URINARY SYSTEM

SAMEEN HANIF
VASCULATURE OF KIDNEY
 JUXTAGLOMERULAR APPARATUS

THE JUXTAGLOMERULAR APPARATUS IS A SPECIALIZED STRUCTURE FORMED BY

THE DISTAL CONVOLUTED TUBULE AND THE GLOMERULAR AFFERENT ARTERIOLE.
IT IS LOCATED NEAR THE VASCULAR POLE OF THE GLOMERULUS AND ITS MAIN
FUNCTION IS TO REGULATE BLOOD PRESSURE AND THE FILTRATION RATE OF THE
GLOMERULUS
. THE MACULA DENSA IS THE THICKENING WHERE THE DISTAL
TUBULE TOUCHES THE GLOMERULUS.
 VASORECTA

A SERIES OF BLOOD VESSELS IN THE BLOOD SUPPLY OF THE KIDNEY

THAT ENTER THE MEDULLA AS THE STRAIGHT ARTERIOLES
AND LEAVE THE MEDULLA TO ASCEND TO THE CORTEX AS THE STRAIGHT
VENULES
THESE VESSELS BRANCH OFF THE EFFERENT ARTERIOLES OF
JUXTAMEDULLARY NEPHRONS. THEY ENTER THE MEDULLA
AND SURROUND THE LOOP OF HENLE.
WHEREAS THE PERITUBULAR CAPILLARIES SURROUND THE CORTICAL PARTS
OF THE TUBULES.[
 MECHANISMS OF URINE FORMATION

• URINE FORMATION AND ADJUSTMENT OF BLOOD COMPOSITION INVOLVES THREE MAJOR

PROCESSES
• GLOMERULAR FILTRATION
• TUBULAR REABSORPTION
• TUBULAR SECRETION
 GLOMERULAR FILTRATION
• SMALL MOLECULES IN BLOOD PLASMA ARE FORCED FROM THE GLOMERULUS TO
BOWMAN'S CAPSULE , THROUGH THE PORES IN THE CAPILLARY WALLS OF GLOMERULUS.

• THE GLOMERULAR PORE SIZE IS EQUAL TO 4.0–4.5 NM AND THE MOLECULAR

SIZE OF ALBUMIN IS EQUAL TO 6.4NM.
• ANY MOLECULES SMALLER THAN THE PLASMA PROTEINS WILL BE FILTERED ACROSS
• E.G. WATER , GLUCOSE , AMINO ACIDS , FATTY ACIDS , VITAMINS , MINERALS ,
ELECTROLYTES , DRUGS, AND NITROGENOUS WASTES .
 GLOMERULAR FILTRATION

• URINE FORMATION BEGINS WHEN WASTE AND WATER AND DISSOLVED MATERIALS ARE
FILTERED OUT OF THE GLOMERULAR CAPILLARY .

URINARY EXCRETION = GLOMERULAR FILTRATION + TUBULAR SECRETION –

TUBULAR REABSORPTION
• THE GLOMERULAR CAPILLARIES ARE MUCH MORE PERMEABLE THAN THE CAPILLARIES
IN OTHER TISSUES .
Filtration pressure = Forces favoring filtration – forces
opposing filtration
Forces favoring filtration =Glomerular capillary hydrostatic
pressure & capsular osmotic pressure
forces opposing filtration =capsular hydrostatic pressure &
Glomerular capillary osmotic pressure)
Thus, filtration pressure is the net force acting to move material
out of glomerulus and into the glomerular capsule .
 GLOMERULAR FILTRATION RATE

• THE RATE OF FILTRATION VARIES WITH FILTRATION PRESSURE. FILTRATION PRESSURE

CHANGES WITH THE DIAMETERS OF THE AFFERENT AND EFFERENT ARTERIOLES
• AFFERENT ARTERIOLES HAVE GREATER DIAMETER THAN EFFERENT ARTERIOLES

• CONSTRICTION OF AFFERENT ARTERIOLES DUE TO SYMPATHETIC STIMULATION

DECREASES GLOMERULAR FILTRATION RATE.
• AS THE ONCOTIC PRESSURE IN THE GLOMERULUS INCREASES, FILTRATION DECREASES
• AS THE HYDROSTATIC PRESSURE IN A BOWMAN CAPSULE INCREASES,FILTRATION
DECREASES.
 REGULATION OF FILTRATION RATE

