Chapter 10

Urinary System and

Excretion
 Chapter 10
Sistem Urinari dan
Ekskresi
 Points to Ponder
• What are the parts and functions of the urinary
system?
• What is the macroscopic and microscopic
structure of the kidney?
• What are the 3 processes in urine formation?
• How is the kidney involved with regulating water-
salt and acid-base balance of blood?
• What are the common disorders of the kidney?
• How can kidney failure be treated?
• How is the kidney involved with maintaining
homeostasis along with other body systems?
 Poin Pembahasan
• Apasajakah bagian dan fungsi dari sistem urin ?
• Bagaimanakah struktur ginjal secara
Makroskopis dan Mikroskopis
• Apa sajakah 3 proses pembentukan urin ?
• Bagaimanakah peran ginjal terhadap
pengaturan air-garam dan asam-basa terhadap
keseimbangan pada darah?
• Apa sajakah kelainan yang terjadi pada ginjal?
• Bagaimana gagal ginjal bisa diatasi?
• Bagaimanakah peran ginjal dalam
mempertahankan homeostasis dengan sistem
tubuh yang lainnya
10.1 Urinary system

What are the organs of the urinary system

• Kidneys (2) – bean-shaped, fist-sized organ where urine
is formed

• Ureters (2) – small, muscular tubes that carry urine from

the kidneys to the bladder

• Bladder (1) – expandable organ that stores urine until it

is expelled from the body

• Urethra (1) – tube (longer in men than women) that

carries urine from the bladder to the outside of the body
10.1 Sistem Urinari

Apakah organ dari sistem Urin

• Ginjal (2) – berbentuk seperti kacang, organ berbentuk
sekepal tangan yg berfungsi membentuk urin

• Ureter (2) – Kecil, Saluran muskular yg membawa urin

dari ginjal ke kandung kemih

• Kandung Kemih (1) – Organ yg menyimpan urin sampai

dikeluarkan dari tubuh

• Uretra (1) – Saluran (pada pria lebih panjang dibanding

wanita) yg membawa urin dari kandung kemih keluar ke
tubuh
10.1 Urinary system

Overview of the urinary system

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Adrenal glands
produce aldosterone.

renal artery 1. Kidneys produce

urine.
renal vein

aorta

inferior vena cava 2. Ureters transport

urine.

3. Urinary bladder
stores urine.

4. Urethra passes
urine to outside.
10.1 Sistem Urinari

Ikhtisar Sistem Urinari

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Adrenal glands
produce aldosterone.

renal artery 1. Kidneys produce

urine.
renal vein

aorta

inferior vena cava 2. Ureters transport

urine.

3. Urinary bladder
stores urine.

4. Urethra passes
urine to outside.
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10.1 Urinary system

What are the functions of the

urinary system?

1. Excretion of metabolic wastes

2. Maintenance of water-salt balance
3. Maintenance of acid-base balance
4. Hormone secretion: renin and
erythropoietin (EPO)
5. Reabsorb filtered nutrients and convert
vitamin D.
10.1 Sistem Urinari

Apakah fungsi dari Sistem Urin?

1. Ekskresi hasil pembuangan metabolisme

2. Mempertahankan keseimbangan air-garam
3. Mempertahankan keseimbangan asam-basa
4. Sekresi hormon : Renin dan erithropoietin
(EPO)
5. Reabsorbsi Nutrien terfiltrasi dan mengubah
vitamin D.
10.1 Urinary system

1. Excretion
• Mostly of nitrogenous wastes:
– Urea made by the breakdown of amino acids
in the liver

– Uric acid made by the breakdown of

nucleotides

– Creatinine made by muscle cells from the

breakdown of creatine phosphate
10.1 Sistem Urinari

1. Ekskresi
• Kebanyakan membuang senyawa nitrogen :
– Urea terbentuk dari uraian asam amino dalam
hati

– Asam Urat terbentuk dari uraian nukleotida

– Kreatinin terbentuk dari sel otot hasil uraian

kreatin fosfat
10.1 Urinary system

2 & 3. Maintenance of water-salt and

acid-base balance
• Both are homeostatic mechanisms

• Water-salt balance helps to maintain blood

pressure

• The kidneys by excreting hydrogen ions and

reabsorbing the bicarbonate ions, this acid-
base balance helps maintain a blood pH of
7.4
10.1 Sistem Urinari

