3.3 Kidney

PHYSIOLOGY OF
EXCRETION. KIDNEY
FUNCTIONS. MECHANISMS
OF URINE FORMATION.
Excretory system lungs
 lungs - СО2, Н2О
Skin-
vapour, ethers,
chlorophorm sweat GIT
 Sweat glands- Н2О, glands
salts, urea, uric acid, blood
creatinin.
 Liver – bile pigments, liver kidney
products of haemoglobin
break down
 GIT - Н2О, salts
 Kidney is the main organ Organs &
of excretion tissues
EXCRETORY SYSTEM
KIDNEY
NEPHRON
Different types of nephrones
Cortical
Jucstar-medullar
TYPES OF NEPHRONS
 Cortical – main nephrons allowing urine
formation (60-70%).
 Jucstar-medullar – have long Henle loops,
enable urine concentration. (10-20%)
 Superficial – have short Henle loops, play the
role of shunts (20-30%)
MECHANISMS OF URINE
FORMATION
FILTRATION
REABSORPTION
SECRETION
Obligatory Facultative
REABSORPTION REABSORPTION
Regulated
water
reabsorp-
filtration tion
Counter-
current system
MECHANISM OF
GLOMERULA
FILTRATION
GLOMERULA FILTER
GLOMERULA FILTER
1 –capillary endothelium
2 – basal membrane
3 – podocyte
4- pores in the endothelium
5 – fissura in podocyte
membrane
Glomerular diuresis -
filtration
h
y
d
r
o
F = Р h. – Р оn. – Р f.=
70-30-20=20 mm Hg
 І Blood hydrostatic pressure (Р h.) -70
mm Hg
 ІІ Blood oncotic pressure (Р оn.) - 30 mm

Hg
 ІІІ Ultrafiltrate hydrostatic pressure (Р f.)

- 20 mm Hg
Factors influencing filtration
pressure
Increase in Decrease in Increase in

Increase in
hydrostatic oncotic oncotic
hydrostatic
pressure pressure pressure
pressure
Factors determining high
hydrostatic pressure in glomerulus
 Short renal artery starts right from the
abdomenal aortha
 Vas afferens is twice wider than vas
efferens
OBLIGATORY
REABSORPTION
PCT epithelium structure
OBLIGATORY
REABSORPTION
 Na+, K+, Ca+2, Mg +2, Cl--,
SO42-- , HPO42--, HCO3--,
vitamins - diffusion
 Amino acids, glucose –
secondary active
2/3 of filtrated transport
urine is  urea, uric acid – diffusion
reabsorped
 H2O - оsmosis
SECONDARY ACTIVE
TRANSPORT
Apical membrane
Glucose
Na+
К+
Basilar membrane
АТФ
Na+
Urea role in urine concentration
Urea
Uric acid  Reabsorption – 1/3 of
filtered urea is
reabsorped in PCT; it
increases Рosm. of
parenchime & helps to
reabsorb water in DCT.
 secretion
Regulation of obligatory
reabsorption
Sympathetic nervous system,
cateholamines, glucocorticoids
Intracellular messengers
Metabolism in epithelial cells (energy formed)
Substances transport
FACULTATIVE
REABSORPTION
Facultative reabsorption
• Sodium, chlorine – is
regulated by aldosterone &
natriuretic peptide;
• Calcium - is regulated by
parathormone, calcitonin &
Vit D3 .
Regulated reabsorption of
water under the influence of
ADH (vasopressin)
Aldosterone diuresis influence
Collecting duct
aldosterone
Adrenal glands
DCT
Sodium decrease
REGULATION OF SODIUM
REABSORPTION
Aldosteron Natriuretic
increases peptide
inhibits
Regulation of calcium reabsorption
Parathormone, Calcitonin
Vit D3 inhibits
increases
АDH effect on water reabsorption in
the collecting ducts НО 2
Apical membrane
Proteins phosphorilation
PROTEINKINAZE
c-АМP
GS-protein,
Gyanile adenylatecyclase
V2receptor
nucleotide Basilar
membrane
Н 2О
АDH
Secretion – substances transport
from blood to urine
 urea, weak acids & bases,
ammonium, ammonia
(diffusion)
 Organic acids & bases,
penicilinum (active
transport)
 Sodium, potassium, аmonia,

urea
Counter-current system
Types of epithelium in canaliculli
Counter-current system mechanism
Н2О
Na
Na Н2О
Роsm Н2О
Роsm
SCHEME OF PROCESSES IN FINAL URINE
FORMATION
FILTRATION
REABSORPTION
SECRETION
EXTRUSION
WITH FINAL
URINE
Filtration Reabsorption Secretion Filtration& Filtration&
reabsorption Secretion
inulin Glucose Urea, glucose in Diodrast

