Renal System Course

Jacqueline Powell, Ph.D.

TOPIC: Glomerular Filtration, Tubular Transport Mechanisms I

TIME:

LEARNING OBJECTIVES
After you have studied the reading material, you should be able to:

GLOMERULAR FILTRATION
1. Understand the anatomy and function of the kidney. Given a cross section of a kidney, identify the
renal cortex, renal medulla, renal calyces, medullary pyramids, renal pelvic space, renal artery, renal
vein, and ureter.
2. Describe in sequence the tubular segments through which ultrafiltrate flows after it is formed at
Bowman’s capsule to when it enters the renal pelvis. Identify each structure as being located in the
renal cortex or renal medulla. Based on the glomerulus location and the length of the loop of Henle,
distinguish between cortical and juxtamedullary nephrons.
3. Describe in sequence the blood vessels through which blood flows when passing from the renal
artery to the renal vein, including the glomerular blood vessels, peritubular capillaries, and the vasa
recta.
4. Identify the following structures of the glomerular tuft: the afferent and efferent arterioles,
glomerular capillary network, Bowman’s capsule, and the juxtaglomerular apparatus (including the
specialized juxtaglomerular arteriole cells and the macula densa). Describe the three layers
comprising the glomerular filtration barrier, and identify podocytes, foot processes, slits, and the
basement membrane.
5. Identify the filtration barriers, if any, which impede the filtration of H 2O, Na+, inulin, albumin, and red
blood cells.
6. Define the filtration coefficient at the glomerular capillary, describe the membrane properties that
contribute to it, and explain its role in determining GFR.
7. Given the capillary and Bowman’s capsule hydrostatic and oncotic pressures, calculate the net
filtration force at the glomerular capillaries. Predict the changes in glomerular filtration caused by
increases or decreases in any of those pressures.
8. Predict the changes in net filtration force that occur as blood travels along the glomerular capillary
and colloid osmotic pressure increases.
9. Describe the relative resistances of the afferent and efferent arterioles and the effects on renal
blood flow and GFR of selective changes in each.
10. Define autoregulation and describe the myogenic and tubuloglomerular feedback mechanisms
that mediate the autoregulation of renal plasma flow and glomerular filtration rate.
11. Describe the effects of changes in peritubular capillary hydrostatic and oncotic pressures on net
proximal tubular fluid reabsorption.
12. Define renal blood flow, renal plasma flow, glomerular filtration rate, and filtration fraction and list
typical values.

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TUBULAR TRANSPORT MECHANISMS I
1. Describe the composition of a cell membrane. Diagram its cross section, and explain how the
distribution of phospholipids and proteins influences the membrane permeability of ions, hydrophilic
and hydrophobic compounds.
2. Distinguish between simple diffusion, facilitated diffusion, secondary active transport, and primary
active transport based on the source of energy driving the process, the molecular pathway, and
carrier protein involvement.
3. Describe how transport rates of certain molecules and ions are accelerated by specific membrane
transport proteins (“transporter” and “channel” molecules).
4. Describe how energy from ATP hydrolysis is used to transport ions such as Na +, K+, Ca+2, and H+
against their electrochemical differences (e.g., via the Na + pump, sarcoplasmic reticulum Ca+2 pump,
and gastric H+ pump).
5. Draw an epithelium, labeling the tight junctions, the apical membrane, and the basolateral
membrane. Compare the transcellular and paracellular routes of solute and water movement across
proximal tubular epithelium. Trace the movement of a compound that travels across an epithelium by
a transcellular pathway and a compound that travels via a paracellular pathway.
6. Explain the role of the “tight” junctions in leaky and tight epithelia. Compare the transcellular and
paracellular routes of solute and water movement across proximal tubular epithelium.

READING ASSIGNMENTS: Linda Costanzo, Physiology, 6th Ed., Chapter 6,

 pp. 245-246 (up to “Body Fluids”);
 pp. 257-259 (up to “Measurement of Renal Plasma Flow and
Renal Blood Flow”);
 pp. 261-265 (“Measuring Renal Blood Flow” to “Measurement of
Glomerular Filtration Rate”) with special attention being given to
the following:
p. 259, Fig. 6-7; p.264, Fig. 6-10; p. 265, Table 6-6.
 p. 266 Fig. 6-11
 p. 267 (“Filtration Fraction”)
Chapter 1, pp. 4-11 (“Characteristics of Cell Membranes” to
“Osmosis”)
(available online-Clinical Key)

Video link: https://www.youtube.com/watch?v=hiNEShg6JTI

PLEASE NOTE REGARDING VIDEO ABOVE: At time 4:05, there is an error in labeling of the
processes “secretion” and “reabsorption”. These processes have been
labeled in reverse. Otherwise, video is accurate.

ADDITIONAL SUPPLEMENTAL READING ASSIGNMENT:

Posted PDF Files: 1. Seifter, Ratner, & Sloane, Concepts in Medical Physiology, 2005, pp. 302-307;
311-319.
2. Golan, Armstrong, & Armstrong, Principles of Pharmacology: The
Pathophysiologic Basis of Drug Therapy, 4th Ed., 2016, p. 372 (Nephrotic
syndrome).

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Questions to Challenge Your Understanding

1. A primary glomerular disease will tend to lower GFR by decreasing the functional surface area for
filtration. What will be the autoregulatory response to this change?

2. Narrowing of the renal arteries (renal artery stenosis) is a relatively common cause of severe
hypertension and is usually due to atherosclerotic lesions in older patients. What would happen to GFR in
a stenotic kidney as blood pressure is lowered with an antihypertensive agent that:
a) Acts independently of angiotensin II?
b) Acts by inhibition of angiotensin converting enzyme to decrease formation of angiotensin II?

3. If a patient consumes a large quantity of salty food, their plasma osmolality increases above normal.
According to the tubuloglomerular feedback theory, what would be the predicted result for this person’s
GFR and RBF due to the increased concentration of NaCl in the tubular fluid near their macula densa?

4. What would you predict for the following parameters in a patient (↑, ↓, →) if there is a vasodilation of
the afferent arteriole?
a. Renal Blood Flow
b. GFR
c. Peritubular capillary hydrostatic pressure
d. Glomerular capillary hydrostatic pressure
e. Peritubular capillary oncotic pressure
f. Net filtration pressure in glomerular capillaries
Would there be net filtration or reabsorption in the peritubular capillaries?

5. What would you predict for the following parameters in a patient (↑, ↓, →) if there is a vasoconstriction
of the afferent arteriole?
a. Renal Blood Flow
b. GFR
c. Peritubular capillary hydrostatic pressure
d. Glomerular capillary hydrostatic pressure
e. Peritubular capillary oncotic pressure
f. Net filtration pressure in glomerular capillaries
Would there be net filtration or reabsorption in the peritubular capillaries?

6. What would you predict for the following parameters in a patient (↑, ↓, →) if there is vasoconstriction
of the efferent arteriole?
a. Renal Blood Flow
b. GFR
c. Peritubular capillary hydrostatic pressure
d. Glomerular capillary hydrostatic pressure
e. Peritubular capillary oncotic pressure
f. Net filtration pressure in glomerular capillaries
Would there be net filtration or reabsorption in the peritubular capillaries?

7. You have given your patient a drug which increases renal blood flow and therefore alters the Starling
forces controlling glomerular filtration and reabsorption. What would be the outcome of administration of
this drug on peritubular capillary reabsorption? Why?

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