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Excretion is the process of removing metabolic waste from the body which is no longer needed by
the body. Some toxic metabolic substances (poisons) for the body include waste nitrogen. This
nitrogen is produced when food is transformed into energy. The nitrogen product is ammonia
which is very toxic. Some animals convert ammonia to urea or uric acid which is less toxic before
being removed from the body (Dahelmi, 1991). The predominant function of the kidney is
excretion, which is broadly defined as the removal of materials from the body. The broad category
of excretion can be subdivided into several more well-defined physiological processes including
nitrogenous waste elimination, ionic and osmotic regulation, acid–base balance, and the control of
extracellular fluid volume (Martinez, 2017).
The excretion system consists of kidneys, ureters, bladder and urethra by producing urine
which carries various metabolic waste products to be disposed of. The kidneys also function in
regulating the body's fluid and electrolyte balance and are the disposal sites for rennin and
erythropitin. Renin plays a role in regulating blood pressure and erythropitin plays a role in
stimulating the production of red blood cells. Urine is also produced by the kidneys running
through the ureter to the bladder through the urethra (Juncquiera, 1997).
The kidneys are important organs that perform various functions to keep blood clean and
chemically balanced. The kidneys are composed of the skin of the kidneys (cortex), kidney marrow
(medulla), and kidney cavity (pelvis). The kidneys are shaped like red bean seeds. It is about 10
cm long, weighs approximately 170 grams, and is located in the abdominal cavity. The kidneys
are 2 pieces and are purplish red. The left kidney is higher than the right kidney. Nephrons are
found in the skin of the kidneys and function as a blood filter. The cortex contains approximately
one million nephrons. Each nephron is composed of a malphighi body and a long (tubular) winding
channel. The malpighi body is composed of the glomerulus and Bowman's capsule. Glomerulus is
a strand of capillary blood where blood is filtered. Glomerulus is surrounded by capsules of
Bowman (Poedjiadi, 2009). The nephron is the functional unit of kidney and greatly varies in its
structure amongst different vertebrates; also the formation of nephrons shows a variable degree of
differences among species. In birds, the kidney has two kinds of nephrons; one is reptilian type
and small sized, without loops of Henle, and other is mammalian type large in size with long or
intermediate length loops. In contrast, the morphological process of podocytes development has
been reported in the classic kidney of human, horse, goat, monkey, rabbit, cat, dog, chicken,
medaka fish, rat and guinea pig indicating that, it would be a good model system for studying renal
regeneration (Maurya et al., 2018).
The kidneys play a role important in removing substances toxic or poison, maintain fluid
and other substances balance inside the body. The kidneys emit metabolic waste products from
urea, creatinine and ammonia (Aditya et al., 2018). The kidneys serve essential functions, such as
filtration and excretion of metabolic waste products from the bloodstream, regulation of necessary
electrolytes and stimulation of red blood cell production. They also serve to regulate blood pressure
by the use of a renin-angiotensin-aldosterone system, controlling reabsorption of water,
maintaining the correct pH level as well as chemical balance and intravascular fluid status of the
body. The kidneys also reabsorb glucose and amino acids which may have involved in regulation
of hormonal functions via erythropoietin, calcitriol, and vitamin D activation (Maurya et al., 2018).

Diskusi

Based on the observations that we made, it was found that with glucose solution, starch, protein,
and aquades, results were obtained in glucose solution (control) before filtration of intense color intensity
(++), while after filration (treated) the intensity of the color was very thick (+++) The protein solution
before filtration of the color intensity is more concentrated (+++) while after filration (given treatment)
the color intensity is thick (++). In amlium solution before filtration (control) the intensity of the color is
very thick (+++), while after filtration the intensity of the color does not change (-). The solution of distilled
color intensity before filtration shows low color changing (+) while after filtration the intensity of the color
becomes very thick (+++). Some color intensity before filtration (control) is stronger and weaker than after
filtration or after treatment, because after filtration many substances are filtered, so that the solution
concentration will decrease and will affect the color intensity. According to Sherwood (2001), states that
small materials that can be dissolved in plasma, such as glucose, amino acids, sodium, potassium, chloride,
bicarbonate, other salts and urea pass through the filter and become part of the sediment. Glucose, amino
acids, and starch are included in substances that will be filtrated and will cause differences in color
intensity, except for protein results that are different from those of Despopoulus (1998), which states that
compounds or large molecules, such as proteins cannot be filtered by kidney. The color intensity for
glucose before and after filtration remains the same, there is no change in color. The intensity is strong
(brick red). This shows that the glucose solution can pass through the kidney filter. The results are in
accordance with the statement of Guyton (1996), which states that generally molecules with a 4 nm or
more raidus cannot be filtered, otherwise a 2 nm or less molecule will be filtered indefinitely, small
materials that can be dissolved in plasma, such as glucose, acid amino, sodium, potassium, chloride,
bicarbonate, other salts, and urea will pass through the filter and become part of the sediment.
