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UNITV

TextbookofMedicalPhysiology,11thEdition

Chapter27:
UrineFormationbytheKidneys:
II.TubularProcessingoftheGlomerularFiltrate
Slides by John E. Hall, Ph.D.

GUYTON & HALL


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Basic Mechanisms
of Urine Formation

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Figure 26-8;
Guyton and Hall

Calculation of
Tubular Reabsorption
(when Excret s < Filt s)
Reabsorption = Filtration -Excretion
Filt s = GFR x Ps
(Ps = Plasma conc of s)

Excret s = Us x V
Us = Urine conc of s
V = urine flow rate
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Calculation of
Tubular Secretion
(when Excret s > Filt s)
Secretion = Excretion - Filtration
Filt s = GFR x Ps

Excret s = Us x V
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Example: Given the following data, calculate the rate


of Na+ filtration, excretion, reabsorption, and secretion
GFR =100 ml/min;
PNa = 140 mEq/L
urine flow = 1 ml/min;
urine Na conc = 100 mEq/L
Filtration Na+ = GFR x PNa
= 0.1 L/min x 140 mEq/L = 14 mEq/min
Excretion Na+ = Urine flow rate x Urine Na conc
=.001 L/min x 100 mEq/L
= 0.1 mEq/min
Copyright2006byElsevier,Inc.

Example: Given the following data, calculate the rate


of Na+ filtration, excretion, reabsorption, and secretion.
GFR =100 ml/min;
PNa = 140 mEq/L
urine flow = 1 ml/min;
urine Na conc = 100 mEq/L
Filtration Na = 0.1 L/min x 140 mEq/L = 14 mEq/min
Excretion Na = .001 L/min x 100 mEq/L = 0.1 mEq/min
Reabsorption Na+ = Filtration Na - Excretion Na
= 14.0 - 0.1 = 13.9 mEq/min
Secretion Na+ =
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There is no net secretion of Na since


Excret Na < Filt Na

Tubular Reabsorption

Figure 27-1;
Guyton and Hall
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Primary Active Transport of Na+

Figure 27-2;
Guyton and Hall
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Mechanismsof
Secondary
ActiveTransport

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Figure 27-3;
Guyton and Hall

GlucoseTransport
Maximum

Figure 27-4;
Guyton and Hall
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TransportMaximum
Some substances have a maximum rate of tubular transport
due to saturation of carriers, limited ATP, etc.
Transport Maximum: Once the transport maximum is
reached for all nephrons, further increases in tubular
load are not reabsorbed and are excreted.
Threshold is the tubular load at which transport maximum is
exceeded in some nephrons. This is not exactly the same
as the transport maximum of the whole kidney because
some nephrons have lower transport maxs than others.
Examples: glucose, amino acids, phosphate, sulphate
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A uninephrectomized patient with uncontrolled diabetes has a


GFR of 90 ml/min, a plasma glucose of 200 mg/dl (2mg/ml), and
a transport max (Tm) shown in the figure. What is the glucose
excretion for this patient?
250
200
Reabsorbed

150

(mg/min)

Glucose

a. 0 mg/min
b. 30 mg/min
c. 60 mg/min
d. 90 mg/min
e. 120 mg/min

Transport
Maximum
(150 mg/min)

100

Excreted
.

50

Threshold

0
50 100
150 200 250 300
Filtered Load of Glucose
350

(mg/min)

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Answer: Filt Glu =(GFR x PGlu) = (90 x 2) = 180 mg/min


Reabs Glu = Tmax = 150 mg/min
Excret Glu = 30 mg/min
250

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Copyright2006byElsevier,Inc.

Reabsorbed

150

(mg/min)

a. 0 mg/min
b. 30 mg/min
c. 60 mg/min
d. 90 mg/min
e. 120 mg/min

200

Glucose

GFR = 90 ml/min
PGlu = 2 mg/ml
Tmax = 150 mg/min

Transport
Maximum
(150 mg/min)

100

Excreted
.

Threshold

50
0
50

100

150

200

250

300

Filtered Load of Glucose


(mg/min)

350

Reasorption of Water and Solutes is


Coupled to Na+ Reabsorption
Tubular
Cells

Interstitial
Fluid

- 70 mV
Na +

K+

ATP

Na +
ATP

0 mv
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Copyright2006byElsevier,Inc.

K+

Tubular
Lumen

H+
Na +
glucose, amino
Na + acids
Urea
H20
Na +

Cl-

- 3 mV

MechanismsbywhichWater,Chloride,
andUreaReabsorptionareCoupledwith
SodiumReabsorption

Figure 27-5;
Guyton and Hall
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CellularUltrastructureandPrimary
TransportCharacteristicsofProximal
Tubule

Figure 27-6; Guyton and Hall


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