RENAL

PHYSIOLOG
Y
-Presented to
Dr. Jan-i-Alam (HOD Physiology)

-Presented by
Labiba Tariq 2nd Year MBBS
 GLOMERULAR
FILTRATION RATE
(GFR)
 Objectives
• Introduction
• Characteristics of Filtrartion Barrier
• Composition of Filtrate
• Determinants of GFR
• Factors affecting GFR
• Physiologic Control of GFR
• Regulation of GFR
 Introduction
There are three main steps of urine formation
• Glomerular Filtration
• Reabsorption
• Secretion
• As blood flows through the glomerulus protein-free
plasma filters through the glomerular capillaries into
Bowman’s capsule forming glomerular filtrate

Definition and Normal Value

• The rate at which plasma is filtered by the kidney
glomeruli in unit time
• An important measurement in the evaluation of kidney
function
• GFR = 125 mL plasma/min or, 180 L/day
Characteristics of Filtrartion Barrier
• The Capillary Endothelium - fenestrations with fixed
negative charges that obstruct the passage of plasma
proteins.

• The Basement Membrane - collagen and proteoglycans

prevents filtration of plasma proteins because of strong
negative charge

• The Glomerular Epithelial Cells - long foot like processes

(podocytes) having negative charge to restrict filtration of
plasma proteins.
Composition of
Filtrate

• Most important - Water

• Electrolytes
-Cations -Na K, Ca
-Anions - Cl, HCO3
• Metabolites
-Glucose, Aminoacids
• Waste Products
-Creatinine
-Urea

no proteins no RBCs, less Ca++ and

fatty acids because partially bound
with proteins
Determinants of GFR
• According to the formula
GFR= Kf x Net filtration pressure

So GFR is determined by
• The sum of the hydrostatic and colloid osmotic
forces across the glomerular membrane that either
favor or oppose filtration, net filtration pressure

• The filtration coefficient, Kf.

GFR = Kf x (PG – PB – µG + µB)
NET FILTRATION PRESSURE
• Factors favouring filtrarion
-Glomerular Capillaries Hydrostatic Pressure
-Bowmens Capsule Colloid Osmotic Pressure

• Factors opposing filtrarion

-Glomerular Capillaries Colloid Osmotic Pressure
-Bowman’s Capsule Hydrostatic Pressure

Under normal conditions, the concentration of protein

in the glomerular filtrate is so low that the colloid
osmotic pressure of the Bowman’s capsule fluid is
considered to be zero
Kf - Filtration Cofficent depends on
-thickness of the membrane
-surface area of the membrane
-permiability of the particle

Calculating Kf Value
Kf = GFR/Net filtration pressure
As
-GFR – 125 ml/min and
-Net filtration pressure– 10 mmHg

So
Kf – 12.5 ml/min/mmHg
Factors affecting GFR
• Glomerular capillary hydrostatic pressure
-arterial pressure-afferent and efferent resistance
• Colloidal osmotic pressure of glomerulus
-Hyperproteinimia/ Hypoproteinimia
• Bowmen’s capsular hydrostatic pressure
-ureteric stone, obstruction of urinary tract
• RBF – GFR directly related to RBF
• Change in Kf value (hypertension/diabetes mellitus)
 Physiologic Control of GFR
• Sympathetic Nervous System
-Norepinephrine, Epinephrine and Endothelin
Constrict Renal Blood Vessels and Decrease GFR

• Angiotensin II Constricts Efferent Arterioles preventing

decreases in glomerular hydrostatic pressure and GFR

• Endothelial-Derived Nitric Oxide Decreases Renal Vascular

Resistance and Increases GFR

• Prostaglandins and Bradykinin Tend to Increase GFR

Auto-Regulation of GFR

• Myogenic mechanism regulating

GFR- resist stretching during
increase arterial pressure

• Tubuglomerular feedback mechanism for regulating GFR -

Alterations in GFR due to changes in glomerular perfusion
pressure will lead to an alteration in the composition of the
fluid to return the GFR to normal
Tubuglomerular feedback mechanism