• GLOMERULAR FILTRATION RATE REMAINS RELATIVELY CONSTANT BY MAY INCREASE OR

DECREASE WHEN NEEDED. INCREASED SYMPATHETIC ACTIVITY DECREASES GFR .
• WHEN TUBULAR FLUID NACL DECREASES, THE MACULA DENSA CAUSES THE JG CELLS TO
RELEASE RENIN WHICH LEADS TO VASOCONSTRICTION , WHICH AFFECT GFR
 REGULATION OF GFR
NEURAL REGULATION
SYMPATHETIC NERVES CAUSES THE CONSTRICTION OR RELAXATION OF THE AFFERENT
ARTERIOLE , RESULTING IN A CHANGE OF GFR.
EXAMPLE: CONSTRICTION DECREASE

RENAL AUTOREGULATION
WHERE THE JUXTAGLOMERULAR APPARATUS (JGA)SECRETES VASOCONSTRICTION
SUBSTANCES TO EITHER AFFERENT ARTERIOLE, IN RESPONSE TO GFR CHANGES AND NACL
LEVELS.
EXAMPLE: RENIN
HORMONAL REGULATION
INVOLVES THE JGA SECRETING A HORMONE CALLED RENIN WHICH ACTIVATES AN
INACTIVE HORMONE FROM THE LIVER CALLED ANIGOTENSINOGEN , RESULTING
IN AN ACTIVE HORMONE ANGIOTENESIN I WHICH WILL BE CONVERTED TO
ANGIOTENSIN II BY THE ANGIOTENSINCONVERTING ENZYME (ACE) (RELEASED
FROM THE LUNGS). ANGIOTENSIN II CAUSES CONSTRICTION OF AFFERENT
ARTERIOLE & RELEASE OF ALDOSTERONE FROM ADRENAL CORTEX WHICH LEADS
TO SALT & WATER RETENSION.
 ALDOSTERONE

• A STEROID HORMONE MADE BY THE ADRENAL CORTEX (THE OUTER LAYER OF

THE ADRENAL GLAND). IT HELPS CONTROL THE BALANCE OF WATER AND SALTS
IN THE KIDNEY BY KEEPING SODIUM IN AND RELEASING POTASSIUM FROM THE
BODY. 
• WORKS ON COLLECTING DUCT
 ANTIDIURETIC HORMONE/VASOPRESSIN

WORKS ON LATE DCT AND COLLECTING DUCT.

IN STATES OF HYPOVOLEMIA OR HYPERNATREMIA, ADH IS RELEASED FROM THE

POSTERIOR PITUITARY GLAND AND BINDS TO THE TYPE-2 RECEPTOR IN PRINCIPAL
CELLS OF THE COLLECTING DUCT. BINDING TO THE RECEPTOR TRIGGERS AN
INTRACELLULAR CYCLIC ADENOSINE MONOPHOSPHATE (CAMP) PATHWAY, WHICH
CAUSES PHOSPHORYLATION OF THE AQUAPORIN-2 (AQP2). AFTER ACHIEVING
WATER HOMEOSTASIS, THE ADH LEVELS DECREASE, AND AQP2 IS INTERNALIZED
FROM THE PLASMA MEMBRANE, LEAVING THE PLASMA MEMBRANE WATERTIGHT
AGAIN
 TUBULAR REABSORPTION

