Urine formation

Mohamad ashraf ismail

 Urine Formation
Urine formation is without question one of the most important
functions of the kidney.  This is the means by which the body is able
to get rid of most metabolic wastes and toxins.  If for any reason this
process is disrupted or inhibited, toxins begin to accumulate in the
body and over time this can cause quite serious medical conditions
and, in extreme circumstances, can result in death.
The kidneys and more specifically, the nephrons, are responsible for
extracting toxins and other waste from the blood.  In addition to
defending the body against diseases, the blood is also responsible for
transporting oxygen, hormones, and other essential nutrients around
the body.  For this reason it is important that the blood maintains a
certain chemical composition and is free of wastes and toxins which
can be dangerous to the body.   This is the main job of the kidneys.
The kidney performs this function by converting blood plasma into
urine and expels it from the body.  (Blood plasma is a clear fluid which
surrounds blood cells.)
As blood plasma flow through the nephrons
its composition changes at different stages.
As the composition of the fluid changes it is
referred to by different names:
The fluid in the in the Bowman’s Capsule is
called glomerular filtrate. It is similar to
blood plasma except that it has almost no
protein.
As the fluid moves through the renal tubule it
is called tubular fluid. It is different form
glomerular filtrate because of substances
which are removed and added by the tubule
cells.
Finally, when the fluid moves into the
collecting tubule it is called urine.
There are primarily three (3) stages of urine
formation: glomerular filtration, tubular
reabsorption and secretion, and water
conservation.
 GLOMERULAR FILTRATION
Glomerular filtration is a process in which water and some
other substances in the blood plasma pass from the capillaries
of the glomerulus into the Bowman's Capsule. Very small
molecules can pass through the filtration membrane into the
Bowman's Capsule. This includes water, electrolytes, glucose,
fatty acids, amino acids, nitrogenous wastes, and vitamins.
Such substances have about the same concentration in the
glomerular filtrate (fluid in the in the Bowman’s Capsule) as in
the blood plasma. Some substances are retained in the
bloodstream because they are bound to plasma proteins that
cannot get through the membrane. For example, most calcium,
iron, and thyroid hormone in the blood are bound to plasma
proteins that retard their filtration by the kidneys. The small
fractions that are not bound to plasma protein, however,
passes freely through the filtration membrane and appears in
the urine.
Kidney infection and trauma can damage the filtration
membrane (located in the Bowman's Capsule). This allows
albumin (a protein) or blood cells to filter through. Kidney
disease can sometimes be detected by the presence of
protein (especially albumin) or blood in the urine. The
medical terms for the presence of protein and blood in the
urine are proteinuria (albuminuria) and hematuria,
respectively.
Glomerular filtration must be precisely controlled. If it is too
high, fluid flows through the renal tubules too rapidly for
them to reabsorb the required amount of water and solutes.
If it is too low, fluid flows too slowly through the tubules and
wastes that should be eliminated are reabsorbed into the
bloodstream. Renal autoregulation is the ability of the
nephrons to adjust their own blood flow. It allows them to
maintain a relatively stable glomerular filtration rate in spite
of changes in arterial blood pressure.
TUBULAR REABSORPTION AND
SECRETION

The second stage of urine formation is

tubular reabsorption and secretion. This
involves removal and addition of
chemicals, after glomerular filtrate leaves
the Bowman's Capsule and enters the
Renal tubule. The Renal tubule is very
long, which increases its absorptive
surface area. It reabsorbs about 65% of
the glomerular filtrate, while it removes
some substances from the blood.
Tubular reabsorption is the process of reclaiming water and other
substances from the tubular fluid (glomerular filtrate which passes from the
Bowman's Capsule to the Renal tubule) and returning them to the blood.
Sodium reabsorption is the key to everything else. It creates the
environment for water and other substances to be reabsorbed.
Glucose is transported along with sodium irons by carriers called sodium-
glucose transport proteins. Normally all glucose in the tubular fluid is
reabsorbed and there is none in the urine.
Water reabsorption is a significant function of the kidney. The amount of
water reabsorption is continually regulated by hormones according to the
body's state of hydration. The more hydrated the body, the less water is
reabsorbed, and vice versa.
Nitrogenous wastes such as urea diffuses through the renal tubule with
water. The kidneys remove about 50% of the urea in the blood thus keeping
its concentration down to a safe level, but not completely clearing the blood
of it. Almost all uric acid is first reabsorbed by the renal tubule but later
parts of the nephron secretes it back into the tubular fluid. Creatinine is not
reabsorbed at all. It is too large to diffuse through water channels in the
plasma membrane, and there are no transport proteins for it. All creatinine
filtered by the glomerulus is, therefore, excreted in the urine.
After water and other substances leave the surface of the renal tubule,
they are reabsorbed by the capillaries, into the bloodstream.

Tubular secretion is the process in which renal tubule

extracts chemicals from the capillary's blood and secretes
them into the tubular fluid. This process serves two main
purposes:
Waste removal. Urea, uric acid, bile acids, ammonia, and
creatinine are secreted into the renal tubule. Tubular secretion
clears the blood of pollutants and drugs as well. One reason
why so many drugs (prescription drugs) must be taken three
to four times per day is to maintain the therapeutically
effective drug concentration in the blood, to compensate for
the rate of clearance, through tubular secretion.
Maintaining the acid-base balance. Tubular secretion of
hydrogen and bicarbonate irons serves to regulate the pH of
the body's fluids.
 WATER CONSERVATION

The third and final stage of urine formation is water conservation.

The kidneys are not only responsible for eliminating metabolic
wastes from the body but they also prevent excessive water loss, in
doing so. This is very important in maintaining the body's fluid
balance. Urine is made up mostly of water. It plays a significant
role in the entire process of waste elimination. If, however, too
much water is removed from the body, it results in dehydration
which could lead to other serious medical conditions.
When tubular fluid leaves the renal tubule it goes to the collecting
tubule (or collecting duct). At this stage the tubular fluid becomes
urine. The renal tubule of several nephrons drain into the
collecting tubule. This results in a significant amount of water
being drained into the collecting tubule. If all this water was
eliminated, it would amount to about 36 liters of urine per day.
One can only imagine the devastating effects this would have on
the body as this far exceeds the average volume of urine excreted
by an adult, of 1 to 2 liters per day.
The collecting tubule receives tubular fluid from numerous
nephrons. As it moves along the collecting tubule it become more
and more concentrated. This causes water to be reabsorbed into the
bloodstream, by the process of osmosis. The relative concentration
of the urine depends on the body's state of hydration. For example, if
you drink a large volume of water, you will produce a large volume of
urine which is less concentrated. On the other hand if you are
dehydrated, your urine is much more concentrated and the volume is
much lower. The collecting duct can adjust water reabsorption,
depending on the body's need for water conservation or removal.
Urine formation is therefore crucial to overall health. It forms the
basis for some medical diagnosis and evaluation of renal function.
Urinalysis (the examination of physical and chemical properties of
urine) is therefore one of the most routine procedures in medical
examinations.
 
Urine Flow Pathway
Bowman's capsule
(Glomerular Capsule)
Proximal Convoluted Tubule
Descending Limb
Loop of Henle
Ascending Limb
Distal Convoluted tubule
Collecting duct
Papillary Duct
Minor Calyx
Major Calyx
Renal Pelvis
Ureter
Urinary Bladder
Urethra
 
End