino acids

Water

Protein

Nitrogenous wastes

Etc.
Proximal tubule

Proximal tubule reabsorbs:

2/3 of plasma Na+

2/3 of plasma Cl-

2/3 of plasma H2O

100% of plasma glucose

 Sodium (Na+)
Most abundant cation in filtrate
Transcellular reabsorption
Simple & facilitated diffusion into

epithelial cell (passive transport)

From epithelial cell ecf (active

transport)
Pericellular reabsorption
Ecf peritubular capillaries (passive)
Sodium concentration gradient drives
reabsorption of other substances
 Glucose & Amino acids
transcellular reabsorption
sodium-glucose cotransport
(active transport)
sodium-amino acid cotransport
(active transport)
passive transport from
epithelial cell to extracellular
fluid
passive uptake by peritubular
capillaries
 Water
tubular fluid hypotonic to intracellular
and extracellular fluids
transcellular reabsorption
passive transport

pericellular reabsorption
passive transport

passive uptake by peritubular

capillaries
constant rate of water reabsorption
modulated rates elsewhere in

nephron
 Chloride (Cl-)
transcellular and paracellular
reabsorption
typically follows sodium ion
(Na+)
 Other electrolytes
K+, Mg+, Ca++
paracellular & transcellular

reabsorption
SO42-, PO42-, NO3-
not reabsorbed
 Protein
small amount in filtrate
transcellular reabsorption
enters epithelial cells via
pinocytosis (endocytosis)
hydrolysis into amino acids
passive transport of amino acids
into extracellular fluid
passive uptake by peritubular
capillaries
 Nitrogenous wastes
urea
passively reabsorbed with water

~50% of urea reabsorbed

(inadvertently)
uric acid
most reabsorbed

(secreted later)

creatinine
not reabsorbed

passive uptake by peritubular

capillaries
Tubular reabsorption in nephron loop
concentrate urine, conserve water
reabsorb ~20% of water in filtrate
thin segments
passive transport
thick segment impermeable to water
reabsorb ~25% of Na+, K+, Cl-
cotransport proteins in thick segments
active transport
Tubular reabsorption in DCT

concentrate urine, conserve

water
36 liters/day enters DCT

reabsorb water from filtrate

reabsorb salts
subject to hormonal control
esp. aldosterone, antidiuretic

hormone (ADH), atrial

natriuretic factor (ANF)
PCT and nephron loop are not

subject to hormonal control

Secretion
Also occurs in tubules
Additional materials transported
from plasma in peritubular
capillaries into tubule
Excess K+, Ca2+ and H+, uric

acid
Foreign compounds

By passive diffusion or active

carrier transport
 Functions:
waste removal
esp. nitrogenous wastes,

drugs
acid-base balance
secretion of H+, HCO -
3
regulation of pH of body
fluids
Water conservation
collecting duct
receives from several nephrons
reabsorbs H2O, concentrates urine
begins isotonic to blood plasma
becomes up to 4 times more
concentrated
concentration of urine dependent
upon bodys state of hydration
The substances that are secreted into
the tubular fluid (for removal from the
body) include:
Potassium ions (K+),
Hydrogen ions (H+),
Ammonium ions (NH4+),
creatinine,
urea,
some hormones, and
some drugs (e.g. penicillin).
Tubular secretion occurs from the epithelial cells that line
the renal tubules and collecting ducts.
 The water, urea, and salts
contained within the ascending
limb of Henle eventually pass into
the distal convoluted tubule (DCT).
Active transport in the proximal
tubule
Na+ actively transported from cell to
blood
Creates Na+ gradient favoring Na+
flow from lumen
Na+ gradient used to transport
glucose against concentration
gradient (cotransport)
Glucose diffuses into blood passively
www2.kumc.edu/ki/physiology/course/figures.htm
www2.kumc.edu/ki/physiology/course/figures.htm
www2.kumc.edu/ki/physiology/course/figures.htm
Passive re-absorption in the
proximal tubule

Cl- to be reabsorbed passively

along electrical gradient
Water reabsorbed along osmotic
gradient
www2.kumc.edu/ki/physiology/course/figures.htm
Acid Base Balance

Proximal tubule also

secretes H+ and absorbs
HCO3-
Used to regulate pH

With pH, H+ secretion

and HCO3- reabsorption

www2.kumc.edu/ki/physiology/course/figures.htm
 Loop of Henle

Kidneys produce a hyperosmotic urine

Less H2O than blood plasma

Concentrating mechanism occurs in the

Loop of Henle
Countercurrent multiplication

Generates osmotic gradient that draws

H2O out of the tubules to be

reabsorbed
Due to active reabsorption of Na+ & Cl-
The nephron and collecting duct: regional functions of the transport epithelium

n1.slideserve.com/PPTFiles/Ch44_89977_89654.ppt
Figure 44.23 How the human kidney concentrates urine in a juxtamedullary nephron in birds/ mammals.
Figure 44.23 How the human kidney concentrates urine: getting rid of solutes and conserving water

Impermeable
to water
Figure 44.23 How the human kidney concentrates urine: Urea and NaCl in the interstitial
fluid outside of nephron help reabsorb water from filtrate to make a hyperosmotic urine.
Loop of Henle
Descending limb
Permeable to water