The mammalian kidney that is meta-nephros, comprises complex epithelial tubules,
nephrons that filter the blood to remove waste and reabsorb water and nutrients to maintain
homeostasis. The human kidney contains up to 2 million nephrons per organ (Takasato & Little,
2015). The paired kidneys are the central organs of homeostasis for our body systems. Around 180
L of blood is filtered per day by the kidneys, accounting for around 20% of cardiac output. Filtering
removes metabolic waste products, and kidney action adjusts water, salt, and pH to maintain the
homeostatic balance of tissue fluids. The kidneys also regulate blood pressure through the renin–
angiotensin–aldosterone system, erythrocyte production through production of erythropoietin, and
circulating calcium and phosphate levels, in part through the activation of vitamin D (Hoenig &
Zeidel, 2014). The kidney is a vital organ of the mammalian body and becomes a foremost subject
of medical research because many renal diseases in humans are incurable when the kidney is
severely damaged (Maurya et al., 2018).
Urine formation occurs through following three processes there are filtration, reabsorption,
and secretion. During filtration, blood enters the afferent arteriole and flows into the glomerulus
where filterable blood components, such as water and nitrogenous waste, moves towards the inside
of the glomerulus, and non-filterable components, such as cells and serum albumins, exit via the
efferent arteriole. These filterable components accumulate in the glomerulus to form the
glomerular filtrate. On average, about 20% of the total blood pumped by the heart per minute
enters into the kidneys to undergo filtration. The remaining 80% of the blood flows throughout the
body to facilitate tissue perfusion and proper exchange of gas. During reabsorption, molecules and
ions present in the blood will be reabsorbed into the circulatory system. The fluid passes through
the components of the nephron (i.e. proximal/distal convoluted tubules, the loop of Henle and
collecting duct) as water and ions are removed due to the change in fluid osmolarity (ion
concentration). In the collecting tube, secretion will occur before the fluid leaves the ureter in the
form of urine. During secretion, some substances such as hydrogen ions, creatinine, and drugs will
be removed from the blood through the peritubular capillary network into the collecting duct. The
end product of all these processes is urine, which is mostly a collection of substances that have not
been reabsorbed during glomerular filtration or tubular reabsorption process (Maurya et al., 2018).
The content of compounds in urine can be tested using various reagents, one of which is
Biuret as a test material for protein in urine, this is based on reagent Biuret solution is a blue
solution which will be changed to appear violet when exposed contact with proteins, or other
substances that have peptide bonds. In tests carried out the reagents did not actually contain Biuret,
they were so named because both the Biuret solution and the protein had the same response to the
filtration testing process carried out (Davey, 2005). The principle of Benedict's work on glucose
in urine will reduce kuprisulfate (in benedict) to kuprosulfate which is seen by the color change
from Benedict's solution. When the benedict reagent is mixed and heated with glucose, where
glucose has electrons to give, copper (one of the ingredients in the benedict reagent) will receive
the electron and undergo reduction so that color changes occur. So, if urine contains glucose, a
color change reaction will occur as described above. However, if there is no glucose, then the
reaction will not occur and the color of benedict will not change (Carlton & Mc Gavin, 1995).
The function of the biuret reagent is to form a complex so that what is contained can be
identified. This biuret reaction is specific, meaning that only compounds containing pepetida
bonds will react with biuret reagents. Benedict is a reagent to test the content of foods containing
glucose. Just like testing using biuret, the food ingredients tested must be in the form of a solution,
then added benedict reagents (usually half of the amount of solution). After that it is heated for a
few minutes. Food containing glucose, there will be green to brick red deposits, green if the glucose
content is small and brick red if there is a lot of glucose content. In addition to using benedict,
glucose testing can also use the FehlingA + FehlingB reagent. Lugol reagents indicate that a
substrate contains starch and will produce a blue black color (Machin, 2012).
