Chapter 26: The Urinary System BIO 211 Lecture Instructor: Dr. Gollwitzer 1 • Today in class we will discuss: – The interrelationship between the CVS and urinary system – The major functions of the urinary system • Excretion • Elimination • Homeostatic regulation – The basic principles of urine formation – Major functions of each portion of the nephron and collecting system – The 3 basic processes involved in urine formation • Glomerular filtration – Filtration pressures • Tubular reabsorption • Tubular secretion 2 CVS and Urinary System • CVS delivers nutrients (from digestive tract) and O2 (from lungs) to cells in peripheral tissues • CVS carries CO2 and waste products from peripheral tissues to sites of excretion – CO2 removed at lungs – Most physiological waste products removed by urinary system 3 Major Functions of Urinary System • Excretion • Elimination • Homeostatic regulation of: – Blood plasma volume – Solute concentration 4 Major Functions of Urinary System • Excretion – Removal of organic wastes (e.g., urea, uric acid, creatinine) from body fluids (= urine formation) – Performed by kidneys which act as filtering units • Elimination – Discharge of waste products into environment (urination) – Occurs when urinary bladder contracts and forces urine through urethra and out of body 5 Major Functions of Urinary System: Homeostatic Regulation • Regulation of blood volume (water balance) and BP – Adjusts volume of water lost in urine – Releases • Renin – Involved in production of angiotensin II that affects BP, thirst, and other hormones (ADH, aldosterone) that affect water retention by kidneys • Erythropoietin – Stimulates erythropoiesis in bone marrow, maintains RBC volume 6 Major Functions of Urinary System: Homeostatic Regulation • Regulation of plasma ion concentrations (electrolyte balance) – Controls amounts lost in urine (e.g., Na+, K+, Cl-) – Controls Ca2+ levels by synthesis of calcitriol • Reabsorption (conservation) of valuable nutrients – Recycles valuable nutrients • e.g., amino acids, glucose – Prevents excretion in urine 7 Major Functions of Urinary System: Homeostatic Regulation • Stabilization of blood pH (acid-base balance) – Controls loss of H+ and HCO3- in urine • Detoxification – Of poisons, e.g., drugs • Deamination – Removes NH2 (amino group) so amino acids can be metabolized 8 Basic Principles of Urine Formation • Urine = fluid containing: – Water – Ions – Soluble compounds • Goal of urine production – To maintain homeostasis – By regulating volume and composition of blood 9 Basic Principles of Urine Formation • Involves excretion of solutes (i.e., metabolic/organic waste products) – Urea • Most abundant • Produced by breakdown of amino acids – Creatinine • Generated in skeletal muscle by breakdown of creatine phosphate (CP, high energy compound that plays a role as energy source in muscle contraction) – Uric acid • Formed by recycling nitrogenous bases from RNA 10 Basic Principles of Urine Formation • Waste products dissolved in bloodstream can only be eliminated when dissolved in urine – Thus removal accompanied by unavoidable water loss • To avoid dehydration, kidneys concentrate filtrate (i.e., reabsorb water) produced by glomerular filtration 11 Functional Anatomy of Nephron and Collecting System Figure 26–6 12 3 Processes Involved in Urine Formation • Glomerular filtration – Forces water and solutes out of blood in glomerulus into capsular space – filtrate • Tubular reabsorption – Recovers useful materials from filtrate • Tubular secretion – Ejects waste products, toxins, and other undesirable solutes into tubules 13 Glomerular Filtration • Occurs in renal corpuscle • Hydrostatic pressure forces water and solutes: – Out of blood in glomerulus – Into capsular space filtrate • Occurs solely on basis of size – Small solute molecules carried with filtrate 14 Glomerular Filtration • Involves passage across filtration membrane which is composed of 3 cellular units – Glomerular capillary endothelium – Lamina densa – Filtration slits 15 Glomerular Filtration • Glomerular capillary endothelium – Filtered through pores in fenestrated capillaries – Least selective filter • Pores too small for RBCs to pass