2 & 3. Mempertahankan
keseimbangan air-garam dan asam-
basa
• Keduanya merupakan mekanisme
homeostatis

• Keseimbangan air-garam membantu

mempertahankan tekanan pada darah

• Ginjal mengekskresi ion hidrogen dan

reabsorpsi ion bikarbonat, keseimbangan
asam-basa membantu mempertahankan pH
darah 7,4
10.1 Urinary system

4. Hormone secretion
• Renin – secreted by the kidneys to allow
the adrenal glands to secrete aldosterone
to help regulate water-salt balance

• Erythropoietin – secreted by the kidneys to

stimulate red blood cell production when
blood oxygen is low
10.1 Sistem Urinari

4. Sekresi hormom
• Renin – Disekresi pada ginjal yg membuat
kelenjar adrenal untuk menseksresi
aldosteron untuk membantu pengaturan
keseimbangan air-garam

• Erithropoietin – Diseksresi pada ginjal yg

menstimulasi produksi sel darah merah
ketika kadar oksigen pada darah rendah
10.1 Urinary system

5. Reabsorb filtered nutrients and

convert vitamin D.
• The urinary system is responsible for
reabsorbing filtered nutrients.

• Vitamin D is a molecule that promotes

calcium absorption from the digestive
tract.
10.1 Sistem Urinari

5. Reabsorbsi nutrien dan mengubah

vitamin D
• Sistem urinari bertanggung jawab
terhadap reabsorpsi nutrien.

• Vitamin D adalah molekul yang memacu

absorpsi kalsium dari saluran pencernaan
10.2 Kidney structure

What are the 3 regions of the kidney?

• Renal cortex – an outer granulated layer

• Renal medulla – cone-shaped tissue

masses called renal pyramids

• Renal pelvis – central cavity that is

continuous with the ureter
10.2 Struktur Ginjal

Apakah 3 bagian pada ginjal?

• Korteks Ginjal– Lapisan granular terluar

• Medula Ginjal – Massa jaringan yg

berbentuk corong yg disebut piramid ginjal

• Pelvis Ginjal– Rongga pusat yg

berhubugan dengan ureter
10.2 Kidney structure
Anatomy of the kidney
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nephrons

renal artery renal cortex

renal vein renal

cortex
collecting duct

renal
medulla

ureter renal pelvis

d. Nephrons
a. Blood vessels

renal cortex

renal pyramid
in renal medulla
renal pelvis

ureter
renal pyramid
in renal medulla

b. Gross anatomy, photograph c. Gross anatomy, art

b: © Ralph T. Hutchings/Visuals Unlimited
10.2 Kidney structure

What are nephrons?

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podocyte

• Microscopic functional
unit of the kidney that glomerulus
and podocytes
proximal
convoluted
tubule

produces urine 1 m
glomerular capsule
distal
convoluted
tubule

efferent arteriole

afferent
arteriole
renal artery
Renal Cortex
renal vein venule

• > 1 million per kidney

Renal Medulla

descending peritubular
loop of
limb capillary
the nephron ascending network
limb

collecting
duct

(top left): © Prof. P.M. Motta & M. Castellucci/Science Photo

Library/Photo Researchers,Inc.
10.2 Struktur Ginjal

Apakah Nefron?
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podocyte

• Unit fungsional
Mikroskopis pada glomerulus
and podocytes
proximal
convoluted
tubule

ginjal yg 1 m
glomerular capsule
distal
convoluted
tubule

efferent arteriole

memproduksi urin afferent

arteriole
renal artery
Renal Cortex
renal vein venule

Renal Medulla

• > 1 juta terdapat loop of

the nephron
descending
limb
ascending
limb
peritubular
capillary
network

setiap ginjal
collecting
duct

(top left): © Prof. P.M. Motta & M. Castellucci/Science Photo

Library/Photo Researchers,Inc.
10.2 Kidney structure

Anatomy of a nephron
• Glomerulus – a knot of capillaries inside the glomerular capsule
where pores produce a blood filtrate

