FISIOLOGI

Simon Polin Silaen

1710211089
Overview of Renal Physiology
• Glomerular Filtration
• Tubular Reabsorption
• Tubular Secretion
1. Glomerular Filtration
• Fluid enter capsular space = Glomerular Filtrate
• Avrge daily volume filtrate in adults =
- Female = 150 litres
- Male = 180 litres

- 2 liters excreted as urine

The Filtration Membrane
• permits filtration of water and small solutes but prevents filtration of
most plasma proteins, blood cells, and platelets

Divided into 3 :
1. Glomerular endothelial cells : large pores , 0.07-0,1 mikrometer in
diameter . ( blood cells and platelets X )
Located among glomerular capilarries and cleft between afferent and
efferent arteriole = Mesangial cells ( Contractile cells which help
glomerular filtration )
2. Basal Lamina
• Consist of collagen fibers and proteoglycan
• Prevent filtration of larger proteins
3. The slit membrane
• permits the passage of molecules having a diameter smaller than
0.006–0.007 mikrometres : water, glucose, vitamins, amino acids,
very small plasma proteins, ammonia, urea, and ions, albumin (1 %)
Net filtration pressure
1 Glomerular blood hydrostatic pressure (GBHP) is the blood pressure in
glomerular capillaries.
- about 55 mmHg.
- It promotes filtration by forcing water and solutes in blood plasma through the
filtration membrane.
2 Capsular hydrostatic pressure (CHP) is the hydrostatic
• pressure exerted against the filtration membrane by fluid already in the capsular
space and renal tubule.
• CHP opposes filtration and represents a “back pressure” of about 15 mmHg.
3 Blood colloid osmotic pressure (BCOP), which is due to the presence of proteins
such as albumin, globulins, and fibrinogen
- Average = 30 mmHg
• NFP = GBHP – CHP - BCOP
• NFP = 55 – 15 – 30
= 10 mmHg ( glomerulus to capsular space)

GLOMERULAR FILTRATION RATE

• The amount of filtrate formed in all renal corpuscles of both
kidneys each minute
Avrge : Male 125ml/min Female 105ml/min
GFR need to be maintained constantly
3 mechanisms that control GFR
• Renal autoregulation of GFR
Consist of Myogenic mechanism and tubuloglomerular feedback
1. Myogenic mechanism
- Occurs when stretching triggers contraction of smooth muscle cells in
the walls of afferent arterioles
2. Tubuloglomerular feedback
- Macula densa detect increased delivery of Na, Cl , Water, = inhibite
release of NO = Vasocontriction = GFR return to normal
Neural regulation of GFR
• Supplied by Sympathetic ANS system
• Release norephineprine
• Vasocontriction through A1 receptor = plenty in smooth muscle in
afferent arteriole
Hormonal regulation of GFR
• Angiotensin II = Potent vasoconstrictor = reduce GFR
• Atrial natriuretic peptide = secreted by atria cells in heart = relaxation
of mesangial cells = capillary surface wider = filtration ++ = GFR ++
Tubular reabsorption and tubular secretion
• Mostly 99% of glomerular filtrate will be reabsorbed
• Paracellular absorption and transcellular absorption
Reabsorption and secretion in PCT
• Largest reabsorption ( about 80ml/min )
• 65% reabsorb of filtered water, Na, K
• 100% reabsorb of glucose and amino acids
• 50% of Filtered Cl
• 80-90% of Filtered HCO3
• 50% of urea
• Variable % of Ca,Mg, HPo4 2 ( Phpspate )
Reabsorption In Nephron Loop
• At a rate 40-45 ml/min
• Glucose, amino acids no longer available
• The nephron loop reabsorbs about 15% of the filtered water,20–30%
of the filtered Na and K, 35% of the filtered Cl, 10–20% of the filtered
HCO3 , and a variable amount of thefiltered Ca2 and Mg2.
• Reabsorption of water did not happen automatically in presence of
other solutes because part of nephron loop are impermeable to
water
Reabsorption in the Early distal convoluted
tubule
• Fluid enters the distal convoluted tubules at a rate of about 25
mL/min because 80% of the filtered water has now been reabsorbed.
• The early or initial part of the distal convoluted tubule (DCT)
reabsorbs about 10–15% of the filtered water, 5% of the filtered Na,
and 5% of the filtered Cl
• Reabsorption of Na and Cl occurs by means of Na–Cl symporters in
the apical membranes.
• Sodium–potassium pumps and Cl leakage channels in the basolateral
membranes then permit reabsorption of Na and Cl into the
peritubular capillaries
• Major site for Parathyroid hormone for reabsorbtion of Ca2+
Reabsorption and Secretion in the Late Distal
Convoluted Tubule and Collecting Duct
• 90–95% of the filtered solutes and water have returned to the
bloodstream

• Consist of Principal cell : reabsorb Na , secrete K

Intercalated cell : reabsorb K and HCO3 , secrete H