The Kidney

What do the kidneys do?

remove toxic waste products remove excess water and salts play a part in controlling your blood pressure produce erythropoietin (epo for short) which stimulates red cell production from the bone marrow you get anaemic without this help to keep calcium and phosphate in balance for healthy bones maintain the blood in a neutral (non-acid) state

Blood is brought to the kidney in the renal artery. The kidneys filter the blood and then reabsorb useful materials such as glucose. After it has been purified the blood returns to the circulation through the renal vein.

 Urine is taken from the kidneys to the bladder by the ureters. The bladder stores the urine until it is convenient to expel it from the body. The main waste product removed in the urine is urea. Urea is a waste product produced in the liver when surplus amino acids are broken down to be used for energy. It is released into the bloodstream until it is filtered out and removed by the kidney. Urine is produced in microscopic structures in the kidney called nephrons. Each kidney has many millions of nephrons

 Blood is filtered in the glomerulus. The filtrate is collected by the bowman's capsule and enters the tubules. Useful substances such as glucose, some salt and water are reabsorbed into the blood. Reabsorption is done by blood capillaries which are closely wrapped round the tubules. The waste, consisting of water, some salt and urea is urine. The urine is collected by the collecting duct, taken to the ureters and then to the bladder.

 A is the glomerulus. It is a ball of blood capillaries in which filtration takes place. Some of the liquid plasma is forced out of the capillaries whilst the solid cells and platelets remain behind. B is a tubule. The filtrate from the glomerulus flows slowly through the tubule. As it does so the blood capillaries which surround it re-absorb the useful substances such as glucose, some salt and some water. Everything which is not re-absorbed is release as urine.

C is the collecting duct. This collects the fluid from the ends of many tubules, which is now urine, and takes it to the ureters for transport to the bladder.

This is a schematic diagram illustrating the kidneys' ability to separate particles in the blood in order to maintain optimal body chemistry. Blood enters the kidney through the renal artery. In the kidney, the blood undergoes filtration and dialysis to separate the particles that will be removed from the body (through the ureter to the bladder) from those that will be returned to the circulating blood (through the renal vein).

Nephron Segment Function

Renal Corpuscle: Glomerulus Bowman's Capsule

Filtration: Glomerulus filters proteins and cells from the blood. All other blood components pass into Bowman's capsule, then into the tubule. Reabsorption and Secretion: Semipermeable membranes surrounding the tubule allow selective passage of particles back into the blood (reabsorption), or from the blood into the tubule (secretion). Collection: Collects all material that has not returned to the blood through the tubular membranes. This material exits the kidney as urine.

U-Shaped Tubule

Collecting Duct

Renal Corpuscle
Blood first enters the kidney through the renal artery which branches into a network of tiny blood vessels called arterioles. These arterioles then carry the blood into the tiny blood vessels of the glomerulus. It is here, in the renal corpuscle, where filtration occurs. The glomerulus filters proteins and cells, which are too large to pass through the membrane channels of this specialized component, from the blood. These large particles remain in the blood vessels of the glomerulus, which join with other blood vessels so that the proteins remain circulating in the blood throughout the body. The small particles (e.g., ions, sugars, and ammonia) pass through the membranes of the glomerulus into Bowman's capsule. These smaller components then enter the membraneenclosed tubule in essentially the same concentrations as they have in the blood. Hence, the fluid entering the tubule is identical to the blood, except that it contains no proteins or cells.

Tubule The tubule functions as a dialysis unit, in which the fluid inside the tubule is the internal solution and the blood (in capillaries surrounding the tubule) acts as the external solution. Particles may pass through the membrane and return to the blood stream in the process known as reabsorption, which is analogous to the movement of particles from the internal to the external solution in the dialysis experiment you performed in lab.

The reabsorption of many blood components is regulated physiologically, as discussed below. Alternatively, particles may pass through the membrane from the blood into this tubule in the process known as secretion, which is analogous to the movement of particles from the external solution into the dialysis bag in the experiment you performed in lab. The most important particles that are secreted from the blood back into the tubules are H+ and K+ ions, as well as organic ions from foreign chemicals or the natural by-products of the body's metabolism.

Collecting Duct The blood components that remain in the nephron when the fluid reaches the collecting duct are excreted from the body.The collecting duct from one nephron meets up with many others to feed into the ureter. The ureters (one from each kidney) enter the bladder, which leads to the urethra, where the liquid waste is excreted from the body. Hence, the material that is filtered and secreted from the blood into the tubule, less the amount that is reabsorbed into the blood, is ultimately excreted from the body

Normal Renal Function Functions of the Kidney: balances solute and water transport excretes metabolic waste products conserves nutrient regulates acid-base balance secretes hormones that help regulate blood pressure, erythrocyte production, and calcium metabolism. forms urine

Formation of Urine in the Kidney A kidney contains around one million nephrons. In general, the kidneys can adequately function with only one third of the normal number of nephrons. Less than that, the body will retain waste products, especially urea and creatinine.