• Proximal convoluted tubule – epithelial layer with a brush border of

microvilli to allow reabsorption of filtrate components

• Loop of nephron – U-shaped structure that has a descending limb to

allow water to leave and an ascending limb that pushes out salt

• Distal convoluted tubule – made of epithelial cells rich in

mitochondria and thus is important for movement of molecules from
the blood to the tubule (tubular secretion)

• Collecting ducts – several nephrons share a collecting duct which

serve to carry urine to the renal pelvis
10.2 Struktur ginjal

Anatomi Nefron
• Glomerulus – simpul kapiler yg didalamnya terdapat kapsul the
glomerular dimana pori-porinya menghasilkan filtrat darah

• Tubulus proksimal– lapisan epitel yg dibatasi oleh mikrovili yg

menyebabkan reabsorpsi beberapa komponen filtrat

• Lekukan nefron – strukturnya berbentuk U bagian turun

menyebabkan air diserap dan bagian atas menyebabkan garam
dikeluarkan

• Tubulus distal – tersusun atas sel epitel yg kaya akan mitokondria

dan penting dalam pergerakan molekul dari darah ke tubulus
(sekresi tubulus)

• Saluran pengumpul– beberapa nefron bertanggung jawab sebagai

saluran pengumpul yg membawa urin ke pelvis ginjal
10.3 Urine formation

How does the nephron form urine?

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glomerular capsule

Glomerular Filtration
H2O
urea Water, salts, nutrient molecules, and
waste molecules move from the
glucose glomerulus to the inside of the glomerular
capsule. These small molecules are
called the glomerular filtrate.
amino Tubular Reabsorption
acids Nutrient and salt molecules are actively
reabsorbed from the convoluted tubules
uric into the peritubular capillary network, and
acid water flows passively.
proximal
salts convoluted
tubule

glomerulus

efferent
arteriole

Tubular Secretion
Certain molecules (e.g., H+ and
penicillin) are actively secreted from the
peritubular capillary network into the
convoluted tubules.

afferent
arteriole
end of another
distal tubule

renal distal
artery convoluted
tubule
renal
vein
venule

collecting
duct

peritubular
capillary
network
H2O
urea
uric acid
loop of the salts
nephron NH4+
creatinine
10.3 Pembentukan Urin

Bagaimanakah Nefron membentuk Urin?

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glomerular capsule

Glomerular Filtration
H2O
urea Water, salts, nutrient molecules, and
waste molecules move from the
glucose glomerulus to the inside of the glomerular
capsule. These small molecules are
called the glomerular filtrate.
amino Tubular Reabsorption
acids Nutrient and salt molecules are actively
reabsorbed from the convoluted tubules
uric into the peritubular capillary network, and
acid water flows passively.
proximal
salts convoluted
tubule

glomerulus

efferent
arteriole

Tubular Secretion
Certain molecules (e.g., H+ and
penicillin) are actively secreted from the
peritubular capillary network into the
convoluted tubules.

afferent
arteriole
end of another
distal tubule

renal distal
artery convoluted
tubule
renal
vein
venule

collecting
duct

peritubular
capillary
network
H2O
urea
uric acid
loop of the salts
nephron NH4+
creatinine
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10.3 Urine formation

What are the 3 processes in the

formation of urine?
• Glomerular filtration
• Tubular reabsorption
• Tubular secretion
10.3 Pembentukan Urin

Apakah 3 proses pembentukan Urin?

• Filtrasi Glomelurus
• Reabsorpsi Tubulus
• Sekresi Tubulus
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10.3 Urine formation

Glomerular filtration
• Water and small
molecules move from
the glomerulus to the
glomerular capsule
while large molecules
and formed elements
remain in the
glomerular blood
10.3 Pembentukan Urin

Filtrasi Glomelurus
• Air dan molekul kecil
bergerak dari
glomelurus ke kapsul
glomelurus sedangkan
untuk molekul besar
dan elemen sisanya
bergerak ke glomelural
darah
10.3 Urine formation

Tubular reabsorption and secretion

• Many molecules and
ions are reabsorbed
from the nephron into
the blood

• A second way to
remove substances
such as drugs, H+ and
creatinine from the
blood
10.3 Pembentukan Urin