through • Large enough for plasma proteins 16 Renal Corpuscle Figure 26–8 17 Glomerular Filtration • Lamina densa – Basement membrane of glomerular capillaries – More selective filter • Blocks passage of large proteins • Only small polypeptides, nutrients, and ions can cross 18 Figure 26–10, 7th edition 19 Glomerular Filtration • Filtration slits – Gaps between pedicels of podocytes (visceral epithelium around glomerulus) – Finest filter • No polypeptides pass through • Only nutrients, ions into capsular space • Thus, glomerular filtrate: – Does not contain plasma proteins or polypeptides – Does contain small organic molecules (e.g., nutrients) and ions in same concentration as in plasma 20 Filtration Pressures • Filtration pressure = balance between: – Hydrostatic (fluid) pressures • Glomerular hydrostatic pressure (GHP) in capillaries (50 mmg Hg) • Capsular hydrostatic pressure (CHP) (15 mm Hg) – Blood osmotic pressure (BOP) (25 mm Hg) 21 Filtration Pressures • Hydrostatic (fluid) pressures – Glomerular hydrostatic pressure (GHP) (50 mm Hg) • = BP in glomerular capillaries • Higher in glomerulus than in peripheral capillaries (35 mm Hg) – Because efferent arteriole smaller in diameter than afferent arteriole, need higher BP to force blood into it • Promotes filtration – pushes water and solutes out of plasma in capillaries into filtrate • Opposed by… 22 Filtration Pressures • Hydrostatic (fluid) pressures – Capsular hydrostatic pressure (CHP) (15 mm Hg) • Opposes filtration – pushes water and solutes out of filtrate into plasma in capillaries • Results from resistance to flow along nephron and conducting system that causes water to collect in Bowman’s capsule • More water in capsule more pressure 23 Filtration Pressures • Blood osmotic pressure (BOP) (25 mm Hg) – Results from presence of suspended proteins in blood – Promotes return of water into glomerulus – Opposes filtration – Tends to draw water out of filtrate and into plasma 24 Figure 26–10, 7th edition 25 Summary of Filtration Pressures • Hydrostatic pressures – GHP (pushing out of glomerulus) = 50 mm Hg – CHP (pushing into glomerulus) = 15 mm Hg – Net = 35 mm Hg (pushing out of glomerulus) • Osmotic pressure – BOP (draws into glomerulus) = 25 mm Hg • Filtration pressure = 10 mm Hg – Difference between net hydrostatic pressure and blood osmotic pressure 26 Summary of Filtration Pressures • Problems that affect filtration pressure – Can seriously disrupt kidney function – Can cause a variety of clinical symptoms, e.g., • Drop in systolic pressure from 120 to < 110 mm Hg would eliminate filtration pressure (10 mm Hg) 27 • Today in class we will discuss: – The 3 basic processes involved in urine formation • Glomerular filtration – Glomerular Filtration Rate – Renal Failure • Tubular reabsorption – PCT, Loop of Henle & Countercurrent Exchange,DCT – Collecting System • Tubular secretion – PCT, DCT and Collecting system – Urine • Compare/contrast to plasma • General characteristics • Hormone influence of volume and concentration – Voluntary & involuntary regulation of urination and the micturition reflex 28 Glomerular Filtration Rate (GFR) • Gomerular filtration – Vital first step essential to all other kidney functions – Must occur so: • Waste products excreted • pH controlled • Blood volume maintained • GFR = amount of filtrate kidneys produce per minute • Avg GFR = 125 mL/min or 50 gal/day (out of 480 gallons of blood flow/day) – 10% of fluid delivered by renal arteries enters capsular spaces – 99% of this reabsorbed so urinate only 0.5 gallons/day 29 Glomerular Filtration Rate (GFR) • Measured using creatinine clearance test (CCT) – Breakdown of CP in muscle creatinine – Creatinine enters filtrate at glomerulus and is not reabsorbed so is excreted in urine – Can compare amount of creatinine in blood vs. in urine during 24 hour and estimate GFR – If glomerulus damaged, GFR will be altered (have more or less creatinine in urine than normal) 30 Glomerular Filtration Rate (GFR) • GFR depends on: – Adequate blood flow to glomerulus – Maintenance of normal filtration pressures • Affected by anything that reduces renal blood flow or BP, e.g., – Hypotension, hemorrhage, shock, dehydration • Decreased renal blood volume and/or BP decreased filtration pressure decreased GFR 31 Control of GFR • GFR increased by: – EPO (relatively minor) – Renin-angiotensin system – Natriuretic peptides (ANP and BNP) 32 Control of GFR • Decreased BP and/or blood volume – Decreased O2 JGA EPO • Increased RBCs – Increased O2 delivery – Increased blood volume increased BP » Increased filtration pressure » Increased GFR – Decreased renal blood flow JGA reninangiotensin system • Increased blood volume increased BP – Increased filtration pressure – Increased GFR 33 EPO and Renin Figure 18–19b 34 Renin-Angiotensin System • Renin (enzyme) (prohormone) angiotensinogen (hormone) angiotensin I (in liver) • Angiotensin I angiotensin II (in lung capillaries) • Angiotensin II increased blood volume and BP increased GFR 35 Primary Effects of Angiotensin II • Stimulates constriction of efferent arterioles increased glomerular pressure • Directly stimulates reabsorption of Na+ and H2O in DCT increased blood volume and BP • Stimulates adrenal cortex aldosterone reabsorption of Na+ (and H2O) increased blood volume and BP • Stimulates posterior pituitary ADH reabsorption of H2O increased blood volume and BP • Stimulates thirst increased blood volume and BP • Stimulates vasoconstriction of arterioles 36 Renin-Angiotensin System: Response to Reduction in GFR Figure 26–11-0 37 Control of GFR • Increased blood volume or BP stretched cardiac muscle cells natriuretic peptides – ANP = atrial NP – BNP = brain NP (produced by ventricles) • Natriuretic peptides – Increase GFR – Decrease blood volume and BP – Via 2 mechanisms 38 Natriuretic Peptides Increase GFR • Act opposite to angiotensin II – Increase Na+ and H2O loss • Inhibit renin release • Inhibit secretion of aldosterone and ADH – Suppress thirst – Prevent increased BP by angiotensin II and NE • Increase glomerular pressures – Dilate afferent arterioles – Constrict efferent arterioles • Also increase tubular reabsorption of Na+ – Decreases blood volume and BP 39 Renal Failure • When filtration (GFR) slows, urine production decreases • Symptoms appear because water, ions, and metabolic wastes retained rather than excreted • Almost all systems affected: fluid balance, pH, muscular contraction, neural function, digestive function, metabolism • Leads to: – Hypertension (due to blood “backing up”) – Anemia due to lack of erythropoietin production – CNS problems (sleepiness, seizures, delirium, coma, death) 40 Renal Failure • Acute renal failure – From exposure to toxic drugs, renal ischemia, urinary obstruction, trauma – Develops quickly, but usually temporary – With supportive treatment can survive • Chronic renal failure – Condition deteriorates gradually – Cannot be reversed – Dialysis or kidney transplant may prolong life 41 Reabsorption and Secretion • Occur in all segments of renal tubules • Relative importance changes from segment to segment 42 Tubular Reabsorption • Molecules move from filtrate across tubular epithelium into peritubular interstitial fluid and blood – Water, valuable solutes (e.g., nutrients, proteins, amino acids, glucose) • Occurs through diffusion, osmosis (H2O), active transport by carrier proteins • Occurs primarily along PCT (also along renal tubule and collecting system) 43 Tubular Secretion • Molecules move from peritubular fluid into tubular fluid • Lowers plasma concentration of undesirable materials • Necessary because filtration does not force all solutes out of plasma • Primary method of excretion for many drugs • Occurs primarily at PCT and DCT 44 Reabsorption and Secretion: PCT • Primarily reabsorption – 60-70% of filtrate – Includes: • Organic nutrients (99-100%), e.g., glucose, amino acids, proteins, lipids, vitamins • Water (60-70%) • Ions (60-70%), e.g., Na+, Cl-; also K+, Ca2+, HCO3- – Reabsorbed materials enter peritubular fluid and capillaries • Secretion – H+, NH4+, creatinine, drugs, toxins 45 Reabsorption: Loop of Henle • Reabsorption – Na+, Cl– Water • Accomplished by countercurrent exchange – Refers to exchange by tubular fluids moving in opposite directions – Fluid in descending limb flows toward renal pelvis – Fluid in ascending limb flows toward cortex 