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    Kidneys, Salt and WaterBalance

    Pipiet Wulandari

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    Functions

    1. Adjust water and water excretion to maintain aconstant extracellular fluid volume and osmolality

    2. Acid base homeostasis

    3. Eliminate end products of metabolism & foreign

    substances4. Preserving usefull compounds by reabsorbtion

    5. Produce hormones (erytropoetin) and hormonactivators (renin)

    6. metabolic functions (catabolism, glukoneogenesis)

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    Structure & Function

    1. Large quantities of water and solutes arefiltered from the blood

    2. Primary urine enters the tubulus, where

    most of it reabsorbed

    3. Certain substances not only not absorbedbut actively secreted into the tubulelumen. The non reabsorbed residual

    filtrate is excreted together with thesecreted substances in the final urin

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    Kidney Structure and Function

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    Cont..

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    Renal circulation

    1. a.arcuata

    2. a. interlobular

    3. vasa afferentia 4. vasa efferentia

    Renal bloood flow (RBF) = 1,2 L/min

    (20-25 % CO)

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    Renal Circulation

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    Glomerular filtration

    GFR total volume of fluid filtered by theglomeruli per unit time, 120 ml/ min per1.73 m2 of body surface area

    99% tubular reabsorbtionTo measure GFR :

    - Freely filterable

    - Filtered amount must not change due to

    reabsorbtion or secretion- Not be metabolized in the kidney

    - Not alter renal function

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    Glomerular filtration

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    Glomerular Filtration and Clearance

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    Cont

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    PAH

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    Transport process

    To measure permeability of theglomerular filter :

    GSC ( Glomerulular Sieving Coefficient )= concentration in filtrate/ in plasma

    0 1

    R< 1,8 nm, Molecular mass < 10.000Da

    4,4 & > 80.000 Da, globulin

    Albumin r = 3,4 nm, GSC = 0,0003

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    Transport Processes at the Nephron

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    Cont

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    Cont

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    Reabsorbtion of OrganicSubstances

    FE = 0,4%

    Complete reabsorbtion(prox t)by secondaryactive transport (Na+glucose symport)

    Glucosuria : Plasmaglukose increase,tubular glucose carrier

    is devective

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    Cont

    25 amino acid 70g filtered each day

    Reabsorb at

    proximal t by Na+coupled secondaryactive transport

    Prerenal

    hyperaminoaciuria,renal (transportdeficient)

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    Cont

    Oligopeptides :Glutation,angiotensin II

    luminal peptidase Dipeptides :

    reabsorb as intactmolecules

    intracellularpeptidase

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    Cont

    Albumin, 2-35 mgexcreted each day(FE=1%)

    Proximal tlysozyme, globulineabsorb byreceptor mediated

    endocytosis

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    Cont

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    Reabsorption of Na+ and Cl-

    99% reabsorbed

    Sites : all pats of the renal tubule and

    colecting duct : 65% proximal t, 25%loop of henle, hormonal (aldosterone)

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    Reabsorbtion of Na+ and Cl-

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    Cont

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    Reabsorbtion of water, formation ofconcentrated urin

    Glomeruli filter 180 l plasma watereach day

    Urin output 0,5-2 l/day

    Antidiuresis vs diuresis

    Poliuria, oligouria (0,5 l/day), anuria(

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    Reabsorbtion of Water, Formationof Concentrated Urine

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    Cont

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    Cont

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    Body Fluid Homeostasis

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    Salt and Water Regulation

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    Cont

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