Reabsorpsi dan sekresi tubulus

• Banyak Molekul dan
ion direabsorpsi dari
nefron ke dalam
darah

• Terjadi pemindahan
substansi seperti
obat, H+ dan kreatinin
dari darah
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10.4 Regulatory functions of the kidneys

How is blood volume and pressure

maintained by the kidneys?
• Reabsorption of salt – increases the blood volume
– Aldosterone: promotes the excretion of K+ and the reabsorption
of Na+
– Atrial natriuretic hormone (ANH) – secreted by the heart when
blood volume increases and inhibits the secretion of aldosterone
which promotes the excretion of Na+

• Establishment of solute gradient – a greater

concentration is towards the inner medulla

• Reabsorption of water – due to the solute gradient water

leaves the descending limb of the loop of the nephron
then antidiuretic hormone (ADH) from the pituitary plays
a role in water reabsorption at the collecting duct
10.4 fungsi regulasi pada ginjal

Bagaimanakah ginjal mempertahankan

volume dan tekanan darah?
• Reabsorpsi garam- meningkatkan volume darah
• _ Aldosterone: memacu ekskresi K+ dan reabsorpsi Na+
– Atrial natriuretic hormone (ANH) – disekresi oleh jantung ketika
volume darah meningkat dan mencegah sekresi aldosteron dan
meningkatkan ekskresi Na+

• Penetapan gradient konsentrasi – konsentarsi tinggi ke

arah bagian dalam pada medulla

• Reabsorpsi air– timbulnya gradient solut air yang diserap

pada bagian turun dari lekukan nefron karena hormon
antidiuretik (ADH) dari pituitari dan berperan juga dalam
reabsorpsi air pada saluran pengumpul
10.4 Regulatory functions of the kidneys

Water reabsorption in nephrons

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Increasing solute concentration in renal medulla

Renal
cortex
Outer NaCl
medulla H2O

NaCl
H2O

H2O NaCl H O
2

H2O
H2O
descending ascending
limb limb
urea

Inner collecting
medulla loop of the nephron duct
10.4 Regulatory functions of the kidneys

What role does alcohol play in this process?

• Alcohol inhibits ADH secretion and thus

increases the amount of urine and
dehydration
10.4 fungsi regulasi pada ginjal

Apakah peran alkohol pada proses ini?

• Alkohol mencegah sekresi ADH dan

meningkatkan jumlah urin dan dehidrasi
10.4 Regulatory functions of the kidneys

How is the acid-base balance maintained?

• Buffers are a chemical or a combination of chemicals
that can take up excess H+ or excess OH-
When H+ are added to blood:
H+ + HCO3- H2CO3

When OH- are added to blood:

OH- + H2CO3 HCO3- + H2O
• The respiratory center in the brain can increase
breathing rate if the buffers cannot maintain the pH
• Ultimately, the kidneys are responsible for maintaining
blood pH
Insert Figure 10.9
10.4 fungsi regulasi pada ginjal

Bagaimanakah mempertahankan keseimbangan

asam-basa?
• Buffer (penyangga) adalah kimia atau kombinasi kimia
yg dapat mengatur kelebihan H+ atau kelebihan OH-
ketika H+ kelebihan pada darah:
H+ + HCO3- H2CO3

Ketika OH- are kelebihan pada darah:

OH- + H2CO3 HCO3- + H2O

• Pusat respirasi pada otak bisa meningkatkan laju

pernapasan jika buffer tidak bisa mempertahankan pH

• Akhirnya , ginjal berespon untuk mempertahankan pH

darah

Insert Figure 10.9

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10.5 Disorders with kidney function

Kidney function disorders

• Diabetes, hypertension and inherited conditions are the
most common cause of renal disease and failure such
as:
– Urethritis – localized infection of the urethra

– Cystitis – infection in the bladder

– Pyelonephritis – infection of the kidneys

– Kidney stones – hard granules formed in the renal pelvis due to

UTI’s, enlarged prostate, pH imbalances or intake of too much
calcium

– Uremia – high levels of urea and other waste substances in the

blood that causes a serious condition when water and salts are
retained due to extensive nephron damage
10.5 kelainan pada fungsi ginjal

Kelainan fungsi pada ginjal

• Diabetes, hipertensi dan kondisi genetik adalah kelainan
dan gangguan pada ginjal pada umumnya seperti
- Urethritis – lokasi infeksi pada uretra

