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Chapter 19b Chapter 19b

Chapter 19b - PowerPoint Presentation

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Chapter 19b - PPT Presentation

The Kidneys Reabsorption Principles governing the tubular reabsorption of solutes and water Figure 1911 Na is reabsorbed by active transport Electrochemical gradient drives anion reabsorption ID: 380425

inulin 100 reabsorption min 100 inulin min reabsorption clearance plasma figure gfr excretion filtration reabsorbed filtrate fluid key glucose

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Slide1

Chapter 19b

The KidneysSlide2

Reabsorption

Principles governing the tubular reabsorption of solutes and water

Figure 19-11

Na

+

is reabsorbed by active transport.

Electrochemical gradient drives anion

reabsorption.

Water moves by osmosis, followingsolute reabsorption.

Concentrations of other solutesincrease as fluid volume in lumendecreases. Permeable solutes arereabsorbed by diffusion.

Na+

Anions

H2O

K+, Ca2+,urea

Tubularepithelium

Extracellular fluid

Tubule lumen

Filtrate is similar tointerstitial fluid.

1

2

3

4

1

2

3

4Slide3

Reabsorption

Transepithelial

transport

Substances cross both apical (lumen side) and basolateral membraneParacellular pathwaySubstances pass through the junction between two adjacent cellsSlide4

Reabsorption

Figure 19-12

[Na

+

] high

[Na

+

] high

[Na+] low

K+Na+

ATP

Proximal tubule cell

Interstitialfluid

TubulelumenNa+ reabsorbed

Na+ enters cell through membrane proteins,moving down its electrochemical gradient.

Na+ is pumped out the basolateral side

of cell by the Na+-K+-ATPase.

ATP

= Active transporter

= Membrane proteinKEY

Na

+Filtrate is similar to

interstitial fluid.

1

2

1

2

Sodium reabsorption in the proximal tubule Slide5

Reabsorption

Sodium-linked glucose reabsorption in the proximal tubule

Figure 19-13

= SGLT secondary active transporter

= GLUT facilitated diffusion carrier

[Na

+

] high

[glu] low

Na+Na+

[Na+] high

[glu] low

glu

glu[Na+] low[glu] high

K+

ATPGlucose and Na+

reabsorbed

+Na+

moving down its electrochemical gradientusing the SGLT protein pulls glucose into thecell against its concentration gradient.

Glucose diffuses out the basolateral side ofthe cell using the GLUT protein.

Na+

is pumped out by Na+-K+-ATPase.

Proximal tubule cell

Interstitial fluid

Tubule lumen

ATP

= Active transporter

KEY

Filtrate is similar to

interstitial fluid.

1

2

3

1

2

3Slide6

Reabsorption

Urea

Passive reabsorption

Plasma proteins

TranscytosisSlide7

Reabsorption

Saturation of mediated transport

Figure 19-14

Renal threshold is

plasma concentration

at which saturation

occurs.

Transport maximum (T

m) is transportrate at saturation.

Saturation occurs.Plasma [substrate] (mg/mL)

Transport rate of substrate (mg/min)Slide8

Reabsorption

Glucose handling by the nephron

Figure 19-15aSlide9

Reabsorption

Figure 19-15bSlide10

Reabsorption

Figure 19-15cSlide11

Reabsorption

Figure 19-15dSlide12

Secretion

Transfer of molecules from extracellular fluid into lumen of the nephron

Active process

Important in homeostatic regulation

K+ and H+Increasing secretion enhances nephron excretionA competitive process

Penicillin and probenecidSlide13

Excretion

Excretion = filtration – reabsorption + secretion

Clearance

Rate at which a solute disappears from the body by excretion or by metabolism

Non-invasive way to measure GFRInulin and creatinine used to measure GFRSlide14

Inulin Clearance

Inulin clearance is equal to GFR

Figure 19-16

Glomerulus

Peritubular

capillaries

Afferent

arteriole

Efferent

arteriole

Nephron

Filtration

(100 mL/min)

= 100 mL of

plasma or filtrate

Inulin concentration

is 4/100 mL.

GFR = 100 mL /min

100 mL plasma is

reabsorbed. No inulin

is reabsorbed.

100% of inulin is

excreted so inulin

clearance = 100 mL/min.

