Renal System Physiology

Dr. Muhammad Saim Bin Saeed

Lecturer BSMT
STMU

19/08/2019
Objectives:

Physiology of Kidney and Urine formation

Glomerular Filtration rate, clearance,
tubular filtration
Urine Excretion
Concentration of urine
Regulation of Na+, Cl-, K+
Excretion physiology of urinary bladder
FUNCTIONS OF THE KIDNEY

Water balance
Electrolyte balance
Plasma volume
Acid-base balance
Osmolarity balance
Excretion
Hormone secretion
Contd.
THE URINARY SYSTEM

Kidneys
Blood supply: Renal arteries and veins
Ureter
Urinary bladder
Urethra
 Bowman’s Proximal Distal
Capsule Convoluted Convoluted
Tubule Tubule
Peritubular Capillaries

Cortex
Glomerulus
Artery Medulla Collecting
Duct
Loop of Henle

Vein
THREE BASIC RENAL
PROCESSES

Glomerular Filtration: Filtering of blood

into tubule forming the primitive urine
Tubular Reabsorption: Absorption of
substances needed by body from tubule
to blood
Tubular Secretion: Secretion of
substances to be eliminated from the
body into the tubule from the blood
BASIC RENAL PROCESSES

Efferent Arteriole
Afferent Glomerulus
Arteriole
GF

Kidney TR
Tubule
Peritubular Capillary
TA

Urine Excreted
Glomerular Filtration

First step in urine formation

180 liters/day filtered
Entire plasma volume filtered 65
times/day
Proteins not filtered
Rennin-Angiotensin-
Aldosterone System

Stimulates Sodium Reabsorption in distal

and collecting tubules
Naturetic peptide inhibits
In absence of Aldosterone, 20mg of
sodium/day may be excreted
Aldosterone can cause 99.5% retention
 Rennin-Angiotensin-
Aldosterone System
Fall in NaCl, extracellular fluid volume, arterial blood pressure

Adrenal Helps
Juxtaglomerular Correct
Cortex
Apparatus

Liver Renin Lungs

+ Converting
Enzyme
Angiotensin Angiotensin Angiotensin Aldosterone

Increased
Sodium
Reabsorption
Glucose and Amino Acids are reabsorbed by
secondary active transport

They are actively transported across the

apical cell membranes of the epithelial
cells
Their active transport depends on the
sodium gradient across this membrane
All other steps are passive
DUAL CONTROL OF
ALDOSTERONE SECRETION
Fall in sodium
Increased
Plasma ECF Volume
Potassium
Blood Pressure

Increased Aldosterone secretion

Increased Tubular Increased Tubular

Potassium Secretion Sodium Reabsorption

Increased Urinary
Fall in Urinary
Potassium Secretion
Sodium Excretion
REGULATION OF URINE
CONCENTRATION

Medullary countercurrent system

Vasopressin
Medullary countercurrent
system

Osmotic gradient established by long

loops of Henle

Descending limb

Ascending limb
Descending limb

Highly permeable to water

No active sodium transport

Ascending limb

Actively pumps sodium out of tubule to

surrounding interstitial fluid

Impermeable to water
COUNTERCURRENT MAKES
THE OSMOTIC GRADIENT
From To Distal
Cortex
Proximal 300 300 100 Tubule
Tubule 450 250 Medulla
450
600 600 400
Active 750 550
750
Sodium
Transport 900 900 700

1050 1050 850

Passive 1200 1200 1000
Water
1200 1200 1000
Transport

Long Loop
of Henle
THE OSMOTIC GRADIENT CONCENTRATES
THE URINE WHEN VASOPRESSIN (ANTI
DIURETIC HORMONE [ADH]) IS PRESENT

Interstitial Fluid From

Distal Cortex
300 300
Tubule
400 Medulla
450
Collecting
600 550
Duct
750 700

900 850

1050 1000
Pores 1100
1200
Open
1200 1200

Passive Water Flow

WHEN VASOPRESSIN (ANTI DIURETIC
HORMONE [ADH]) IS ABSENT A DILUTE
URINE IS PRODUCE

Interstitial Fluid From

Distal Cortex
300 100
Tubule
100 Medulla
450
Collecting
600 100
Duct
750 100

900 100

1050 100
Pores 100
1200
Closed
1200 100

No Water Flow
Out of Duct
THE URINARY BLADDER
STORES THE URINE

Gravity and peristaltic contractions propel

the urine along the ureter
Parasympathetic stimulation contracts the
bladder and micturition results if the
sphincters (internal and external urethral
sphincters) relax
The external sphincter is under voluntary
control
Reflex and Voluntary
Control of Micturition

Bladder filling Stretch receptors in

reflexively contracts bladder send
the bladder inhibitory impulses to
Internal Sphincter external sphincter
mechanically opens Voluntary signals
from cortex can
override the reflex or
allow it to take place
 Thank You 

THIS TOO SHALL PASS

LIKE A KIDNEY STONE :P