– Cistitis – infeksi pada kandung kemih

– Pielonephritis – infeksi pada ginjal

– Batu ginjal – butiran yg keras terbentuk pada pelvis ginjal,

prostate membengkak, pH tidak seimbang atau asupan terlalu
banyak kalsium

– Uremia – kandungan urea tinggi dan subtansi pembuangan

lainnya juga tinggi pada darah yg menyebabkan kondisi yg
serius ketika air dan garam yg tertahan menyebabkan kerusakan
pada nefron
10.5 Disorders with kidney function

How can kidney failure be treated?

• Hemodialysis – uses an artificial kidney machine
to subtract and add substances to the blood as
needed

• Continuous ambulatory peritoneal dialysis

(CAPD) – used the peritoneal membrane to filter
the blood and allows a person to go about their
normal life without interruption

• Kidney replacement – single kidney transplant

with a high success rate
10.5 kelainan pada fungsi ginjal

Bagaimanakah pengobatan/terapi bila

terjadi kegagalan pada ginjal ?
• Hemodialisis – menggunakan mesin pengganti
ginjal tiruan untuk mengurangi dan
menambahkan unsur yg dibutuhkan oleh darah

• Continuous ambulatory peritoneal dialysis

(CAPD) – menggunakan membran peritoneal
untuk menfiltrasi darah dan bisa membuat
seseorang kembali kekeadaan normal tanpa
gangguan

• Kidney replacement – transplantasi salah satu

ginjal yg merupakan cara yg sukses
10.6 Homeostasis

How do the kidneys maintain

homeostasis?
• Excrete wastes
– Urea, creatinine and uric acid

• Water-salt balance of blood

– Helps regulate blood volume and pressure

• Acid-base balance of blood

– Helps regulate pH

• Assistance to other systems

– Endocrine, cardiovascular, skeletal, muscular
nervous and digestive
10.6 Homeostasis

Bagaimanakah ginjal mempertahankan

homeostasis?
• Hasil pembuangan
– Urea, Kreatinin dan Asam urat

• Keseimbangan air-garam pada darah

– Membantu mengatur volume dan tekanan pada darah

• Keseimbangan Asam-Basa pada darah

– Membantu mengatur pH

• Membantu sistem lain

– Endokrin, kardiovaskular, skeletal, muskular
Saraf dan digestive (pencernaan)
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10.6 Homeostasis
How the urinary system interacts with
other systemsCopyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

All systems of the body work with the Nervous System

urinary system to maintain homeostasis.
These systems are especially noteworthy. The kidneys regulate the amount of ions
(e.g., K+ , Na+, Ca2+) in the blood. These ions
are necessary for nerve impulse conduction.
Urinary System The nervous system controls urination.

As an aid to all the systems, the kidneys

excrete nitrogenous wastes and maintain the
water-salt balance and the acid-base balance
of the blood. The urinary system also
specifically helps the other systems.
Respiratory System

Cardiovascular System The kidneys help the lungs by exhaling

carbon dioxide as bicarbonate ions, while the
Production of renin by the kidneys helps lungs help the kidneys maintain the acid-base
maintain blood pressure. Blood vessels balance of the blood by exhaling carbon
transport nitrogenous wastes to the kidneys dioxide.
and carbon dioxide to the lungs. The
buffering system of the blood helps the
kidneys maintain the acid-base balance.

Digestive System Endocrine System

The liver produces urea excreted by the The kidneys produce renin, leading to the
kidneys. The yellow pigment found in urine, production of aldosterone, a hormone that
called urochrome (breakdown product of helps the kidneys maintain the water-salt
hemoglobin), is produced by the liver. The balance. The kidneys produce the hormone
digestive system absorbs nutrients, ions, and erythropoietin, and they change vitamin D to
water. These help the kidneys maintain the a hormone. The posterior pituitary secretes
proper level of ions and water in the blood. ADH, which regulates water retention by the
kidneys.

Muscular System Integumentary System

The kidneys regulate the amount of ions in the Sweat glands excrete perspiration, a solution
blood. These ions are necessary to the of water, salt, and some urea.
contraction of muscles, including those that
propel fluids in the ureters and urethra.