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TextbookofMedicalPhysiology,11thEdition
Chapter27:
UrineFormationbytheKidneys:
II.TubularProcessingoftheGlomerularFiltrate
Slides by John E. Hall, Ph.D.
Basic Mechanisms
of Urine Formation
Copyright2006byElsevier,Inc.
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
Copyright2006byElsevier,Inc.
Calculation of
Tubular Secretion
(when Excret s > Filt s)
Secretion = Excretion - Filtration
Filt s = GFR x Ps
Excret s = Us x V
Copyright2006byElsevier,Inc.
Tubular Reabsorption
Figure 27-1;
Guyton and Hall
Copyright2006byElsevier,Inc.
Figure 27-2;
Guyton and Hall
Copyright2006byElsevier,Inc.
Mechanismsof
Secondary
ActiveTransport
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Figure 27-3;
Guyton and Hall
GlucoseTransport
Maximum
Figure 27-4;
Guyton and Hall
Copyright2006byElsevier,Inc.
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
Copyright2006byElsevier,Inc.
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)
Copyright2006byElsevier,Inc.
Copyright2006byElsevier,Inc.
Copyright2006byElsevier,Inc.
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
350
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
Copyright2006byElsevier,Inc.
CellularUltrastructureandPrimary
TransportCharacteristicsofProximal
Tubule