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The Urinary System: Pembentukan Urin Dan Peran Ginjal Dalam Keseimbangan Cairan Tubuh
The Urinary System: Pembentukan Urin Dan Peran Ginjal Dalam Keseimbangan Cairan Tubuh
Afferent
Arteriole
Efferent
Arteriole
Urine formation
Eliminasi produk sisa metabolik
Urea, Kreatinin, Asam urat, Sulfat,
Nitrat, Phosphat, dll.
Proses :
1. Filtrasi glomerulus
2. Reabsorpsi tubulus
3. Sekresi tubulus
4. Ekskresi
1) Glomerular Filtration
2) Tubular Reabsorption
& Secretion
3) Water Reabsorption
(Conservation)
p 904
Urine Formation Preview
How the Kidney Works
Filtrasi Glomerulus
Pgc pgc Pt
Filtrasi glomerulus
Filtration Membrane
• Fenestrated endothelium
• 70-90nm pores exclude blood
cells
• Basement membrane
• proteoglycan gel, negative
charge excludes molecules >
8nm
• blood plasma 7% protein,
glomerular filtrate 0.03%
• Filtration slits
• podocyte arms have pedicels
with negatively charged
filtration slits, allow particles
< 3nm to pass
Filtrasi Glomerulus
Reabsorpsi dan Sekresi Tubulus
Proximal Tubulus
Reabsorpsi 80% air dan garam
Reabsorpsi semua glukosa, asam amino
Reabsorpsi protein, urea, asam urat,
bicarbonat
Sekresi ion Hidrogen, asam-basa organik
Reabsorpsi
Aktif : glukosa, asam amino, natrium, dll
Pasif : air dan urea
Hormonal Renin-Angiotensin
Aldosteron
ADH
Atrial Natriuretic Peptide
Renal Autoregulation of GFR
• BP constrict
afferent arteriole, dilate
efferent
• BP dilate afferent
arteriole, constrict
efferent
• Stable for BP range of
80 to 170 mmHg
(systolic)
• Cannot compensate for
extreme BP
Glomerular Filtration Rate
(GFR)
• Renal autoregulation
– Regulation of NFP
– Macula densa
• Cells of DCT
• Slow filtrate flow, low
osmolality (low Na, Cl)
causes dilation of
afferent arterioles
• High flow, high
osmolality causes
contraction of JGA
cells, vasoconstriction
Duktus kolegentes
Reabsorpsi Na dan Cl
dipengaruhi ADH
Hormones
• Aldosterone
– Acts on distal convoluted tubule cells to
stimulate active transport of 3 molecules
of Na+ out of tubule (reabsorption) for
every 2 molecules of K + brought into
tubule (secretion)
– Water from tubule lumen follows Na+ by
osmosis into blood
• Antidiuretic hormone (ADH)
– Acts to increase the number of aquaporins
(water channels) in the collecting duct
membranes
– Collecting ducts travel through
hyperosmotic medulla
– Higher levels of ADH increase the
number of aquaporins allowing water to
leave the duct and urine volume decreases
Homeostatic
Control
involving
Aldosterone
Formation of Water Pores:
Mechanism of Vasopressin Action
Aldosterone Release: the Renin-Angiotensin
Pathway
Factors affecting the release of ADH.
Factors affecting release of Atrial Natriuretic
Peptide.
Urine Composition
• about 95% water
p 923
MIKSI
Menjaga keseimbangan cairan tubuh
homeostasis
• Drinking &
eating
provides
water
• Kidney
conserves
water so
output =
intake
Body Water Balance
Circulating Volume control
Thirst
• Angiotensin II
– formed from the interaction of renin (produced by
the kidneys) with circulating angiotensinogen in the
plasma
– also acts on brain to promote thirst and ADH
secretion
Normal Urine & Blood
Urine pH ~ 6.0
Blood pH = 7.4
Blood [HCO3-] = 24 mM
Blood PCO2 = 40 mmHg
Plasma osmolality = 285 mOsm/kg water
Urine osmolality (depends upon
hydration status) = 600 mOsm/kg water
(note that this can vary between 50-1200
depending on water intake etc.)
Buffer System
Integration Renal – Cardiovascular –
Respiratory System
RENAL SYSTEM
CARDIOVASCULAR RESPIRATORY
SYSTEM SYSTEM
Gas exchange, ACE
TERIMA KASIH