 Nephrons process the blood to make urine. A tuft of capillaries called the glomerulus is contained in each nephron. The glomerulus is surrounded by Bowman's capsule. The capillaries are extremely porous, allowing large amounts of solute-rich fluids to pass from the capillaries into the capsule. This fluid is the raw material of urine.

The secondary active secretion of H+ during Na+ reabsorption is called countertransport since the ions move in opposite directions. Normally, only 20% of total Na+ reabsorption occurs during active secretion of H+ and K+. When H+ ions are not available for exchange as in alkalemia, K+ ions are secreted. This is why alkalemia may lead to hypokalemia. In H+ and K+ secretion, HCO3- ions are reabsorbed in place of Cl-. When chloride ions are in short supply, there is an increased demand for H+ and K+ secretion to reabsorb sodium.

 The proximal tubules are responsible for the iso-osmotic reabsorption of water, electrolytes, non-electolytes. As much as 80% of the filtrate is reabsorbed into the capillaries that line the tubules. All glucose and amino acids filtered are completely reabsorbed. Almost all potassium is reabsorbed. Almost all uric acid is reabsorbed. 90% of bicarbonate is reabsorbed. Two- thirds of filtered sodium is reabsorbed. H2O, chloride, and urea are reabsorbed by passive transport. Hydrogen ion is secreted, creatinine is secreted. Most of the calcium and phosphate is reabsorbed.

 Past the PCT is the loop of Henle which consists of both ascending and descending limbs. The descending limb is freely permeable to water, while the ascending is less permeable. In the Loop of Henle there is continued reabsorption of water, sodium, chloride.

The distal convoluted tubule receives fluid from the loop of Henle. The distal tubules are important in the final regulation of water balance and acid-base balance since hydrogen ion is excreted with ammonia as ammonium and with phosphate buffers. Bicarbonate is regenerated in this process and retained in the body.
The collecting tubule then receives the newly formed urine from the nephrons. In the collecting duct water reabsorption is completed. The final concentration of urine takes place here under the control of antidiuretic hormone (ADH). In the presence of ADH, more water is reabsorbed. The urine flows through the minor and major calyces of the renal pelvis into the ureter. From the ureter, urine makes its way to bladder.

Controlling Kidney Function

Water and ion volume and content in urine is controlled by hormones. ADH. . . Antidiuretic hormone is secreted from the posterior pituitary. The target tissue for this hormone is the distal convoluted tubule which reabsorbs more water back into the blood in response to ADH The effect of ADH is: less urine, greater blood volume, and greater blood pressure. Aldosterone. . . This hormone is secreted from the adrenal cortex. The target tissue for this hormone is the distal convoluted tubule which reabsorbs more sodium (Na+) in response to aldosterone. When more Na+ is reabsorbed water follows by osmosis. The effect of aldosterone is less urine, greater blood volume, and greater blood pressure

Atrial Natriuretic factor. . . Hormone released from the right atrium This hormone is released in response to high blood pressure. It triggers increased urine production, which results in lower blood volume and lowered blood pressure. Renin. . . Is released from the kidney in response to low blood pressure. Renin causes angiotensinogen to be converted to angiotensin. Angiotensin causes: 1. Vasoconstriction 2. Aldosterone secretion 3. ADH secretion The combined affect is decreased urine output, increased blood volume, and increased blood pressure. Parathyroid Hormone. . . Is released from the parathyroid glands This hormone increases calcium reabsorption from the distal convoluted tubule into the blood.

 Nervous control. . . Sympathetic stimulation to the kidneys constricts arteries This results in decreased blood flow, decreased filtrate and therefore decreased urine production.

Blood filtered by the glomerulus

GF = glomerulus filtering. TR = tubular reabsorption. TS = tubular secretion

 Summary of Chemical Changes of Filtered Blood Reabsorbed: sugar, sodium, vitamins, nutrients, water Secreted: hydrogen ion, potassium, ammonia, drugs, toxins

Summary of Chemical Changes of Filtered Blood

Reabsorbed

sugar, sodium, vitamins, nutrients, water hydrogen ion, potassium, ammonia, drugs, toxins

Secreted

Example Effects of the Kidney Function

Substance
Water Sodium Glucose Urea (waste product) Phenol (waste product)

Average percentage of filtered substance re-absorbed 99 99.5 100 50 0

Average percentage of filtered substance excreted 1 0.5 0 50 100

Inside each kidney, blood is channelled to 1 million tiny filters, each one called a glomerulus (the plural is glomeruli). Glomeruli are each joined onto small tubes (tubules) to make nephrons, and each day 150 litres of filtrate passes into the nephrons - 100 times the average daily amount of urine. As the fluid passes along these tubes, most of it is taken back into the blood stream (reabsorbed), leaving only those things that are to be sent out in the urine. Control mechanisms can vary the amount of water, salt, and other substances that are left in the urine when it finally goes into the ureter and down to the bladder.