ANS 331: Renal System




I.	The Kidneys

	1.	Functions
		A.	Excretion of metabolic waste products
		B.	Regulation of the volume and composition of 
			extracellular fluids
	2.	Produces Urine
		A.	Formed from blood
		B.	Varies in composition

II.	Anatomy of the Renal System

	1.	Kidney
		A.	Pair of Organs
			a.	Bean-Shaped--Most Species
			b.	Heart-Shaped--Horses
			c.	Lobulated--Cattle
		B.	Retroperitoneal
			a.	Located outside of abdominal cavity 
				suspended by peritoneum
		C.	Blood Supply
			a.	Renal Artery
				i.	Brings blood to Kidney
				ii.	Arises directly from aorta
			b.	Renal Vein
				i.	Brings blood away from Kidney
				ii.	Empties into the Caudal Vena Cava
		D.	Divisions
			a.	Cortex
				i.	Outer Portion
				ii.	Contains upper parts of nephrons
					--Glomeruli and Tubules
			b.	Medulla
				i.	Inner Portion
				ii.	Contains lower parts of nephrons
					--Loops of Henle and Collecting Ducts
			c.	Renal Pelvis
				i.	Drains kidney and connects ureters
			d.	Renal Hilus
				i.	Indented area on concave edge
				ii.	Ureter, Blood Vessels, Nerves 
					and Lymphatics enter or leave
	2.	Ureter
		A.	Smooth muscle lined tube
		B.	Conveys urine from renal pelvis to bladder
		C.	Enter bladder through ureterovesicular junction
			a.	Acts as a valve
			b.	Prevents backflow
	3.	Urinary Bladder
		A.	Hollow muscular organ (Smooth Muscle)
		B.	Stores Urine
			a.	Stretches
		C.	Lined with Transitional Epithelium
			a.	Flatten when filling occurs
	4.	Urethra
		A.	Caudal continuation of the neck of the bladder
		B.	Conveys urine from bladder to exterior
		C.	Urine release into urethra controlled 
			by external sphincter
			a.	Skeletal muscle

III.	Microstructure of the Kidney: The Nephron

	A.	The functional unit of the kidney
		a.	Numbers range from 250,000 (cat) to 4 million (cow) 
			per kidney
		b.	Components
			i.	Glomerulus
			ii.	Bowman's Capsule
			iii.	Proximal Tubules
			iv.	Loop of Henle
			v.	Distal Tubules
	B.	Glomerulus
		a.	Tufts of Capillaries
		b.	Afferent arterioles
			i.	Conduct blood to glomerulus
		c.	Efferent arterioles
			i.	Conduct blood away from glomerulus
			ii.	Divide into peritubular capillaries 
				--Surround nephron tubules
				--Vasa Recta: 
					Peritubular capillaries 
					surrounding loops of Henle
		d.	Function:	
				Filtration of Blood
	C.	Bowman's Capsule
		a.	Collect Glomerular Filtrate
		b.	Conduct filtrate into proximal tubules
	D.	Proximal Tubules
		a.	Conduct filtrate into Loop of Henle
		b.	Very convoluted 
			(Surrounded by Peritubular Capillaries)
		c.	Reabsorb, Secrete, & Excrete
			--Simple cuboidal or columnar epithelium
	E.	Loop of Henle
		a.	Play important role in concentration of urine
		b.	Divisions
			i.	Descending limb
				--thin segment
				--simple squamous epithelium
			ii.	Ascending limb
				--thick segments
				--simple cuboidal epithelium
				--returns to sight near glomerulus 
					of origin
		c.	Surrounded by Vasa Recta
	F.	Distal tubules
		a.	Convey urine from Loops of Henle
		b.	Also convoluted (Surrounded by peritubular 
			capillaries)
		c.	Reabsorb, Secrete, and Excrete
			--Simple
		d.	Feed Collecting tubules and ducts
	G.	Juxtaglomerular Apparatus
		a.	Junction between distal tube and glomerulus
		b.	Contain unique cell types
			i.	Macula Densa in tubules
			ii.	Juxtaglomerular cells in arterioles
		c.	Function:
			i.	Regulate renal blood flow
			ii.	Regulate glomerular filtration
			iii.	Secrete Renin
				--Involved in production of angiotensin II
	H.	Two Types of Nephrons
		a.	Cortical
			i.	Short loops of Henle
			ii.	Only go into Outer medulla
		b.	Juxtamedullary
			i.	Long loops of Henle
			ii.	Can go clear to renal pelvis

