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mechanism of urine formation

In the formation of urine, a series of events lead to the elimination of metabolic waste from body, regulation of total body water balance, control chemical composition of blood and control acid, base balance.


1. Filtration

Filtration takes placed at Malpighian body.

Urine formation begins with process of filtration.

Kidneys filter blood, when blood flows from afferent arteriole into glomerulus.

Afferent arteriole is under high pressure (60 mmHg) to filtered.

This pressure forces some of blood plasma (protein and blood cell) unable to pass through endothelial capsular membrane. It remain with in glomerulus and reabsorbed lated.

 


GFR (Glomerular filteration rate) controlled by JGA (juxtaglomerular apparatus).

Juxtaglomerular secret renin cell (present in afferent and efferent arteriole).

Macula densa cells (present in DCT) ; detect Na+, Cl-

Mesangial cells 


Blood constitutent in glomerular filtration

Water

Mineral salt; Na+, K, Cl

Amino acid

Creatinine

Uric acid 

Urea

Glucose

Some hormone/ some toxins/ some drugs


Blood constitutent which remains in glomerular capillaries.

WBC, RBC, Platelets, Plasma proteins and some drug.


2. Selective reabsorption

Reabsorption is the movement of substance out of renal tubules back into blood capillaries.

This process enables reabsorption into blood of filterate constituents needed to maintain fluid and electrolytes balance of the blood.


Sites of Reabsorption

Reabsorption begins in proximal convoluted tubules (PCT) and continues in loop of Henle, distal convoluted tubules (DCT) and collecting tubules.

1. Reabsorption in PCT

PCT have many microvilli that increases surface area for reabsorption.

Reabsorb;

100% of filtered glucose and amino acids.

80-90% of HCO3-

50% of Cl- 

65% of water, Na+ and K+

2. Reabsorption in loop of Henle

10-20% of filtered HCO3-

15% of water

35% of Cl-

20-30% of filtered Na+, K+,and Ca+


3. Reabsorption in DCT

Reabsorb 10-15% of water 

4. Collecting duct

Reabsorb water


Some constitutents of glomerular filtrate such as glucose, amino acid don't normally appear in urine because they are completely reabsorbed unless they are excessive in blood level.


Other substance reabsorbed by active transport and includes sodium, calcium, potassium, phosphate and chloride.

Some ions such as sodium and chloride can be reabsorbed depending on the site in the nephron.

Hormone helps in reabsorption

Parathyroid hormone

ADH hormone

Aldosterone

ANP (atrial natriuretic peptide)

1. Parathyroid hormone

Secreted from parathyroid gland. It regulates the reabsorption of calcium and phosphate.

2. ADH (antidiuretic hormone)

Secreted from pituitary gland and it increases the water reabsorption.

3. Aldosterone

Secreted by adrenal cortex. It increases the reabsorption of sodium and excretion of potassium.

4. ANP (atrial natriuretic peptide)

Secreted by atria of heart in response to stretching of atrial valve which decreases reabsorption of sodium and water in the collecting tubules to control in blood pressure.


Reabsorption of Nitrogenous waste product

Nitrogenous waste products such as urea, uric acid, ammonia, creatinine


3. Tubular secretion

Tubar secretion remove material from blood and adds them to filtrate.

Secretion is process by which substances move into distal and collecting tubules from blood into capillaries.

Tubular secretion is very important to maintain the fluid and electrolytes balance and to remove the waste product from body.

Secretion take place in PCT, DCT and collecting duct, allows kidney to increase their efficiency.

1. Secretion in PCT

H+, NH3, K+

2. Secretion in DCT

K+, H+, NH3

3. Secretion in collecting duct 

K+, H+, PH balance


Substance into tubular secretion for removal from the body.

Transport of certain molecules out of blood and into the urine.

In cleaning certain substance from plasma and helps to maintain normal PH of blood.


Factors affecting GFR (Glomerular filteration rate)

Changes in renal blood flow

Changes in glomerular capillary hydrostatic pressure

Changes in systemic blood pressure

Changes in effective filtration surface area

Edema in kidney

Change in glomerular capillary permeability

Afferent and efferent arteriole constriction

Changes in hydrostatic pressure in Bowman's capsule

Changes in concentration of plasma protein

Ureteral obstruction




Blood supply to kidney

Kidney receives blood from renal arteries, left and right which branch directly from abdominal aorta.

Renal artery

Segmental arteries

Interlobar arteries

Arcuate arterioles

Interlobular arteries

Afferent arteries

Glomerular capillaries

Efferent arterioles

Pertitubular capillaries/or vasa recta

Interlobular veins

Arcuate vein

Interlobar vein

Renal vein (exiting kidney at renal Hilus).


Characteristic of Urine

Urine is clear, pale in color due to presence of bile pigment, which are reabsorbed and then excreted by kidney.

A healthy adult passes 1000-1500 ml urine per day.

Urine production is decrease during sleep and excercise.


Composition of urine

Water (96%)

Urea (2%)

Remaining 2% is uric acid, creatinine, ammonia, sodium, potassium, chloride, sulphate, phosphate, oxalate


Renin -Angiotensin System (RAS)

Renin-Angiotensin aldosterone system that regulates blood pressure and water (fluid) balance.

It is center of contrling blood pressure in the body.


Low renal blood flow or low blood pressure or law Na+ level

Tubules/ kidney renal blood flow pressure is low

Secrete renin by JG cells

Reach liver and excite to liver relaease

Angiotensin l

Reach in lung and convert (due to presence of ACE inhibitors)


Angiotensin ll ( angiotensin converting enzyme comming from lung)

Increased blood pressure  (vasoconstriction; raised blood pressure)

(Start negative feedback mechanism here)


Go to kidney again and decrease the secretion of renin and maintain blood pressure normal.


Tubules (JG cell)

Decrease secretion of renin

Maintain normal Blood pressure

Angiotensin ll -- Vasoconstriction --- increase blood pressure --- -ve feed back mechanism start

Adrenal gland (adrenal cortex)

Aldosterone

Selective reabsorption of sodium and excretion of potassium

Due to reabsorption

Increase blood level of Na+ 

Blood pressure will be increase

(Start negative feedback mechanism here)

Go to adrenal cortex

Decrease the secretion of aldosterone

Bring blood pressure back to normal


1. Due to decreased renal blood flow or decreased blood pressure or decreased sodium level in kidney.

2. Renin will secreted in kidney

3. This secretion of renin will convert angiotensinogen (comming from liver and kidney)  converted into angiotensin l.


4. Angiotensin l wiil be converted into Angiotensin ll

5. Due to formation of angiotensin ll vasoconstriction will increase blood pressure.

6. After vasoconstriction or after increase blood pressure, negative feed back mechanism is activated which will act in kidney and decrease the secretion of renin.


Onthe other hand, 

1. Angiotensin ll will act on adrenal cortex and will cause secretion of aldosterone.

2. Secretion of aldosterone will lead to reabsorption of sodium and excretion of potassium from kidney tubules.

3. Due to reabsorption of sodium, blood sodium level will increase and ultimately will cause increase in blood pressure.

4. With the increasing blood pressure, negative feed back mechanism will be activated and it will act on adrenal cortex and reduce secretion of aldosterone.

5. Which will bring back blood pressure in normal.







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