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Chapter8ExcretionoftheKidneysGrossAnatomyoftheKidneyMajorFunctionsoftheKidneys1.Regulationof:bodyfluidosmolarityandvolumeelectrolytebalanceacid-basebalancebloodpressure2.Excretionofmetabolicproductsforeignsubstances(pesticides,chemicalsetc.)excesssubstance(water,etc)3.Secretionoferythropoitin1,25-dihydroxyvitaminD3(vitaminDactivation)reninprostaglandinSection1CharacteristicsofRenalStructureandFunctionPhysiologicalAnatomyoftheKidneyNephronandCollectingDuctCorticalnephronAnatomyofKidneyRenaltubulesandcollectingduct2.Thejuxtaglomerularapparatus3.BloodSupplytotheKidneyBloodSupplytotheKidneyRenalBloodFlow(RBF)Characteristicsoftherenalbloodflow:1,highbloodflow.1200ml/min,or21percentofthecardiacoutput.94%tothecortex2,TwocapillarybedsHighhydrostaticpressureinglomerularcapillary(about60mmHg)andlowhydrostaticpressureinperitubularcapillaries(about13mmHg)BloodflowinkidneysandotherorgansSection2FunctionofGlomerularFiltrationFunctionsoftheNephronRenaltubulesandcollectingductHUMANRENALPHYSIOLOGYHUMANRENALPHYSIOLOGYHUMANRENALPHYSIOLOGYHUMANRENALPHYSIOLOGYHUMANRENALPHYSIOLOGYGlomerularFiltrationFactorsthatdeterminingtheglumerularfilterabilityMolecularweightChargesofthemoleculeFiltrationMembraneStantonBA&KoeppenBM:‘TheKidney’inPhysiology,Ed.Berne&Levy,Mosby,1998Proteinfiltration:ConstituentStarlingForcesInvolvedinFiltration:GlomerularfiltrationGlomerularFiltrationAmountoffiltrateproducedinthekidneyseachminute.125mL/min=180L/dayFactorsthatalterfiltrationpressurechangeGFR.Theseinclude:Increasedrenalbloodflow--IncreasedGFRDecreasedplasmaprotein--IncreasedGFR.Causesedema.Hemorrhage--DecreasedcapillaryBP--DecreasedGFRGFRregulation:Adjustingbloodflow1.RenalautoregulationUrine(6ml/min)Mechanism?BloodFlow=CapillaryPressure/Flowresistance29342.NeuralregulationofGFR3.HormonalregulationofGFRMeasuringGFRRenalhandlingofinulinQualitiesofagentstomeasureGFRCreatinine:EndproductofmusclecreatinemetabolismUsedinclinicalsettingtomeasureGFRbutlessaccuratethaninulinmethod
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