Renal pelvis & calyces

 The renal pelvis is the dilated

part from where the ureter
originates
 The renal pelvis divides into
major calyces which further
subdivides to for minor calyces
 Nephron & Parts of nephron
• Basic structural and functional unit of kidney
• Parts of nephron
1. glomerulus
2. bowman’s capsule
3. PCT
4. loop of Henle
5. DCT
6. Collecting tubule
There are a total of 2 million nephrons
2 types cortical & juxtameduallary (20-30%)
 Urine formation
• Urinary excretion= filtration+secretion-
reabsorption
• Filtration occurs at the glomerular
membrane
• Part of this filtrate is reabsorbed in
nephron
• Secretion of substances is added in the
different parts of nephron to form urine
• Rate of excretion of urine depends on
these three processes
 Glomerular membrane
• The membrane at which filtration occurs
• It is made up of 3 layers
1. capillary endothelium
2. basement membrane
3. layer of epithelial cells (podocytes)
surrounding the capillaries
 Thus slit pores are formed between the
capillary fenestrations and podocytes
Selectivity of glomerular membrane
• Based on the molecular size and electrical
charges the membrane is highly porous and
filtration occurs at high rate. Filtration rate is
inversely proportional to the MW. Water with
highest filterability and albumin with lowest
• The pore size is 8 nanometer
• Albumin is also not filtered because of its
negative charge repulsed by the negatively
charged glomerular capillary proteoglycans
 Functions of kidney
• Excretion of waste products specially urea and
creatinine
• Regulation of water & electrolyte balance
• Regulation of osmolarity of body fluids
• Regulation of ABP
• Regulation of acid base balance
• Secretion of erythropoetin & PG
• Activation of vitamin D
• Gluconeogenesis
 GFR
• Glomerular filtration rate is the rate of
filtration of plasma in all the glomeruli of
both kidneys
• The filtrate is devoid of proteins and RBC
• The concentration of filtrate is similar to
plasma
• The normal value is 125ml/min or
180L/day
 Renal blood flow
• RBF is 22% of the cardiac output or 1100
ml/min
• Renal plasma flow is 55% of the RBF
approximately 600ml/min
• GFR is 20% of the renal plasma flow
• Filtration fraction is the fraction of plasma
which is filtered and is 20% of RPF=120ml
• Filtration fraction =GFR/RPF
 Determinants of GFR
• There are three forces on which the net
filtration pressure depends
1. capillary hydrostatic pressure
2. capillary colloid osmotic pressure
3. bowmans capsular pressure
GFR=Kf x net filtration pressure
Where Kf is filtration coefficient
 Net filtration pressure
• Is the sum of capillary hydrostatic pressure
minus the colloid osmotic pressure plus
the bowmans capsular pressure
• 60-(32+18)=10mmHg
• Capillary hydrostatic pressure is the
outward force (60 mmHg)
• Colloid osmotic and bowmans pressure
are inward forces (32mmHg+18mmHg)
 Filtration coefficient
• Is the measure of the product of hydraulic
conductivity and surface area of
glomerular capillaries
• Kf =GFR/net filtration pressure
• Kf =12.5ml/min/mmHg of filtration pressure
 Factors Affecting the GFR
• Changes in renal blood flow
• Changes in glomerular capillary
hydrostatic pressure
• Changes in systemic blood pressure
• Afferent or efferent arteriolar constriction
• Changes in hydrostatic pressure in
Bowman's capsule Ureteral obstruction
 Factors Affecting the GFR
• Edema of kidney inside tight renal capsule
• Changes in concentration of plasma
proteins: dehydration, hypoproteinemia,
etc (minor factors)
• Changes in Kf
• Changes in glomerular capillary
permeability
• Changes in effective filtration surface area
 Factors which can decrease GFR
• Kf in DM, HTN, renal diseases
• PB in urinary tract obstruction
• GCOsmP due to RBF or in plasma
proteins
• PG
1. ABP
2. angiotensin II
3. sympathetic stimulation leading to
vasoconstiction  RBF in afferent arteriole
 Agents Causing Contraction or
Relaxation of Mesangial Cells.
• Contraction Relaxation
• Endothelins ANP
• Angiotensin II Dopamine
• Vasopressin PGE2
• Norepinephrine cAMP
• Thromboxane A2
• Histamine
 Contraction of mesangial cells
• Decreases GFR by reducing the Kf due to
reduction in surface area for filtration
Factors which increase GFR
 Auto regulation of GFR
• Also called Tubuloglomerular Feedback
& Glomerulotubular Balance
 Auto regulation of GFR
• Signals from the renal tubule in
each nephron feed back to affect
filtration in its glomerulus. As the
rate of flow through the ascending
limb of the loop of Henle and first
part of the distal tubule increases
glomerular filtration in the same
nephron decreases