IV.	Formation of Urine

	1.	General
		A.	Involves Three Processes
			a.	Glomerular Filtration
			b.	Tubular Reabsorption
			c.	Tubular Secretion
	2.	Distribution of Blood at the Glomerulus
		A.	Renal Blood Flow (RBF)
			--Rate at which blood flows to the kidney
		B.	Renal Plasma Flow (RPF)
			--Part of RBF that is Plasma
		C.	Glomerular Filtration Rate (GFR)
			--Rate at which glomerular filtrate will be 
				formed from plasma
		D.	Filtration Factor (FF)
			a.	GFR/RPF = FF
			b.	% of filtrate that is plasma flowing 
				through glomerulus 
		E.	RBF, RPF and GFR are all measured in ml/min
		F.	RBF directly related to final output of urine	
	3.	Glomerular Filtration
		A.	Glomerulus is a high hydrostatic pressure system
			a.	Favors filtration
		B.	Peritubular Capillaries are a low hydrostatic 
			pressure system
			a.	Favor reabsorption
		C.	Slit pores at Glomerulus slightly larger than 
			normal capillaries
			a.	Filter larger molecules
			b.	Most proteins still too large
		D.	Pressures favor direction towards Bowman's Capsule
			a.	No Colloidal Osmotic Pressure on Bowman's 
				Capsule side
		E.	GFR can be changed (changes in glomerular pressure)
			a.	Vasodilation and/or constriction of 
				efferent or afferent arterioles
		F.	Two autoregulation mechanisms of GFR control
			a.	Macula densa
				i.	Sensitive to changes in ionic 
					concentrations
					--Na+ and Cl-
				ii.	Lower concentrations signal 
					afferent arterioles to dilate
					--Increase blood flow 
						and hydrostatic pressure
					--Increase GFR
			b.	Juxtaglomerular cells
				i.	Secrete Renin
					--Released during low blood 
						pressure
				ii.	Initiates Angiotensin II
					--Causes Efferent arteriole 
						to constrict
					--Increases GFR
					--Increases water reabsorption 
						by tubules to peritubular 
						capillaries
	4.	Tubular Reabsorption and Secretion
		A.	Reabsorption Path
			a.	Tubular Lumen
			b.	Tubular Epithelium
			c.	Interstitial Fluid
			d.	Capillary
		B.	Secretion Path
			a.	Just the opposite
		C.	Reabsorbed Molecules
			a.	 Amino Acids & Glucose
				--Important for body function
			b.	Use carrier proteins coupled with Na+ 
				to enter tubular cells
				--Symporter
				--Na+ is actively transported to lumen
				--Causes concentration gradient for Na+
			c.	Water reabsorption follows osmotic gradient 
				from lumen to epithelium to capillaries
			d.	Other diffusible substances follow water 
				by diffusion because they increase 
				in concentration in the lumen
				--Proximal Tubule Reabsorption
					65% of H2O, Na+, Cl-, and
					100% of Glucose and Amino Acids 
		D.	Secreted Molecules
			a.	H+ is secreted throughout tubules
				--Antiporter with HCO3-
			b.	K+ is secreted in distal 
				and collecting tubules
				--Antiporter with Na+
			c.	Ammonia is secreted
				--Depends on acid-base balance
	5.	Transport Maximum (TM)
		A.	Maximum Rate in which a substance can be absorbed
		B.	Diabetes mellitus
			a.	Excess Glucose Filtered
			b.	Exceed TM
			c.	Decreases Osmotic Gradient for H2O 
				reabsorption
			d.	Excess water loss through urine (diuresis)
		6.	Countercurrent Mechanism