46 Countercurrent Exchange • Occurs because of different permeabilities of segments of LOH • Descending limb (thin) – Permeable to water – Relatively impermeable to solutes • Ascending limb (thick) – Relatively impermeable to water and solutes – Has active transport mechanisms • Pump Na+ and Cl- from tubular fluid into peritubular fluid 47 Countercurrent Exchange • Na+ and Cl- pumped out of thick ascending limb into peritubular fluid • Increases osmotic concentration in peritubular fluid around thin descending limb • Results in osmotic flow of H2O out of thin descending limb into peritubular fluid increased solute concentration in thin descending limb • Arrival of concentrated solution in thick ascending limb increases transport of Na+ and Cl- into peritubular fluid 48 Overview of Urine Formation Figure 26–16 49 Reabsorption and Secretion: DCT • Reabsorption (by vasa recta) – Na+ (under influence of aldosterone), Cl– Ca2+(under influence of PTH and calcitriol) – H2O (under influence of ADH) • Secretion – K+ (in exchange for Na+), H+ – NH4+ (from deamination; produces lactic acid, ketone bodies acidosis) – Creatinine, drugs, toxins 50 Reabsorption and Secretion: Collecting System • Makes final adjustments to ion concentration and urine volume • Reabsorption – Na+ (under influence of aldosterone) – H2O (under influence of ADH) – HCO3- – Urea (distal portion) • Secretion – K+, H+ 51 Figure 26–15 52 Summary: Urine Formation • Involves all parts of nephron and collecting system • Processes occur primarily in certain areas – Glomerular filtration at the renal corpuscle – Nutrient reabsorption in the PCT – Water and salt conservation in loop of Henle – Tubular secretion in the DCT • Regulation of final volume and solute concentration occurs in loops of Henle and collecting system 53 Normal Kidney Function • Continues as long as filtration, reabsorption, and secretion function within narrow limits • Disruption of kidney function has immediate effects on composition of circulating blood • If both kidneys affected, death occurs within few days 54 Normal Kidney Function • Glomeruli produce approx 48 gallons (180 L) of filtrate/day – 70X plasma volume! • Almost all fluid volume must be reabsorbed to avoid fatal dehydration 55 Urine • Clear, sterile solution • Yellow (“straw”) color due to pigment (urobilin) • Urinalysis = analysis of urine sample • Results from filtration, absorption, secretion activities of nephron 56 Table 26–5 57 Urine vs. Plasma • Little to no metabolites and nutrients (glucose, lipids, amino acids, proteins) • Slightly increased Na+, greatly increased K+ and Cl-, and greatly decreased HCO3• Very high levels of nitrogenous wastes (creatinine, urea, ammonia, uric acid) • Lower pH (6.0 vs. 7.4) • Much greater water content (95% vs. 50%) 58 Table 26–2 59 Diuresis • Elimination of urine • Usually used to indicate production large volumes of urine • Diuretics – Drugs that promote water loss in urine – Reduce • Blood volume • Blood pressure • Extracellular fluid volume 60 Micturition Reflex • Coordinates the process of urination • Begins when stretch receptors in bladder stimulate parasympathetic neurons – Results in contraction of detrusor muscle contraction • Voluntary relaxation of external urethral sphincter causes relaxation of internal urethral sphincter 61 Micturition Reflex Figure 26–20 62 Voluntary Control • Infants – Lack voluntary control over urination – Corticospinal connections are not established • Incontinence = – Inability to voluntarily control urination – May be caused by trauma to internal or external urethral sphincter 63 Age-Related Changes in Urinary System • Decline in number of functional nephrons • Reduction in GFR • Reduced sensitivity to ADH 64 Age-Related Changes in Urinary System • Problems with micturition reflex – Sphincter muscles lose tone incontinence – Lose control due to: • Stroke • Alzheimer’s disease • CNS problems – In males, enlarged prostate compresses urethra, restricts urine flow urinary retention 65 The Excretory System • Includes all systems with excretory functions that affect body fluids composition – Urinary system – Integumentary system – Respiratory system – Digestive system 66