Urinary System. Dr. ZHANG Xiong. Dept. of Physiology. ZJU School of Medicine. QUESTION 6
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1 Urinary System Dr. ZHANG Xiong Dept. of Physiology ZJU School of Medicine Xiong Zhang QUESTION 6 How is the filtrate reabsorbed in tubular system? Copyright@ Xiong Zhang 1
2 Xiong Zhang Composition of plasma: Water, proteins, glucose, amino acids, electrolytes (Na +, K +, Ca 2+, Cl -, HCO 3-, Pi), urea and uric acids Composition of renal filtrate in proximal tubules: Water, glucose, amino acids, electrolytes (Na +, K +, Ca 2+, Cl -, HCO 3-, Pi), urea and uric acids Composition of Urine: Water, electrolytes (Na +, K +, Ca 2+, Cl -, HCO 3-, Pi), urea and uric acids Copyright@ Xiong Zhang 2
3 Ways with which the kidney reabsorbs a substance Pathways which the substances are reabsorbed Paracellular path Transcellular path Active reabsorption Passive reabsorption 3
4 Reabsorption in proximal tubule: Na +, glucose, Amino Acids, bicarbonate, Cl -, water. Reabsorption in thin Henle s loop: Only water is allowed to reabsorbed in thin descending limb and Na + is reabsorbed in thin ascending limb. Reabsorption in thick ascending limb of Henle s loop: Na +, K +, Cl - (in the ratio 1:1:2) are actively transported by Na + /K + /Cl - cotransporter. Reabsorption in distal convoluted tubule and collecting duct: Reabsorption of Na + is regulated by aldosterone. Reabsorption of water is regulated by antidiuretic hormone(adh). 4
5 Reabsorption of sodium ion and nutrients Co-transport: Na + glucose and Na + amino acids symport Renal threshold for glucose diabetes mellitus Counter-transport: Na + H + antiport 5
6 Reabsorption of bicarbonate It is important to keep acid-base balance. Peritubular capillary Reabsorption of water diffuse through tight junction between the adjacent tubule cells 6
7 Reabsorption of Chloride Ion Passive reabsorption: With water is reabsorbed, the concentration of Cl - in filtrate is increased and produces a concentration-drived diffusion. More Na + than substances with negative charge is reabsorbed and produced a potential-drived diffusion. The main pathway is paracellular pathway. Reabsorption in proximal tubule: Na +, glucose, Amino Acids, bicarbonate, Cl -, water. Reabsorption in thin Henle s loop: Only water is allowed to reabsorbed in thin descending limb and Na + is reabsorbed in thin ascending limb. Reabsorption in thick ascending limb of Henle s loop: Na +, K +, Cl - (in the ratio 1:1:2) are actively transported by Na + /K + /Cl - cotransporter. Reabsorption in distal convoluted tubule and collecting duct: Reabsorption of Na + is regulated by aldosterone. Reabsorption of water is regulated by antidiuretic hormone(adh). 7
8 Substances Reabsorption in Henle s loop 8
9 Reabsorption in proximal tubule: Na +, glucose, Amino Acids, bicarbonate, Cl -, water. Reabsorption in thin Henle s loop: Only water is allowed to reabsorbed in thin descending limb and Na + is reabsorbed in thin ascending limb. Reabsorption in thick ascending limb of Henle s loop: Na +, K +, Cl - (in the ratio 1:1:2) are actively transported by Na + /K + /Cl - cotransporter. Reabsorption in distal convoluted tubule and collecting duct: Reabsorption of Na + is regulated by aldosterone. Reabsorption of water is regulated by antidiuretic hormone(adh). Substances Reabsorption in distal convoluted tubule 9
10 QUESTION 7 How to keep acid-base balance in body by kidney? Copyright@ Xiong Zhang Our body is an acid producer 1. Volatile acid CO 2 + H 2 O = H 2 CO 3 ~ 10,000mM of H + 2. Non-volatile or fixed acid mm H + H 3 PO 4 - breakdown product of phosphoprotein, phospholipid, phosphoglyceride H 2 SO 4 - breakdown product of methionine and cysteine Copyright@ Xiong Zhang 10
11 Conseqences of acid-base imbalance Acidosis (ph < 7.35) : depression of CNS disorientation coma death Alkalosis (ph > 7.45) : hyper-excitability of nerve and muscle convulsions tetany Copyright@ Xiong Zhang Responses to acid-base disturbance 1. Buffer system in blood plasma H + + HCO 3- = H 2 CO 3 The most important buffer in the body 2. Respiratory defense 3. Renal defense Secretion of H + and Reabsorption of HCO 3 - Secretion of NH 3 and Production of NH 4 + Secretion of H + and HPO 4 2- / H 2 PO 4- buffer Copyright@ Xiong Zhang 11
12 Secretion of H + and Reabsorption of HCO 3 - Na + H + exchanger in proximal and distal tubule Intercalated cell in late distal and collecting tubules: H + -ATPase Secretion of NH 3 and Production of NH 4 + Proximal tubule Distal tubule Glutamine 12
13 Acidosis and hyperkalaemia In the distal tubule: Secretion of K + by Na + K + exchange is compete with secretion of H +. Acidosis enhances the secretion of H + and inhibits secretion of K +, to cause hyperkalaemia. H + Secretion of H + and HPO 4 2- / H 2 PO 4- buffer 13
14 Tubular Secretion of Other Substances Para-aminohippuric acid (PAH) Some foreign substances, such as penicillin and phenol red. 14
15 References 1. Guyton and Hall Textbook of Medical Physiology 10th Edition 2. Datta, Mirpuri and Patel Crash Course Renal and urinary Systems, 2nd edition 3. Vander s Human Physiology 10 th Edition Thank you! 15
Dept. of Physiology. ZJU School of Medicine.
Urinary System Dr. ZHANG Xiong Dept. of Physiology ZJU School of Medicine Http://10.10.10.151/Able.Acc2.Web/Template/View.aspx?action =view&coursetype=0&courseid=26519 QUESTION 6 How is the filtrate reabsorbed
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