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1-Metabolic Functions of Kidney-محول
1-Metabolic Functions of Kidney-محول
1-Metabolic Functions of Kidney-محول
The NEPHRON
FUNCTIONAL UNIT OF THE KIDNEY
REVIEW Urine Formation
1- GLOMERULAR FUNCTIONS
2 TUBULAR FUNCTIONS
Proximal Convoluted Tubules (PCT)
Reabsorbs:
The bulk of each valuable substances back to the blood
75% of Water, Sodium & Chlorides
100% of Glucose (according to renal threshold)
Almost ALL Amino Acids, Proteins & Vitamins
Variable Amounts of Urea, Creatinine, Uric
Acid, Ions (Mg, Ca2+, , K-, HCO3-)
Secretes:
Products of kidney tubular cells metabolism:
H+ & drugs, etc
5 Pottasium Balance:
- Aldosterone increase or decrease (to
increase potassium reabsorption or excretion)
- In Metabolic Alkalosis, K+ competes with H+
x
for exchange with Na+ in PCT
6- Acid-Base Balance:
1- Regeneration of Bicarbonate (Carbonic Anhydrase System)
2- Excretion of Metabolic Acids (H+ ions)
3- Ammonia (NH3) Production in Renal Tubules from glutamine (by
glutaminase). Ammonia reacts with H+ to form ammonium (NH4-)
which can be reabsorped (Ammonium Trap)
PHYSIOLOGICAL REVIEW: FUNCTIONS OF the KIDNEYS
7- Calcium Homeostasis:
1- Activation of Vitamin D by Renal 1a Hydroxylase
The key regulatory enzyme in vitamin D activation is the 1a hydroxylase enzyme
produced by the kidney.
Vitamin D3 (Cholecalceferol) is hydroxylated in the liver to 25 hydroxycholecalciferol
(25 HCC)
Then, the renal 1 hydroxylase converts 25 HCC to 1, 25 dihydroxycholecalceferol
(1, 25 DHCC), which is the active form of vitamin D.
The main physiological role of active vitamin D (1, 25 DHCC) is promoting calcification
of bones (adding calcium) mainly through increasing calcium absorption from GIT.
In Renal Insufficiency,
Active vitamin D is not sufficient ending in renal rickets (poor calcification of bones).
The resulting hypocalcemia due to vitamin D deficiency may end in secondary
hyperparathyroidism i.e. increased production of the parathyroid hormone (PTH).
renalosteodystrophy
SUMMARY REVIEW:
PHYSIOLOGICAL of FUNCTIONS OFOF
FUNCTIONS THE
the KIDNEYS
KIDNEYS
8 Endocrinal Functions:
- Renin-Angiotensin- Aldosterone Pathway
- Activation of Vitamin D by 1 Hydroxylase Enzyme
- Erythropoietin
9 Metabolic Functions:
- Synthesis of Creatine (Guanidoactetic Acid)
- Synthesis of Carinitine (for FA oxidation)
- Synthesis of Glucose in Prolonged Fasting (Gluconeogenesis)
- Energy (ATP) Production for Renal Functions:
- In Fed-State: Glycolysis (Aerobic Glucose Oxidation & CAC)
- In Fasting State: Fatty Acid Oxidation & Ketone Bodies Degradation (Ketolysis)
- Synthetic Functions:
- Synthesis of Cholesterol & Fatty acids
- Synthesis of Amino Acids
- Degradation of Amino Acids
Functions of the Kidney
Acid-Base Metabolic
Balance
Functions
Endocrinal Functions
• Production of certain enzymes (e.g. Renin)
• Endocrinal Roles:
Activation of Vitamin D
Production of
Erythropoietin
Metabolic Functions of The Kidney
REVIEW
Body
Weight
Kidney STORES
of
Glycogen
Phosphocreatine (CP)
Lipids
are Very Low Energy Sources
So
ATP
Hormonal Regulation of
Renal Glucose Metabolism
Insulin
- Stimulate Glucose Oxidation (Glycolysis)
- Inhibits Renal Gluconeogenesis
-
Epinephrine:
- Stimulates Renal Gluconeogenesis
Glucagon
- NO EFFECT on renal glucose metabolism
Glucose Metabolism in Fasting
18 – 60 Hours of Fasting:
Source of blood glucose is mainly gluconeogenesis (in liver & kidneys)
1
Formation of guanido acetic acid
From amino acids glycine & argenine
In the kidney
Role Ammonia Metabolism in the Kidney in Acid
base Balance
NH4+ production in the tubular lumen accounts for about 60% excretion of hydrogen
ions associated with nonvolatile acids.
Source of H+ required for NH4+ formation:
1. Glomerular filtrate
2. The effect of carbonic anhydrase enzyme during the synthesis of carbonic acid
in the tubular cells, H+ is secreted into the lumen by the Na+/ H+ exchanger.