In the process of filtration until urinary excretion in the kidneys can be influenced by
factors that can affect the amount or state of urine, namely, the amount of water taken, the state of
the nervous system, ADH hormone, the amount of salt that must be removed from the blood so
that the pressure becomes osmotic, in diabetics Glucose mellitus followed by increased urine
volume. ADH functions as a hormone that facilitates the absorption of water from the distal tubule
to collecting ducts. These ADH hormones influence each other with the concentration of water in
the body. If the water concentration decreases, ADH will flow with the blood which results in
increased vascular permeability and absorbed water. Less urine is formed. Conversely if the
concentration of high water in the blood, ADH secretion will decrease and cause absorption of
water in the distal vessels decreases. Urine becomes more numerous and aqueous. This urine
formation process while balancing fluid levels in the body that are not needed. If the consumption
of water in large quantities, then the urine produced will also be a lot and the voiding process
becomes more frequent. Increased concentration of water in the blood reduces colloid pressure and
pressure during fitration. This resulted in reduced absorbed water and increased urine production.
The amount of water in the blood, makes the colloid pressure smaller so that the absorption process
does not run optimally and the water loss is immediately carried out. Lack of insulin levels in the
body will increase glucose levels for example in patients with diabetes mellitus. This high sugar
level will interfere with the process of reabsorption in the distal tubule. High glucose makes blood
flow or blood viscosity more thick so it is more difficult to absorb. This can also trigger damage
to the kidneys if it occurs continuously. Kidney burden gets heavier with more viscous blood
viscosity (Thenawijaya & Maria, 1995).
Kidney disease is also defined as a disorder that affects the kidneys which results from
various factors, such as infections, tumors, congenital abnormalities, metabolic or degenerative
diseases, and others. Chronic kidney failure is a progressive disorder of kidney function and
irreversibIe. When the kidney is unable to carry out its function it will cause kidney failure. This
process ultimately results in decreased urine production and kidney failure, with buildup of waste
products in the blood and body tissues. One common reason for kidney failure in the United States
is diabetes. Sometimes chronic kidney disease is accompanied by high blood pressure, which not
only can be caused by kidney damage but also further accelerates kidney injury and is a major
reason for the negative effects of chronic kidney disease on other organs, including increased risk
of heart disease and stroke, collection of excess body fluids, anemia, weakening of bones, and
impairment of the way the body eliminates medications (Razmaria, 2016).
Diabetes is the main cause of kidney disease. Around 1 of 4 adults with diabetes have
kidney disease. Kidney damage due to chronic diabetes mellitus is often found. Kidney
hypertrophy due to increased work must be done by the kidneys of chronic diabetics to reabsorb
glucose. High blood glucose levels make the kidneys filter too much blood. High blood glucose
can damage blood vessels in kidneys. When blood vessels are damaged, they don't work properly.
Many people with diabetes also experience high blood pressure, which can damage the kidneys.
Diabetes mellitus (DM) or abbreviated as Diabetes is a health disorder in the form of a collection
of symptoms caused by an increase in blood sugar (glucose) levels due to lack or insulin resistance.
DM is a disease where a person secretes a large amount of urine that feels sweet. There are at least
three forms of diabetes mellitus, namely type I, type II, and gestational diabetes (Aditya et al.,
2018). Albuminuria is a disease that is shown by the presence of albumin and other proteins in the
urine so the kidneys cannot carry out the screening process, especially protein screening. Because
protein (albumin) is not filtered, the protein can come out with urine. Albuminuria is the cause
because of damage to the filtration device. Increased levels of lactate can also be found in patients
with Chronic Kidney Disease (CKD) and one way to overcome this is with HD (Hemodyalysis)
(Shima et al., 2011).
Kidney stones or nephrolithiasis can form due to the deposition of calcium salts in the
kidney cavity, renal tract or bladder. Kidney stones are crystals that are insoluble and contain
calcium oxalate, uric acid, and calcium phosphate crystals. The reason is because you consume
too much mineral salt and consume too little water. These kidney stones can further cause
hydronephrosis. Hydronephrosis is the enlargement of one kidney because urine cannot flow out.
This is due to narrowing of the flow of the kidneys or blocked by kidney stones. Glucosuria is a
disease characterized by glucose in the urine. The disease is often also called diabetes or diabetes
(diabetes mellitus). Glucose levels in the blood increase due to a lack of insulin. Nephrons are not
able to reabsorb excess glucose, so excess glucose is removed with urine. Nephritis is damage to
the glomerular part of the kidneys due to allergic germ poisons. Nephritis is usually caused by the
presence of Streptococcus bacteria. Hematuria is a disease characterized by the presence of red
blood cells in the urine. The disease is caused by inflammation of the urinary organs or due to
irritation due to friction in kidney stones. (Wilson, 1979).
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