		A.	Kidney function:	To Control the osmolality of
						 the body fluids

			a.	Osmolality:	Osmotic concentration, the 
						characteristic of a solution
						determined by the ionic 
						concentration of a dissolved
						substance per unit solvent
				i.	Solvent:	Water
				ii.	Solutes:	Na+ and Urea
			b.	The kidney excretes excess H2O in urine 
				when body fluids are too dilute.
			c.	The kidney excretes excess solutes when 
				the body fluids are too concentrated.
		B.	Players
			a.	Medulla
				--Low to High Concentration gradient from 
					Outer to Inner
			b.	Loop of Henle
				--From Juxtamedullary capillaries that dip 
					deep into the renal medulla
			c.	Vasa Recta
				--Peritubular capillaries that surround 
					Loop of Henle
			d.	Distal Tubule and Collecting Ducts
				--Reabsorb some Water, NaCl, and Urea
		C.	Two types of nephrons
			a.	Cortical
				i.	Short Loops of Henle
				ii.	Only go into outer medulla
			b.	Juxtamedullary
				i.	Long Loops of Henle
				ii.	Can go clear to renal pelvis
		D.	Species differences:
			a.	Desert Kangaroo Rat
				i.	Only long loops of Henle
				ii.	Can live on Metabolic H2O
			b.	Humans, Cattle, & Swine
				i.	Few long loops (1/3 to 1/5 of total)
				ii.	Void large amounts of dilute urine
			c.	Dogs, Cats, Camels, Sheep, and Goats
				i.	Many long loops of Henle
				ii.	Produce a relatively concentrated 
					urine
		E.	Mechanism
			a.	Hyperosmolality of the medullary 
				interstitial fluid
				i.	Create a very high osmotic pressure 
					for H2O osmosis into the kidney 
					interstitium.
				ii.	Three mechanisms
					1.	Active Transport of Na+ in 
						ascending limp of loop 
						of Henle--Chloride pump
					2.	Active Transport of Na+ in 
						collecting duct
						--Sodium Pump
					3.	Passive diffusion of Urea 
						from Collecting duct
			b.	Countercurrent Multiplier--Loop of Henle
				i.	The countercurrent (hairpin loop) 
					arrangement of the nephron allows 
					urine a chance to flow through a 
					region of high osmolarity permitting
					urine concentration by passive 
					reabsorption of H2O.
				ii.	Active transport of NaCl from the 
					thick ascending limb of the loop 
					of Henle is responsible for 
					increased hyperosmolality.
				iii.	Continual flow of new NaCl into 
					the loop of Henle allows it to 
					become a countercurrent multiplier.
			c.	Countercurrent Exchanger--Vasa Recta
				i.	Without a special medullary vascular
					system the flow of blood through the
					interstitium would rapidly remove 
					the excess solutes in the medulla 
					and keep the concentration from 
					rising too high.
				ii.	The vasa recta have two 
					characteristics which maintain this
					high solute concentration:
					--Blood flow through the vasa recta 
						is very sluggish.
					--Hairpin loop structure and high 
						permeability of vasa recta 
						allow exchange between arms
						of loop.
	

V.	Hormones and Kidney Function

	1.	Antidiuretic Hormone
		A.	The shift of the kidney from excreting excess H2O 
			to excess solute is controlled by 
			Antidiuretic Hormone (ADH).

			a.	ADH (also called Vasopressin) is synthesized
				by the hypothalamus and secreted by the 
				posterior pituitary (or neurohypophysis).
			b.	Low Blood [ADH] = increased H20 excretion 
				or a dilute urine.
			c.	High Blood [ADH] = increased solute 
				excretion or a concentrated urine.

		B.	Concentration of Urine

			a.	ADH allows H2O reabsorption by the late 
				distal tubules and collecting ducts 
				thus facilitating the concentration of urine.

			b.	ADH acts by facilitating the formation of 
				"water channels" on the luminal membrane of 
				tubule and ductal epithelial cells.
				i.	The H2O is then pulled by osmosis 
					into the highly concentrated 
					interstitial fluid.
				ii.	The deeper the collecting ducts go 
					into the medulla the stronger the 
					osmotic pull and the more 
					concentrated the collecting duct 
					fluid gets until it reaches the
					1200 mOsm/l concentration equal to 
					the osmolality of the medullary 
					interstitium near the papilla.

			c.	ADH also increases the permeability of 
				the collecting ducts to urea.  
				This urea adds to the hyperosmolality of 
				the medullary interstitium.

