Anatomy of the Kidney,

GFR and RBF

Learning Objectives
Know the basic anatomy of the kidney and nephron.
Know how urine is transported to the bladder and
the process of micturition.
Understand the relationship between filtration,
reabsorption, secretion and excretion.
Understand the determinates of the glomerular
filtration rate (GFR).
Know how afferent and efferent arteriolar
resistances influence GFR and RBF.
Know how the juxtamedullary complex
autoregulates GFR and RBF.

Functions of the Kidneys

Excrete metabolic waste products, foreign
chemicals, drugs and hormone metabolites.
Regulate H2O and electrolyte balances.
Regulate arterial pressure.
Regulate acid-base balance.
Release erythropoietin for erythrocyte
production.
Produce vitamin D important in Ca 2+
regulation.
Regulate glucose synthesis.

Gross Anatomy of the

Kidney

Renal Anatomy

Nephron Anatomy

Anatomy of the Urinary

Bladder

Transport of
Urine from
Kidney to
Bladder
Stretching of the renal
calyces induces peristaltic
contractions that spread
down the ureter and force
urine into the bladder.
The ureter is constricted
at the entrance to the
bladder due to the basal
tone of the detrusor
muscle. The constriction
prevents backflow of urine.
Peristaltic contractions in
the ureter are enhanced
by parasympathetic
stimulation and inhibited
by sympathetic
stimulation.

Micturition
Micturition is the process of emptying
the urinary bladder.
- As the bladder fills, stretch receptors
initiate the micturition reflex. This
causes contraction of the bladder,
whose strength progressively increases.
- Once the micturition reflex is stronger
than the voluntary control of the
external sphincter, urination occurs.

Innervation and
Anatomy of the
Urinary Bladder
Pelvic Nerves
Sensory nerves detect the
degree of stretch in the
bladder wall.
Parasympathetic motor
nerves then cause
contraction of the bladder.
Somatic nerves
(pedendal) that control the
voluntary skeletal muscle
of the external sphincter.
Sympathetic nerves
stimulate the bladder neck
and external sphincter
during filling (contraction).
This is inhibited during
micturition.

Micturition Reflex

As pressure rises, stretch

receptors begin to induce
contractions via the
parasympathetic nerves.
As the bladder fills, this
reflex become more
frequent and stronger.
When the bladder
contains a lot of urine, a
signal is also sent that
inhibits the pedendal
nerves.
If this last signal is more
powerful than voluntary
constriction of the
external sphincter,
urination occurs.

Voluntary Urination
Contract abdominal muscles to
increase pressure in bladder.
This excites the micturition reflex and
inhibits the external sphincter.

Factors of Urine Formation

Renal Handling
of Some
Substances
A. Waste products
such as creatine.
B. Many
electrolytes.
C. Nutritional
substances, such
as glucose and
amino acids.
D. Organic acids
and bases, some
foreign
compounds and
some drugs.

Purpose of Reabsorption
Why filter, then reabsorb?
- Control
- High filtration rate makes it easy to
remove waste products.
- Reabsorption allows control of the
bodys electrolyte balance.

Volume of Filtered Plasma

~20% of plasma flowing through a
glomerular capillary is filtered.
In the average adult human, the
glomerular filtration rate (GFR) for
the kidney is 125 ml/min, or 180
L/day.
Entire plasma volume is ~3 L; so the
entire plasma can be filtered ~60
times/day.

Glomerular
Capillary
Membrane
Similar to fluid
flow at other
capillaries except,
that the pores are
larger.
Negative charge
on the 3 layers of
the capillary wall
keep negatively
charged albumin
from being
filtered.

Determinants of GFR
As we discussed with other capillaries:
- Glomerular hydrostatic pressure (PG).
- Bowmans capsule hydrostatic pressure (P B).
- Glomerular colloid osmotic pressure (PGC).
- Bowmans capsule colloid osmotic pressure (PBC).

In addition,
- Glomerular capillary filtration coefficient (K f).
- Kf is the product of the hydraulic conductivity and
the surface area.

GFR Kf(PG PB PGC + PBC)

- PBC is normally considered to be 0.

Net Filtration Pressure

(excludes Kf)

Capillary Filtration
Coefficient
Kf is the product of the hydraulic
conductivity and the surface area.
- Hydraulic conductivity is the ease at
which H2O flows through.

Kf is not measured directly, but

calculated from Kf = GFR/Net
filtration pressure
Kf does not normally change
ITS A CONSTANT!!

Bowmans Capsule Hydrostatic

Pressure
Increases would decrease GFR.
Normally not changed.
Obstructing urinary outflow can
increase the hydrostatic pressure in
Bowmans capsule, as may occur
with kidney stones.

Glomerular Capillary
Osmotic Pressure
PG changes during flow
through glomerular
capillary.
PG is increased by
increasing filtration
fraction and arterial
osmotic pressure.
Filtration fraction is
GFR/renal plasma flow.
Increased renal plasma
flow decreases the
filtration fraction. This
causes a slower rise in
the PG.
With a constant PG, an
increase of BF into the
glomerulus tends to
increase GFR and viceversa.

Glomerular Capillary Hydrostatic

Pressure
Primary mechanism for physiological
regulation of GFR, with increase in
glomerular hydrostatic pressure,
causing an increase in GFR.
3 variables influencing glomerular
hydrostatic pressure:
1. Arterial pressure; however, this is buffered by
autoregulation (more later).
2. Afferent arteriolar resistance.
3. Efferent arteriolar resistance.

Anatomy Reminder

Changing Afferent and

Efferent Arterioles

Renal Blood Flow

RBF exceeds the kidneys metabolic
need, because of the need to filter
the plasma.
RBF is determined with Ohms Law,
which you already know.
Autoregulation keeps GFR and RBF,
particularly GFR, fairly constant
during changes in arterial pressure.

Sympathetic and Humoral Control of

GFR and RBF
Sympathetic nervous system constricts
the vessels. Little influence at moderate
stimulation. Important during severe
stimulation, such as brain ischemia.
Norepinephrine and epinephrine same
as above.
NO provides a basal level of vasodilation.
Angiotensin II constricts the efferent
arteriole (more next lecture).

Autoregulation of GFR and RBF

What if GFR Increased with Arterial

Pressure?

GFR does not increase proportionally with arterial pressure

(autoregulation) and reabsorption does increase with GFR .

Autoregulation
There is a feedback mechanism that
ensures a constant delivery of NaCl
to the distal tubule.
This feedback mechanism, called
tubuloglomerular feedback, is
mediated by the macula densa in the
juxtaglomerular complex.

Juxtaglomerular Complex