THE RENAL TUBULAR REABSORPTION IS THE PROCESS WHERE THE REMOVED

WATER AND SOLUTES FROM THE GLOMERULAR CAPILLARIES TRANSPORT INTO
THE BLOOD CIRCULATORY SYSTEM TO MAINTAIN HOMEOSTASIS, WHICH MOSTLY
OCCURS IN THE PROXIMAL TUBULE BY OSMOTIC PRESSURE AND ACTIVE
TRANSPORT OF THE TUBULAR EPITHELIAL CELLS.
• THE PRERITUBULAR CAPILLARY IS ADAPTED FOR REABSORPTION.
• MOST REABSORPTION (70%), OCCURS IN THE PROXIMAL TUBULE.
• GLUCOSE AND AMINO ACIDS BY ACTIVE TRANSPORT. H2O IS REABSORBED BY OSMOSIS.
PROTEINS ARE REABSORBED BY PINOCYTOSIS.
• PINOCYTOSIS IS ONE TYPE OF ENDOCYTOSIS, THE GENERAL PROCESS BY WHICH
CELLS ENGULF EXTERNAL SUBSTANCES
• ACTIVE TRANSPORT IS THE MOVEMENT OF DISSOLVED MOLECULES FROM A REGION
OF LOWER CONCENTRATION TO A REGION OF HIGHER CONCENTRATION.
• OSMOSIS IS THE DIFFUSION OF WATER OR OTHER SOLVENTS THROUGH A
SEMIPERMEABLE MEMBRANE
 COUNTERCURRENT MECHANISM
• THE CHARACTERISTICS OF EACH PORTION OF THE LOOP OF HENLE :
• THE DESCENDING LIMB IS VERY PERMEABLE TO H2O (OUT) AND TO NA+ AND CL-
• CL- FOLLOWS NA+ THE ASCENDING LIMB IS IMPERMEABLE TO H2O BUT ACTIVELY TRANSPORTS
CL- OUT OF THE TUBULAR FLUID INTO INTERSTITIAL FLUID, WITH NA+ ION FOLLOWING
PASSIVELY
THUS THIS SMALL HORIZONTAL OSMOLAR GRADIENT IS DUE TO ACTIVE PUMPING
OF SALT OUT
THE OSMOLALITY OF THE FLUID DECREASES FROM 300 TO 100 (MILLIOSMOLOL)
 TUBULAR SECRETION

UNWANTED SUBSTANCES ARE SECRETED BY THE PERITUBULAR CAPILLARIES TO

THE RENAL TUBULES (MAINLY PCT AND DCT), SO THAT IT CAN BE DISPOSED IN THE
URINE .
MOST SUBSTANCES ARE SECRETED BY ACTIVE TRANSPORT .
SUBSTANCES SECRETED INCLUDE
EXCESSIVE NA+ , CL- , H+, K+ , HISTAMINE,CREATININE ,AMMONIA,URIC ACID
AND EXCESSIVE DRUGS.
 SUMMARY OF EVENTS IN THE LOOP OF
HENLE
FLUID ENTERS THE DESCENDING LIMB OF THE LOOP. AT EACH HORIZONTAL LEVEL CL- IS
ACTIVELY TRANSPORTED OUT OF THE ASCENDING LIMB INTO THE ISF.NA+ FOLLOWS &
DIFFUSES OUT OF THE ASCENDING LIMB INTO THE ISF.
• THE DESCENDING LIMB PERMEABLE TO H2O. WATER MOVES PASSIVELY OUT OF THE
DESCENDING LIMB INTO THE ISF.
• H2O CAN NOT LEAVE THE ASCENDING LIMB. THUS, THE OSMOLARITY OF FLUID IN THE
ASCENDING LIMB DECREASES AS YOU GO UP AND WITHIN THE ISF. IT INCREASES AS YOU GO
DEEPER IN THE MEDULLA.
• THE DISTAL CONVOLUTED TUBULE AND COLLECTING DUCT ARE IMPERMEABLE TO H2O
• IF ADH IS PRESENT , THESE SEGMENTS BECOME PERMEABLE , AND WATER IS REABSORBED
BY OSMOSIS.
• ADH STIMULATES H2O REABSORPTION AND THE PRODUCTION OF CONCENTRATED URINE
• IF THE BODY FLUIDS CONTAIN EXCESS H2O, ADH SECRETION IS DECREASED AND THE DCT AND CD
BECOMES LESS PERMEABLE TO H2O.
• ALDOSTERONE SECRETED BY ADRENAL CORTEX CAUSES MORE SODIUM REABSORPTION AT DCT, AND
THE POSITIVE CHARGES OF THESE IONS ATTRACT WATER MOLECULES TO BE REABSORBED AT DCT.
THE NET OVERALL RESULT IS THAT AN OSMOLAR GRADIENT IS ESTABLISHED, AS ONE PROGRESSES
FROM THE BEGINNING TO THE END IN THE LOOP OF HENLE. (300 TO 100)
THUS, MORE FLUID HAS BEEN REABSORBED FROM THE ORIGINAL VOLUME OF GLOMERULAR
FILTRATE.