			d.	In addition, ADH has been reported to 
				decrease the blood flow of the 	vasa recta, 
				further playing a role in the concentration 
				of urine.
		C.	Excretion of a dilute urine.
			a.	Dilution of urine is accomplished by 
				reabsorption of solutes, without a further 
				reabsorption of H2O.
				i.	Solutes are absorbed in the thick 
					ascending limp of the loop of Henle,
					distal tubules, and the collecting 
					ducts.
				ii.	The thick ascending limb of the 
					loop of Henle and early distal 
					tubules are called the diluting 
					segment of the nephron because 
					they are impermeable to H2O.
				iii.	Without ADH the late distal tubules 
					and collecting ducts nephron are 
					impermeable to H2O.
		D.	Other Factors Affecting ADH Release
			a.	ADH is stimulated by decreased blood volume 
				which allows body to conserve H2O in 
				the face of a severe hemorrhage	
--Volume receptors in blood vessels b. ADH is inhibited by alcohol which leads to excess diuresis when consuming alcohol. c. Diabetes insipidus is a disease caused by the lack of ADH. d. Cold environments inhibit ADH which leads to increase urine production and water intake e. Na+ concentrations regulate ADH --Osmoreceptors in hypothalamus 2. Angiotensin II A. Causes Efferent arteriole to constrict --Increases GFR B. Increases water reabsorption by tubules to peritubular capillaries C. Increases vasoconstriction of peripheral blood vessels D. Causes the secretion of Aldosterone 3. Aldosterone A. Produced in adrenal cortex (Mineralocorticoid) A. Involved in K+ regulation a. Causes secretion in distal tubules, collecting tubules and ducts B. Antiporter causes Na+ reabsorption a. Causes H2O reabsorption --Increase blood volume & pressure 4. Parathyroid Hormone A. Causes a reabsorption of Ca++ B. Secretion of Phosphorus C. Controls formation of Vitamin D a. Activated in kidney b. Vitamin D promotes Ca++ absorption from intestine VI. Micturition (Urination) 1. Transfer of Urine to the Urinary Bladder A. From Glomerulus to Renal Pelvis --Hydrostatic pressure B. From Renal Pelvis to Bladder --Peristalsis of the ureter 2. Micturition Reflexes A. Micturition: Emptying of Bladder a. Involuntary Control b.. Voluntary Control B. Involuntary Control of Bladder a. Stretch receptors in bladder wall i. Want to contract b. Reflex center in Brain Stem i. Prevent Contraction of Wall ii. Prevent Relaxation of Sphincter c. Parasympathetic C. Voluntary Control of Bladder a. Cortex aroused upon filling b. Allows micturition when appropriate D. Urethral Reflex a. Involuntary b. Allows for complete emptying of bladder c. Parasympathetic E. Sympathetic Control a. Closure of sphincter during ejaculation 3. Characteristics of Mammalian Urine A. Composition a. Varies b. Similar to extracellular fluid c. Dependent on whether substance is conserved or excreted B. Color a. Yellow color i. Derived from bilirubin ii. Forms urobilin at intestine iii. Oxidizes to urochrome (yellow pigment) C. Odor a. Species Specific b. Dependent on diet D. Consistency a. Watery in most species b. Horse: Thicker and more syrupy i. Mucous secreted in Renal Pelvis ii. Also contains Carbonates and Phosphates --Easily precipitate upon standing E. Nitrogenous Component a. Urea i. Formed in liver from ammonia --Decreases toxicity of ammonia F. Output a. Varies b. Terms i. Polyuria --Increased urine output ii. Oliguria --Decreased urine output iii. Anuria --No urine output iv. Continence --Normal condition of storing urine v. Incontinence --Leaking or dribbling of urine uncontrollably --Usually neural problem --Prostate problems vi. Dysuria --Painful urination V. Renal Clearance 1. Measurement of the kidney's ability to remove substances from the plasma 2. Formula: Cx=UxV/Px Cx = Clearance of substance x (ml/min) Ux = Concentration of x in urine (mg/ml) V = Rate of urine formation (ml/min) Px = Concentration of x in plasma (mg/ml) 3. Pharmacological and Diagnostic Tool VI. Maintenance of Acid-Base Balance 1. Relationship of pH to H+ Concentration A. Normal = pH 7.4 B. Severe Acidosis = pH 7.1 a. H+ concentration doubled b. High meat diet more acid C. Severe Alkalosis = pH 7.7 a. H+ concentration halved b. High vegetable diet more basic 2. Mechanism of H+ Secretion by the Kidneys A. Na+/H+ antiporter secretes H+ a. Occurs along whole nephron b. 85% in Proximal tubules B. Secreted H+ combines with: a. Bicarbonate b. Phosphate c. Ammonia 3. Role of Respiratory System A. Respiratory System also controls pH of extracellular fluids B. Bicarbonate from hydration reaction binds CO2 C. Releases H+ with CO2 at alveoli D. Increased H+ and CO2 in extracellular fluid cause increase ventilation 4. Chemical Buffer Systems and Mechanisms A. System can buffer acids and bases in extracellular fluids B. Types: a. Bicarbonate Acid buffer: HCl + NaHCO3 --> H2CO3 + NaCl Base buffer: NaOH + H2CO3 --> NaHCO3 + H2O b. Phosphate Acid buffer: HCl + Na2HPO4 --> NaH2PO4 + NaCl Base buffer: NaOH + NaH2PO4 --> Na2HPO4 + H2O c. Proteins i. Amino-end (basic) buffer acids ii. Carboxy-end (acidic) buffer bases iii. Hemoglobin most abundant buffer in body --anemic animals get acidosis


ANS 331 Notes


~~~~~Revised 11/5/97~~~~~ TAW