No active transport

Ascending limb
Impermeable to water

Lined with Na+-K+ pumps

The Loop of henle is a counter current

multiplier, allowing the high concentrat
Loop of Henle
Pumping of ions out of
ascending limb creates osmotic
gradient
Water flows out of descending
limb
Absorbed by peritubular
capillaries
Fluid becomes more
concentrated as it passes down
descending limb
Loop of Henle
Removal of ions without water
causes fluid to become less
concentrated in the ascending
limb
Less concentrated than blood in
distal convoluted tubule
25% of initial Na+ and water
reabsorbed by loop of Henle
 Unlike the descending limb, the
ascending limb of Henles loops
impermeable to water, a critical feature
of the countercurrent exchange
mechanism employed by the loop.
The ascending limb actively pumps
sodium out of the filtrate, generating the
hypertonic interstitium that drives
countercurrent exchange.
In passing through the ascending limb,
the filtrate grows hypotonic since it has
lost much of its sodium content. This
hypotonic filtrate is passed to the distal
convoluted tubule in the renal cortex.
Distal Convoluted Tubule
and Collecting Duct

Secretion of K+ and H+
Reabsorption of Na+ and water
Generation of hyperosmotic urine
Final ~8% of water and Na+

reabsorbed
www2.kumc.edu/ki/physiology/course/figures.htm
 As the urine travels down the collecting
duct system, it passes by the medullary
interstitium which has a high sodium
concentration as a result of the loop of
Henle's countercurrent multiplier
system.
Though the collecting duct is normally
impermeable to water, it becomes
permeable in the presence of
antidiuretic hormone (ADH). ADH affects
the function of aquaporins, resulting in
the reabsorption of water molecules as
it passes through the collecting duct.
 Aquaporins are membrane proteins
that selectively conduct water
molecules while preventing the
passage of ions and other solutes.
As much as three-fourths of the
water from urine can be reabsorbed
as it leaves the collecting duct by
osmosis.
Thus the levels of ADH determine
whether urine will be concentrated
or diluted. An increase in ADH is an
indication of dehydration, while
www2.kumc.edu/ki/physiology/course/figures.htm
 Lower portions of the collecting
duct are also permeable to urea,
allowing some of it to enter the
medulla of the kidney, thus
maintaining its high
concentration (which is very
important for the nephron).

The water, urea, and salts contained within

the ascending limb of Henle eventually pass
into the distal convoluted tubule (DCT).
Changes in permeability of collecting duct produce
concentrated or non-concentrated urine
Composition of urine
Nitrogenous wastes
From protein catabolism
Urea, uric acid, ammonia, and
creatinine.
Electrolytes
Sodium, potassium, ammonium,
chloride, bicarbonate, phosphate,
and sulfate.
Amount varies due to diet and other
factors.
Toxins
Bacteria leaves the body in urea,
thus the need to dilute the urine
 Aldosterone
Hormonal regulation of Reabsorption
Increases Na+ reabsorption and K+

secretion by distal & collecting

tubules
salt retention and BP (H2O

retention)
ADH
Induces implantation of aquaporins

(water channels) into tubule cell

membranes
permeability of Distal and Collecting

tubules to water
The amount of ADH in the blood
may be affected by conditions
such as diabetes insipidus, or by
consumption of diuretics* in the
diet (*substances that occur in
some foods and drinks).
Triggering of Aldosterone Release

Release induces by juxtaglomerular

apparatus
Region of afferent arteriole that

comes into contact with ascending

limb of Loop of Henle
Releases renin (enzyme) into blood in
response to BP
Renin converts angiotensinogen
angiotensin I
Triggering of Aldosterone
Release (cont.)

Angiotensin I converted to
angiotensin II (fully activated) by
angiotensin converting enzyme in
lungs
Angiotensin II stimulates
aldosterone release
Urination
Ureter
Transfer urine to pelvic region

Urinary Bladder
Stores urine

Smooth muscles, stretchable walls

Two sphincters
Internal urethral sphincter

(involuntary)
External urethral sphincter

(voluntary)
Ureters
Carry urine from kidneys to urinary
bladder via peristalsis
Rhythmic contraction of smooth

muscle
Enter bladder from below
Pressure from full bladder
compresses ureters and prevents
backflow
Small diameter
Easily obstructed or injured by
kidney stones (renal calculi)
Urinary bladder

Muscular sac
Wrinkles termed rugae
Openings of ureters common
site for bladder infection
Urethra

Conveys urine from body

Internal urethral sphincter
Retains urine in bladder

Smooth muscle, involuntary

External urethral sphincter

Provides voluntary control over

voiding of urine
Urethra (cont.)
~18 cm long in males
Prostatic urethra

~2.5 cm long, urinary bladder

prostate
Membranous urethra

~0.5 cm, passes through floor of

pelvic cavity
Penile urethra

~15 cm long, passes through penis

Urethra (cont.)

3 4 cm long in females
Bound by connective

tissue to anterior wall of

vagina
Urethral orifice exits body

between vaginal orifice

and clitoris
 Urination (Micturition) / Urination Reflex:
~200 ml of urine held
Distension initiates desire to void Stretch
receptors in bladder wall spinal cord
Efferents to smooth muscles contraction

Internal sphincter relaxes involuntarily

Smooth muscle
External sphincter voluntarily relaxes
Skeletal muscle

Poor control in infants

Bladder muscle contracts

Urine forced through urethra
Terimakasih
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