K
(normally) hyperglucemia
Non-threshold substances
 Non-threshhold
substances – are
substances which are
excreted with final
urine regardless of
their concentration in
blood
Velocity of glomerular filtration -
clearens
 Velocity of glomerular filtration (clearens) is a
volume of blood plasma which was filtrated
via kidney in certain time.
 Filtrometric substances are used to
define clearens (инулин, креатинин), they
are non-threshold substances which are
neither secreted nor reabsorped
 In man – 125 ml/min
 In woman -110 ml/min
CLEARENS DETERMINATION
Ucr . х V
F=
Рcr.
 Рcr. х F = Ucr. х V
 Рcr. Creatinin concentration in blood plasma;
 U cr. Creatinin concentration in final urine;
 F –volume of primary urine;
 V- volume of final urine.
Threshold UBSTANCES
 Threshold
SUBSTANCES – are
substances which
have threshold of
elimination & are
excreted with final
urine only if their
concentration in blood
is above threshold
KIDNEY FUNCTIONS
CONNECTED WITH
URINE FORMATION
EXCRETION OF:
 End products of metabolism (urea, uric
acid, creatinin)
 Pigments which are formed at haemoglobin
breakdown (urobilin, urochrome)
 Metabolites of hormones & other
biologically active substances
 Drugs & substances which enter with food
HOMEOSTASIS MAINTENANCE
due to excretion of threshold
substances
 Ionic content of blood(Na, Cl, K, SO 4,)
 Osmotic pressure (Na & H2O)
 Q (volume of blood in circulation) & BP
(due to regulation of water excretion)
 Glucose & amino acids level
 Blood pH regulation (due to regulation of
H+ , bicarbonate, sulfate, phosphate anions
excretion)
KIDNEY FUNCTIONS
NOT CONNECTED WITH
URINE FORMATION
ENDOCRINE FUNCTION:
 Renin-angiotensine-aldosterone system
 Vit D3
 Erithropoetins
 Anticoagulating system factors (urokinase,
heparine,antithrombines)
 Prostaglandines (A2, E2)
 Kinins (bradikinin, kallikrein)
METABOLIC
 Protein metabolism (fermentative
hydrolysis of proteins with amino acids
formation and their release into the blood
stream)
 Carbohydrates metabolism (glucose
reabsorption & gluconeogenesis)
 Lipids metabolism (tryacilglicerides
&phospholipids formation)
KIDNEY IN
HOMEOSTASIS
MAINTENANSE
Salt-water balance regulation
Physiological swelling
(up to 30%) Hepatic osmoreceptors
liver
hypotalamus
v. portae
АDH
intestines
Isotonic solution, Н2О reabsorption

food
Q diuresis
Kidney in osmotic pressure regulation
Increase in
ADH
secretion
Decrease Increased
in plasma water
osmotic reabsorption
pressure in kidney
decreased
water
reabsorption
in kidney Decrease in
Decrease in plasma
osmotic
ADH pressure
secretion
Osmotic pressure regulation
SO & Posterial
Hypothalamus
PV nn. pituitary
osmoreceptors
Adrenal glands АDH

Роsm
blood
aldosterone Н2О reabsorption
Na+ reabsorption
Роsm diuresis
Q
OSMOTIC PRESSURE REGULATION
SO & Posterior pituitary
Hypothalamus
PV nn
osmoreceptors
АDH
РOSM Н2О reabsorption
Nauretic hormone
diuresis
выделение Na+ Роsm

Q REGULATION
Volume receptors SO &
of atrium
PV nn.
Volume receptors АDH
of hypothalamus
Q
threshold Н2О reabsorption
350 ml
diuresis
Q
BP
Н2О
Na+reabsorption
BP reabsorption
aldosterone
UGА Q
Рosm
Adrenal glands =
renin
angiotensin
diuresis
EFP filtration
Q REGULATION
Volume receptors АDH
of hypothalamus
Q Н2О reabsorption
Right atrium diureis

Q
Na-uretic hormone
Na+ excretion

3.3 Kidney

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PHYSIOLOGY OF

 ІІ Blood oncotic pressure (Р оn.) - 30 mm

 ІІІ Ultrafiltrate hydrostatic pressure (Р f.)

Increase in Decrease in Increase in

Metabolism in epithelial cells (energy formed)

 Sodium, potassium, аmonia,

inulin Glucose Urea, glucose in Diodrast

Isotonic solution, Н2О reabsorption

Adrenal glands АDH

РOSM Н2О reabsorption

выделение Na+ Роsm

Right atrium diureis

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