Inulin

molecules

100 mL,

0% inulin

reabsorbed

Inulin clearance

= 100 mL/min

100% inulin

excreted

KEY

1

2

3

4

1

2

3

4Slide15

Inulin Clearance

Figure 19-16, steps 1–4

Glomerulus

Peritubular

capillaries

Afferent

arteriole

Efferent

arteriole

Nephron

Filtration

(100 mL/min)

= 100 mL of

plasma or filtrate

Inulin concentration

is 4/100 mL.

GFR = 100 mL /min

100 mL plasma is

reabsorbed. No inulin

is reabsorbed.

100% of inulin is

excreted so inulin

clearance = 100 mL/min.

Inulinmolecules

100 mL,

0% inulin

reabsorbed

Inulin clearance

= 100 mL/min

100% inulin

excreted

KEY

1

2

3

4

1

2

3

4Slide16

GFR

Filtered load of X = [X]

plasma

 GFRFiltered load of inulin = excretion rate of inulinGFR = excretion rate of inulin/[inulin]plasma = inulin clearanceGFR = inulin clearanceSlide17

Excretion

Table 19-2Slide18

Filtration

(100 mL/min)

Glucose

molecules

100 mL,

100% glucose

reabsorbed

Glucose

clearance

= 0 mL/min

(a) Glucose clearance

No glucoseexcreted

Plasma concentrationis 4/100 mL.

GFR = 100 mL /min100 mL plasma is

reabsorbed.Clearance depends onrenal handling of solute.

KEY

= 100 mL ofplasma or filtrate

1

2

34

1

2

3

4Excretion

The relationship between clearance and excretion Figure 19-17aSlide19

Excretion

Figure 19-17b

(b) Urea clearance

Plasma concentration

is 4/100 mL.

GFR = 100 mL /min

100 mL plasma is

reabsorbed.

Clearance depends on

renal handling of solute.

KEY

Filtration

(100 mL/min)

Ureamolecules

100 mL,50% of ureareabsorbed

50% of ureaexcreted

Ureaclearance = 50 mL/min

= 100 mL ofplasma or filtrate

1

2

3

4

1

2

3

4Slide20

Excretion

Figure 19-17c

(c) Penicillin clearance

Plasma concentration

is 4/100 mL.

GFR = 100 mL /min

100 mL plasma is

reabsorbed.

Clearance depends on

renal handling of solute.

KEY

Filtration

(100 mL/min)

100 mL,0 penicillinreabsorbed

Someadditionalpenicillinsecreted.

Penicillinclearance =150 mL/min

More penicillinis excreted than

was filtered.Penicillin

molecules

= 100 mL ofplasma or filtrate

1

2

3

4

1

2

3

4Slide21

Gout

Limit animal protein.

Avoid or severely limit high-

purine

foods, including organ meats, such as liver, and herring, anchovies and mackerel. Red meat (beef, pork and lamb), fatty fish and seafood (tuna, shrimp, lobster and scallops) are associated with increased risk of gout. Because all animal protein contains purines, limit your intake.

Eat more plant-based proteins. You can increase your protein by including more plant-based sources, such as beans and legumes. This switch will also help you cut down on saturated fats, which may indirectly contribute to obesity and gout.

Limit or avoid alcohol. Alcohol interferes with the elimination of uric acid from your body. Drinking beer, in particular, has been linked to gout attacksSlide22

Micturition

The storage of urine and the

micturition

reflex

Figure 19-18a

Bladder

(smooth muscle)

Internal sphincter (smooth

muscle)

passively contracted

External sphincter (skeletal muscle) stays contracted

(a) Bladder at rest

Tonicdischarge

Relaxed(filling)state

HigherCNSinputIncontinenceSlide23

Micturition

Figure 19-18b

Stretch receptors fire.

Parasympathetic neurons fire.

Motor neurons stop firing.

Smooth muscle contracts.

Internal sphincter passively

pulled open. External sphincter

relaxes.

(b) Micturition

Internal sphincter

External sphincter

Tonic

discharge

inhibited

Higher CNSinput mayfacilitate orinhibit reflex

Sensory neuron

Parasympatheticneuron

Motor neuron

Stretchreceptors

1

2

3

1

2

3

2

3Slide24

Summary

Functions of the kidneys

Anatomy

Kidney, nephron, cortex, and medulla

Renal blood flow and fluid flow from glomerulus to renal pelvisOverview of kidney functionFiltrationPodocytes, filtration slits, and mesangial cellsFiltration fraction, GFR, and regulation of GFRSlide25

Summary

Reabsorption

How solutes are transported

Transport maximum and renal threshold

SecretionExcretionClearance, inulin, and creatinineMicturition